Valencia Marcelino Hernández, Pacheco Adia Carrillo, Quijano Tomás Hernández, Girón Antonio Vargas, López Carlos Vargas
Hospital General de Ecatepec Dr. José Ma. Rodríguez, ISEM y Unidad de Investigación en Enfermedades Endocrinas, Hospital de Especialidades, CMN Siglo XXI, IMSS, México, D.F., Mexico.
Clin Pract. 2011 Nov 8;1(4):e93. doi: 10.4081/cp.2011.e93. eCollection 2011 Sep 28.
Human papilloma virus (HPV) can infect any of the mucosal areas of the body and cause cervical cancer. Until recently, no specific treatments were available for this condition; therefore, any damaged tissue had to be removed or destroyed, which may have presented obstetrical repercussions for some women. Recently, new drugs have been developed that have shown to be effective for the cure of HPV infection. Glycyrrhizinic acid (GA) has shown fewer side effects and its systemic use makes it possible to reach difficult-to-treat lesions. The purpose of this study was to evaluate the clinical outcome of GA to eliminate the epithelial lesion and HPV. We carried out a longitudinal, descriptive study that included women of reproductive age who were diagnosed with HPV associated with low-grade squamous intraepithelial lesion (LSIL). Subjects began treatment based on GA using two routes of administration - systemic (oral) and topical (spray) - with assessments every month to determine the clinical changes of the lesions through colposcopy and Papanicolaou (Pap) smear. Simple statistics were used along with two-tailed Student's t-test; P<0.05 was considered statistically significant before and after treatment. There were 70 eligible patients, of whom 62 fulfilled the inclusion criteria. Age of subjects was 27.8±9.5 years. At the time of the study, 100% of the patients had HPV infection, 40% were associated with LSIL, and only 16% used a barrier contraceptive (condom) method. Resolution was achieved in all patients from 4 weeks of treatment initiation and improvement was achieved in the majority of patients at 12 weeks (74%) (P<0.001). However, there was persistence of LSIL in 27.7% of patients and only one patient progressed to cervical intraepithelial neoplasia (CIN) II. The use of GA proved to be effective in resolving clinical HPV lesions. For cervical lesions with epithelial changes (LSIL), treatment may be required for a longer period as with other drugs used for this infection, as well as monitoring for at least 1 year according to the natural evolution of the disease.
人乳头瘤病毒(HPV)可感染身体的任何黏膜部位并引发宫颈癌。直到最近,针对这种病症还没有特效治疗方法;因此,任何受损组织都必须被切除或破坏,这可能会给一些女性带来产科方面的影响。最近,已研发出的新药已显示对治愈HPV感染有效。甘草次酸(GA)副作用较少,其全身用药使得能够触及难以治疗的病变部位。本研究的目的是评估GA消除上皮病变和HPV的临床效果。我们开展了一项纵向描述性研究,纳入了被诊断为与低级别鳞状上皮内病变(LSIL)相关的HPV感染的育龄女性。受试者基于GA开始治疗,采用两种给药途径——全身(口服)和局部(喷雾)——每月进行评估,通过阴道镜检查和巴氏涂片来确定病变的临床变化。使用了简单统计方法以及双尾学生t检验;治疗前后P<0.05被认为具有统计学意义。有70名符合条件的患者,其中62名满足纳入标准。受试者年龄为27.8±9.5岁。在研究时,100%的患者感染了HPV,40%与LSIL相关,且只有16%使用屏障避孕(避孕套)方法。从开始治疗4周起所有患者均实现了病情缓解,12周时大多数患者(74%)病情得到改善(P<0.001)。然而,27.7%的患者存在LSIL持续情况,只有一名患者进展为宫颈上皮内瘤变(CIN)II级。事实证明,使用GA对解决临床HPV病变有效。对于伴有上皮改变(LSIL)的宫颈病变,可能需要与用于这种感染的其他药物一样进行更长时间的治疗,以及根据疾病的自然演变至少监测1年。