Ma Kun, Zhong Guan-Lan, Wang Yue, Ma Lin-Na, Luo Jie
Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China.
Graduate School of Tianjin University of Traditional Chinese Medicine Tianjin 301617, China.
Zhongguo Zhong Yao Za Zhi. 2024 Dec;49(24):6784-6802. doi: 10.19540/j.cnki.cjcmm.20240905.501.
The study employed network Meta-analysis to evaluate the efficacy and safety of Chinese patent medicines combined with recombinant human interferon α-2b(interferon) in the treatment of cervical human papillomavirus(HPV) infections. The relevant randomized controlled trial(RCT) published from inception to May 8, 2024 were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science. The modified Jadad scale and the Cochrane risk of bias tool were used to evaluate the quality of the included studies, and RevMan 5.4, R 4.3.3, and Stata 17 were used for data analysis. A total of 105 RCTs were included, involving 12 732 participants and 7 Chinese patent medicines: Baofukang Suppository, Compound Seabuckthorn Seed Oil Suppository, Huangqi Shengmai Decoction, Kangfu Gel, Kangfuyan Capsules, Kushen Gel, and Puling Penyankang Granules. Network Meta-analysis yielded the following results:(1)For improving the negative conversion rate of HPV, SUCRA top-ranked intervention was Puling Penyankang Granules + interferon.(2) For shortening vaginal discharge time, SUCRA top-ranked intervention was Compound Seabuckthorn Seed Oil Suppository + interferon.(3) For reducing the serum level of hypersensitive C-reactive protein(hs-CRP), SUCRA top-ranked intervention was Baofukang Suppository + interferon.(4) For elevating the serum level of CD+_4 T cells, SUCRA top-ranked intervention was Baofukang Suppository + interferon.(5) For elevating the serum level of CD+_8 T cells, SUCRA top-ranked intervention was Kangfuyan Capsules + interferon.(6) For improving the CD+_4/CD+_8 ratio, SUCRA top-ranked intervention was Compound Seabuckthorn Seed Oil Suppository + interferon.(7)In terms of reducing serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), recurrence rate at 6 months after treatment, and incidence of adverse events, there were no significant differences between the interventions when compared pairwise. The cluster analysis revealed that Puling Penyankang Granules + interferon, Baofukang Suppository + interferon, Kangfu Gel + interferon, and Huangqi Shengmai Decoction + interferon simultaneously improved the negative conversion rate of HPV and reduced the incidence of adverse events. The findings suggested that Chinese patent medicines combined with interferon were effective in treating cervical HPV infection by enhancing the negative conversion rate, shortening the vaginal discharge time, and improving the levels of hs-CRP and T lymphocyte subsets. However, due to the limitations of sample size and quality of the included studies, these conclusions require further validation by studies with larger sample sizes and higher quality.
本研究采用网状Meta分析，以评估中成药联合重组人干扰素α-2b（干扰素）治疗宫颈人乳头瘤病毒（HPV）感染的疗效和安全性。从中国知网、万方、维普、中国生物医学文献数据库、PubMed、考克兰图书馆、EMbase和Web of Science检索了从创刊至2024年5月8日发表的相关随机对照试验（RCT）。采用改良的Jadad量表和考克兰偏倚风险工具评估纳入研究的质量，并使用RevMan 5.4、R 4.3.3和Stata 17进行数据分析。共纳入105项RCT，涉及12732名参与者和7种中成药：保妇康栓、复方沙棘籽油栓、黄芪生脉饮、康复凝胶、抗妇炎胶囊、苦参凝胶和普苓盆炎康颗粒。网状Meta分析得出以下结果：（1）在提高HPV转阴率方面，表面相似性排序最高的干预措施是普苓盆炎康颗粒+干扰素。（2）在缩短阴道排液时间方面，表面相似性排序最高的干预措施是复方沙棘籽油栓+干扰素。（3）在降低超敏C反应蛋白（hs-CRP）血清水平方面，表面相似性排序最高的干预措施是保妇康栓+干扰素。（4）在提高CD4+T细胞血清水平方面，表面相似性排序最高的干预措施是保妇康栓+干扰素。（5）在提高CD8+T细胞血清水平方面，表面相似性排序最高的干预措施是抗妇炎胶囊+干扰素。（6）在提高CD4+/CD8+比值方面，表面相似性排序最高的干预措施是复方沙棘籽油栓+干扰素。（7）在降低血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、治疗后6个月复发率和不良事件发生率方面，各干预措施两两比较无显著差异。聚类分析显示，普苓盆炎康颗粒+干扰素、保妇康栓+干扰素、康复凝胶+干扰素和黄芪生脉饮+干扰素可同时提高HPV转阴率并降低不良事件发生率。研究结果表明，中成药联合干扰素可通过提高转阴率、缩短阴道排液时间及改善hs-CRP和T淋巴细胞亚群水平有效治疗宫颈HPV感染。然而，由于纳入研究的样本量和质量有限，这些结论需要通过更大样本量和更高质量的研究进一步验证。
