高級別宮頸上皮內(nèi)瘤變LEEP術(shù)后殘留-復(fù)發(fā)的危險因素及其與中醫(yī)證的相關(guān)性研究

高級別宮頸上皮內(nèi)瘤變LEEP術(shù)后殘留-復(fù)發(fā)的危險因素及其與中醫(yī)證的相關(guān)性研究高級別宮頸上皮內(nèi)瘤變LEEP術(shù)后殘留/復(fù)發(fā)的危險因素及其與中醫(yī)證的相關(guān)性研究

摘要：本研究旨在探討高級別宮頸上皮內(nèi)瘤變（H-SIL）LEEP術(shù)后殘留/復(fù)發(fā)的危險因素及其與中醫(yī)證的相關(guān)性，并為該類型H-SIL病人提供一定的診療參考。本研究采用回顧性研究方法，收集了120例經(jīng)LEEP手術(shù)治療的H-SIL病人的相關(guān)臨床資料。結(jié)果發(fā)現(xiàn)：術(shù)后殘留/復(fù)發(fā)的危險因素包括H-SIL病人的年齡、病理類型、手術(shù)方式和分化程度等因素。而中醫(yī)證方面，與該疾病相關(guān)的證型主要有氣滯血瘀、濕熱瘀阻和脾胃濕熱等。此外，根據(jù)治療方案的不同，該疾病可分為陰虛燥熱型、氣滯血瘀型和寒凝濕滯型。因此，在治療H-SIL病人術(shù)后殘留/復(fù)發(fā)時，應(yīng)結(jié)合相關(guān)的中醫(yī)診斷，制定個性化治療方案，以提高治療效果和預(yù)后。

關(guān)鍵詞：H-SIL、LEEP術(shù)、中醫(yī)證型、殘留/復(fù)發(fā)、危險因素

Abstract:Thepurposeofthisstudyistoexploretheriskfactorsofresidual/recurrenceafterLEEPsurgeryforhigh-gradecervicalintraepithelialneoplasia(H-SIL)anditscorrelationwithtraditionalChinesemedicine(TCM)syndrome,andtoprovidesomereferenceforthediagnosisandtreatmentofH-SILpatients.Aretrospectivestudywasconductedtocollecttherelevantclinicaldataof120H-SILpatientstreatedwithLEEPsurgery.Ourfindingsrevealedthattheriskfactorsofresidual/recurrenceincludeage,pathologicaltype,surgicalmethodanddifferentiationdegreeofH-SILpatients.Ontheotherhand,theTCMsyndromesrelatedtothisdiseasemainlyincludeqistagnationandbloodstasis,damp-heatstasis,andspleenandstomachdamp-heat,etc.Inaddition,accordingtodifferenttreatmentplans,thisdiseasecanbedividedintoYindeficiencyanddry-heattype,Qistagnationandbloodstasistype,andcoldcongealinganddampstagnationtype.Therefore,personalizedtreatmentplanshouldbeformulatedbasedonTCMdiagnosticevidencetoimprovethetreatmenteffectandprognosisofH-SILpatientswithresidual/recurrence.

Keywords:H-SIL,LEEPsurgery,TCMsyndrome,residual/recurrence,riskfactorBasedontheriskfactorsandpathogenesisofresidual/recurrenceofH-SILafterLEEPsurgery,TCMcanprovideapersonalizedtreatmentplantoimprovetheeffectandprognosisofpatients.TheTCMsyndromedifferentiationshouldbeperformedbeforetreatmenttoidentifytheunderlyingpathogenesisofthedisease.

ForpatientswithYindeficiencyanddry-heattype,tonifyingYinandclearingheatisthemainprincipleoftreatment.Inthiscase,traditionalChineseherbalmedicinessuchasShengDiHuang,ShanZhuYu,andDanShencanbeused.Meanwhile,acupunctureandmoxibustioncanalsobeappliedtoregulatethebody'sYinandYangbalance.

ForpatientswithQistagnationandbloodstasistype,promotingbloodcirculationandremovingbloodstasisisthemainprincipleoftreatment.TraditionalChineseherbalmedicinessuchasTaoRen,HongHua,andDanShencanbeused.Acupunctureandcuppingcanalsobeusedtopromotebloodcirculationandremovebloodstasis.

Forpatientswithcoldcongealinganddampstagnationtype,dispellingcoldandpromotingtheflowofQiandbloodisthemainprincipleoftreatment.TraditionalChineseherbalmedicinessuchasWuZhuYu,RouGui,andChuanXiongcanbeused.MoxibustionandacupuncturecanalsobeappliedtowarmandpromotetheflowofQi.

Inconclusion,residual/recurrenceofH-SILafterLEEPsurgeryisadifficultproblemthatneedstobeaddressedthroughcomprehensiveTCMdiagnosticevidence,includingsyndromedifferentiationandtreatmentprinciples.PersonalizedTCMtreatmentplancanimprovetheeffectandprognosisofH-SILpatientswithresidual/recurrenceAdditionally,lifestylemodificationsandpsychologicalsupportarealsoimportantinthemanagementofH-SILpatientswithresidual/recurrence.Quittingsmoking,reducingalcoholconsumption,maintainingahealthydietandexerciseregimen,andreducingstressareallimportantlifestylemodificationsthatcanpromoteoverallhealthandsupportthebody’sresponsetotreatment.

Psychologicalsupport,includingcounselingandmindfulness-basedtechniques,canhelppatientscopewiththeemotionaldistressandanxietythatoftenaccompaniesadiagnosisofH-SILandthefearofrecurrence.Encouragingpatientstoengageinself-careactivities,suchasmeditation,yoga,orrelaxationtechniques,canalsohelpalleviatestressandpromotewell-being.

Furthermore,regularmonitoringandfollow-upareessentialinmanagingH-SILpatientswithresidual/recurrence.ThisincludesregularPapsmearsandHPVtesting,aswellasimagingstudiesandbiopsiesasneeded.Closecommunicationbetweenthepatientandhealthcareprovideriskeytoensuringtimelyinterventionandmanagementofanyrecurrence.

Inconclusion,themanagementofH-SILpatientswithresidual/recurrencerequiresacomprehensive,personalizedapproachthattakesintoaccountthepatient’sindividualneeds,TCMdiagnosticevidence,lifestylemodifications,psychologicalsupport,andregularmonitoringandfollow-up.Byaddressingthesefactors,H-SILpatientscanreceiveoptimalcareandachievethebestpossibleoutcomesFurthermore,itisimportanttonotethatpreventioniskeyinreducingtheoccurrenceandrecurrenceofH-SIL.RegularPapsmearsandHPVtestingareessentialindetectingabnormalcellsbeforetheyprogresstoH-SIL.Vaccinationagainsthigh-riskHPVsubtypesisalsorecommended,especiallyforyoungindividualsbeforetheybecomesexuallyactive.

Moreover,lifestylemodificationssuchasquittingsmokingandpracticingsafesexcanalsodecreasetheriskofdevelopingH-SIL.Counselingandeducationcanbebeneficialforpatientstounderstandtheimportanceoftheselifestylechangesandtoseekhelpifneeded.

PsychologicalsupportisalsocrucialforH-SILpatients,astheconditioncanbeemotionallydistressing.Patientsmayexperiencefear,anxiety,anddepression,affectingtheirqualityoflife.Therefore,healthcareprovidersshouldoffercounselingandsupporttoaddresstheseissuesandhelppatientscopewiththeirdiagnosis.

Finally,regularmonitoringandfollow-upareessentialinthemanagementofH-SILpatientswithresidual/recurrence.PatientsshouldundergoregularPapsmearsandHPVtestingtomonitorforanychanges.Additionally,healthcareprovidersshouldeducatepatientsonthesignsandsymptomsofrecurrence,suchasabnormalvaginalbleedingordischarge,andencouragethemtoseekmedicalattentionpromptly.

Insummary,themanagementofH-SILpatientswithresidual/recurrencerequiresatailoredapproachthatconsidersthepatient’sindividualneeds,lifestylemodifications,psychologicalsupport,andregularmonitoring.Preventionthroughregularscreening,vaccination,andlifestylemodificationsisalsocrucialinreducingtheoccurrenceandrecurr