Research On The Distribution Of TCM Syndrome Type And Vaginal Microecological And Risk Factors Of Cervical Lesions In 534 Patients With HR-HPV Infection

Objective:To study the characteristics of TCM syndrome type and vaginal microecology distribution of 534 patients with HR-HPV infection,and to explore the relationship between TCM syndrome types,vaginal microecology and cervical lesions,as well as the related risk factors of cervical lesions,so as to provide some evidence for TCM clinical diagnosis and treatment of HR-HPV infection and prevention and treatment of cervical lesions.Methods:From January 2019 to January 2020,534 patients with HR-HPV infection were collected from the First Affiliated Hospital of Tianjin University of traditional Chinese medicine.The statistical data were analyzed byc^（17）test,multivariate analysis by logistic regression,with P<0.05 as the representative of statistical significance,and TCM syndrome type analysis by TCM inheritance auxiliary platform.To study the epidemiological characteristics of HR-HPV infection,the results of cervical cytology,cervical histopathology,TCM syndrome types and the distribution of vaginal microecology,and to explore the relationship between TCM syndrome types,vaginal microecology and cervical lesions,as well as the related risk factors of cervical lesions.Results:1.Among 534 cases of HR-HPV infection,the top five subtypes were HPV16（186 cases,34.8%）,HPV52（118 cases,22.1%）,HPV58（64 cases,12.0%）,HPV56（53 cases,9.9%）and HPV51（49 cases,9.2%）,of which HPV18（42 cases,7.9%）ranked seventh.HR-HPV infection was mainly single infection（360 cases,67.4%）.2.Among the patients with HR-HPV infection,the infection rates of 20-29 years old and40-49 years old were 27.3%and 31.5%respectively,showing a bimodal distribution.3.Among 534 patients with HR-HPV infection,87（16.3%）had low-grade squamous cell disease（LSIL）,96（18.0%）had high-grade squamous cell disease（HSIL）,and 14（2.6%）had cervical cancer.4.In 534 cases of HR-HPV infection,TCM syndrome types were as follows:dampness heat downpour syndrome（189 cases,35.4%）,spleen deficiency syndrome（153 cases,28.7%）,yin deficiency and dampness syndrome（77 cases,14.4%）,qi stagnation and blood stasis syndrome（64 cases,12.0%）,kidney yang deficiency syndrome（51 cases,9.6%）.The distribution of TCM Syndrome Types in patients with cervical lesions was mainly spleen deficiency syndrome（40.3%）in LSIL patients,dampness heat downward injection syndrome（46.9%）in HSIL patients,and yin deficiency and dampness syndrome（35.7%）in cervical cancer patients.5.In the patients with HR-HPV infection,the detection rate of cervical lesions in the vaginal microecological disorder group was higher than that in the normal vaginal microecology group（P<0.05）.In different types of vaginal microecological disorders,the detection rate of cervical lesions in BV group was higher than that in normal vaginal microecology group（P<0.05）.There was no significant difference between AV group,VVC group,TV group,mixed infection group and normal vaginal microecology group（P>0.05）.The detection rate of cervical lesions in the vaginal secretion pH>4.5 group was higher than that in vaginal secretion pH≤4.5 group（P<0.05）.Multivariate regression analysis showed that BV and vaginal secretion pH>4.5 were risk factors for cervical lesions（OR>1）.6.In univariate analysis,whether drinking alcohol,pregnancy times,delivery times,drug abortion times and menopause were not related to cervical lesions（P>0.05）.HR-HPV infection type,age,living environment,education background,smoking,age of first sexual life,number of sexual partners,contraceptive method,number of induced abortion and whether there was sexual intercourse bleeding were related to cervical lesions（P<0.05）,of which HR-HPV was more Serious infection,living in rural areas,junior high school education,smoking,age of first sexual life≤18 years old,number of sexual partners≥2,induced abortion≥3 times are risk factors of cervical lesions（OR>1）,condom use is the protective factor of cervical lesions（OR<1）.Conclusion:In 534 cases of HR-HPV infection,the most common TCM syndrome types were dampness and heat,followed by spleen deficiency,yin deficiency and dampness,qi stagnation and blood stasis,kidney yang deficiency.In this study,LSIL in patients with cervical lesions is mainly spleen deficiency syndrome,HSIL is mainly damp heat downpour syndrome,and cervical cancer is mainly Yin deficiency and dampness syndrome.BV and vaginal secretion pH>4.5 were risk factors of cervical lesions.Multiple infection of HR-HPV,rural area,junior high school and below,smoking,age of first sexual life≤18 years old,number of sexual partners≥2,induced abortion≥3 times were other risk factors of cervical lesions.Using condom was the protective factor of cervical lesions.