A Preliminary Study On The Distribution Characteristics Of Traditional Chinese Medicine Syndrome Elements In The First Time Of Cervical High-risk HPV Infection

Objective To preliminarily analyze the distribution characteristics of TCM disease location and pathological evidence elements in our patients with first-time cervical HR-HPV infection through the evidence element identification system,and to explore the high-risk factors that correlate with TCM evidence elements or cervical HPV subtypes from patients’ basic information,with a view to having some significance for the prevention and treatment of the disease and TCM disease identification and evidence identification.Methods1.Collect the patients who were diagnosed with cervical HR-HPV infection for the first time in the gynecology and physical examination center of The People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 2021 to January 2022.After excluding 3 patients who met the exclusion criteria,a total of 157 patients were included.2.Using the standard TCM four diagnosis information collection table(Appendix B),investigate and record the basic information of all patients and TCM four diagnosis data,with the help of "Fujian University of TCM Health State Identification System" to obtain the corresponding TCM syndrome elements and syndrome factor scores.3.The distribution characteristics of TCM disease location and disease syndrome elements of cervical HR-HPV infection for the first time were analyzed by using SPSS23.0 software package,and the relevant syndrome types of this batch of patients were classified and summarized by "Cluster Analysis".The high risk factors related to TCM syndrome elements or cervical HPV subtypes in the basic information of patients were discussed.Results1.General data: a total of 157 patients were included in this study,ranging in age from 25 to65 years old,with the largest number of patients aged 41 to 50 years old(36.31%).Those who had sex for the first time at the age of 25 or less accounted for 89.93%;those who had more than three pregnancies accounted for 56.05%;and in terms of contraceptive methods,non-barrier contraceptives such as surgical ligation,birth control ring and oral contraceptive accounted for 42.04%,while those without birth control accounted for 26.75%.2.Cervical HR-HPV infection for the first time: among the 157 patients in the group,the positive rate of HPV-16 was the highest(25.97%),followed by HPV-52(18.18%)and HPV-58(14.29%).The main mode of infection was single infection(120cases,77.92%),of which the proportion of HPV-16 was the highest(21.67%).Among the patients with co-infection,two subtypes were common(73.53%),and the combined types with the highest frequency were HPV-16 and 56(12%).Among the five age groups,HPV-16 type is most common in51-60 years old,HPV-52 type is mainly in 31-40 years old,and HPV-58 type is common in25-30 years old.3.Distribution characteristics of TCM syndrome elements: all syndrome elements were derived from the "Fujian University of TCM Health State Identification System",among them,there are 18 TCM syndrome elements: heart,liver,spleen,lung,kidney,uterus,stomach,gallbladder,bladder,large intestine,small intestine,skin,meridians,muscles and bones,less abdomen(lower jiao),heart and spirit(brain),surface,half surface and half li.The top five syndrome elements of grade Ⅲ(degree "severe")are: uterus(87.90%),liver(81.53%),kidney(55.41%),spleen(40.76%)and meridians(10.83%).There are 28 syndrome elements of disease in traditional Chinese medicine: Yin deficiency,Yang deficiency,Yang hyperactivity,Yang floating,Qi deficiency,Qi stagnation,Qi non-solid,Qi depression,(Qi)closure,blood deficiency,blood stasis,blood cold,blood heat,cold,dampness,phlegm,drink,heat,summer heat,dryness,essence loss,deficiency of food,pus,poison,external wind,moving wind,moving blood.The top 11 syndrome elements of grade Ⅲ(severe)disease were yang deficiency(78.98%),qi deficiency(77.71%),qi stagnation(77.07%),yin deficiency(72.61%),dampness(71.34%),blood stasis(68.15%),blood deficiency(67.52%),heat(40.13%),cold(15.29%),phlegm(14.01%)and hyperyang(8.92%).Among them,the top five syndrome elements of grade Ⅲ deficiency disease are yang deficiency(78.98%),qi deficiency(77.71%),yin deficiency(72.61%),blood deficiency(67.52%)and essence deficiency(0.64%).The top five syndrome elements of grade Ⅲ are qi stagnation(77.07%),dampness(71.34%),blood stasis(68.15%),heat(40.13%)and cold(15.29%).The syndrome elements of "five internal organs" of traditional Chinese medicine(degree "serious")take "liver" as the core(grade Ⅲ syndrome elements account for 81.53%);grade III(degree "serious")syndrome elements of "five internal organs" and "cell palace" are concentrated in the age of 41 to 50 years old;the syndrome elements of grade III(degree "serious")are mainly "yang deficiency" and "qi stagnation".4.Clustering results of syndrome elements: after "cluster analysis",all TCM syndromes can be divided into 7 related syndrome types:(kidney)deficiency yang hyperactivity syndrome,spleen deficiency phlegm heat syndrome,blood stasis syndrome,liver blood deficiency syndrome,liver yin deficiency syndrome,(spleen)qi deficiency and dampness stagnation syndrome,yang deficiency syndrome.5.Correlation between patients’ basic information and TCM syndrome elements,cervical HPV subtypes: statistical analysis showed that there was a significant correlation between "pregnancy" and "cervical HPV subtypes".There was a significant correlation between "uterus" and "spleen","yin deficiency" and "age"(P<0.05).Conclusion1.Among the 157 patients enrolled in the group,the age from 41 to 50 years old is the age at which cervical HR-HPV infection occurs for the first time,so the pre-screening of cervical cancer and the education of related diseases in female patients of this age should be strengthened.2.The first cervical HR-HPV infection was dominated by single type infection,in which the positive rate of HPV-16 was the highest,and "pregnancy" was the high risk factor for the first cervical HR-HPV infection.3.The "severe" pathological degree of TCM syndrome elements in patients with cervical HR-HPV infection for the first time mainly involved "uterus" and "liver".The "severe" pathological degrees of TCM disease syndrome elements("deficiency" and "excess")were mainly "yang deficiency","qi deficiency" and "qi stagnation" and "dampness".Seven related syndrome types were found in clustering:(kidney)deficiency yang hyperactivity syndrome,spleen deficiency phlegm heat syndrome,blood stasis cell uterus syndrome,liver blood deficiency syndrome,liver yin deficiency syndrome,(spleen)qi deficiency and dampness stagnation syndrome,yang deficiency syndrome.