【作者】 徐海波；

【导师】 卢苏；

【作者基本信息】 南京中医药大学 ， 中西医结合妇科， 2007， 硕士

【摘要】 目的：通过观察分析宫颈上皮内瘤变(cervicalintraepithelialneoplasia，CIN)临床特点，回顾性调查CIN患者的相关行为危险因素，探讨其重点筛查人员，早期诊断方法以及中医证型归属。方法：721例CIN患者均经阴道镜+病理诊断确诊，观察分析CIN患者的，临床特征及高危人类乳头状瘤病毒(HPV)测定的结果，并采用问卷调查的方式了解患者相关症状体征、月经史、婚孕史、性行为和生活卫生习惯、避孕史以及既往疾病史，进而分析它们与所患疾病之间的关系以及中医证型的归属特点。结果：CIN患者多为生育期妇女，多因白带增多，血性白带，性交后出血就诊，病程较长。查体多发现宫颈慢性炎，但病变级别与宫颈糜烂程度没有相关性。癌前病变高峰年龄段为20-39岁，统计结果显示HPV感染，多性伴，盆腔炎、性传播疾病(STD)病史是其发病的高危因素。中医证型分析本病以湿热下注证、肾阴虚证、气滞血瘀证为主，高级别与低级别的患者比较，虚证比例增高，具有统计学意义。结论：CIN患者最重要的病史为有性生活的妇女出现宫颈接触性出血。性生活混乱、早孕多育的妇女、近年内有STD病史者应加强妇科体检和宫颈癌前筛查。中医证型多属实、热证，与肝、脾、肾功能失常有关，多因外感邪毒发病。更多还原

【Abstract】 Objective: to observe and analyze the clinical behaviors of cervicalintraepithelial neoplasia (cervica[intraepithelialneo plasia, CIN) forretrospectively investigating CIN patients’ related behavioral risk factors,discussing focused on screening, early diagnosis and TCM-owner.Methods: 721 cases with different grades of CIN confirmed with colposcopy andpathological examination were reviewed for the clinical features and theresults from colposcopy, pathology, testing for HPV (human papilloma virus).Determination of the results understanding and use of a questionnaire surveyof patients with signs and symptoms related to menstrual history of marriageand pregnancy, sexual health, living habits, medical history and the historyof contraception, and then analyze the relationship between them and diseaseswhich patients suffer from and the characteristics of the TCM-owner.Results: Most patients with CIN were in childbearing period and sought formedical advices because of increased leucorrhea and/or bloody leucorrhea,psotcoital bleeding for a comparatively long course. Chronic cervicitis wasoften found in these patients, but the disease levels were not correlated withthe degree of cervical erosion. The peak age of cervical carcinoma was 2039 years. The logistic analysis showed that the risk factor were HPV infection,multiple sexual partners, pelvic inflammatory disease and STD history. Throughto the TCM Syndromes research, prompted the Chinese medicine morbidity factorwhich this got sick by the downward migration of dampheat, kidney Yin deficient,qi stagnation and blood stasis.Conclusion: The most common sign for the patients with CIN is postcoitalbleeding. Sexual confusion, more infertile women and patients who has STDhistory of the past five years should strengthen gynecological examinations and screening for cervical cancer. The sick due to asthenia of the liver, spleenand kidney.更多还原