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Observation of Effects of Internal Herbs Combined ALA-PDT Therapy on the Recurrence of Male Urethra Orifice Condyloma Acuminatum Based on CO₂Laser Therapy

Author: GaoYing
Tutor: ChenLi
School: Nanjing University of Traditional Chinese Medicine
Course: Surgery of Chinese Medicine
Keywords: male urethral orifice condyloma accuminatum fuzhengquyou decoction photodynamic therapy recurrence rate recurrence interval TCM syndrome safety
CLC: R275.9
Type: Master's thesis
Year: 2013
Downloads: 13
Quote: 0
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Abstract

Research background:CA (condyloma acuminatum) is one of the common sexually transmitted diseases caused by the HPV(human papilloma virus) infection.The MUCA(male urethra orifice condyloma acuminatum) is the type occured in specific part, and at present there are high recurrence rate, easy infection, heavy damage, such as scar formation and urethral stricture in its clinical treatments. The occurrence and development of HPV infection are closely related to the penile cancer, colorectal cancer, and are more likely to infect female genital tract, causing women cervical intraepithelial neoplasia disorders, increasing the incidence of cervical cancer and other serious malignant lesions.Traditional Chinese Medicine hold that Condyloma Acuminatum is caused by interior dampness-heat and exogenous pathogenic poison. Its recurrence is caused by the weakened body and the lingering pathogenic factor. So we must tonify qi, strengthening the body resistance, and drift the poison out. Modern pharmacological research also confirmed that a lot of traditional Chinese medicine has the function of treating condyloma acuminatum, including radix isatidis, folium isatidis, coix seed, horsetail herb, astragalus, atractylodes, etc. and they have obvious functions of antiviral, resisting the proliferation and inducing interferon and antitumor effect. Traditional Chinese medicine has huge potential for treating condyloma acuminatum and preventing the recurrence in clinical application.5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) is a new treatment for CA in recent years, and it has a high cure rate, low relapse rate and adverse reaction especially for MUCA.Through selective destruction of HPV infected cells, preventing viral replication and clearing the latent infection and subclinical infection, it can effectively improve the cure rate and reduce the recurrence rate of MUCA.Research purposes:Evaluate and observe the effects of internal herbs and5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) on the recurrent rate and its safety of male urethra orifice condyloma acuminatum based on CO2laser therapy.Research methods:From September2011to January2013, All40cases of MUCA of follow-up observations presented are diagnosed and treated in Jiangsu Province Hospital of Traditional Chinese Medicine Dermatological Department, According to the difference of the application of ALA PDT-individual treatment and application of combined internal herbs after CO2laser therapy, the patients can be divided into two groups, one is named ALA-PDT group (Control Group) and the other is ALA-PDT combined internal herbs group (Treatment Group). It collect20cases respectively in Treatment Group and Control Group and observe the recurrence rate and adverse reaction in the7th day, the15th day, the1st month,2nd month and3rd month after the treatment to make curative effect evaluation and safety evaluation. SPSS16.0statistical analysis is applied.Results:1. Comparison of the effectivenessIn20cases of Treatment Group, there are18cases recovered (90.00%), effective in2cases (10.00%), ineffective in0cases (0.00%); In20cases of Control Group, there are14cases recovered (70.00%), effective in1cases (5.00%), ineffective in5cases(25.00%). The total effective rate have significant difference (P<0.05).2. Comparison of the recurrence rateBy comparing the recurrence of both groups, the Treatment Group and Control Group has significant difference (P<0.05), and the recurrence of the Treatment Group is lower than the one of Control Group;By comparing the recurrence in the1st month in both groups, the Treatment Group and Control Group has significant difference (P<0.05); With the recurrence rate in the2nd,3rd month, there was no significant difference between two groups (P>0.05).3. Comparison of the recurrence of time intervalThere are2cases of recurrence in the1st to3rd month after the treatments in Treatment Group and the recurrence interval is57.5days; In Control Group there are6cases of relapse in the7th day to the3rd month after the treatments, and the recurrence interval is17.5days. With the recurrence intervals, there was no significant difference ((P>0.05). But the treatment group of the recurrence time is longer than the one of the control group.4. Comparison of symptomatic efficacy of Chinese MedicineAccording to the results of two groups about treatments of traditional Chinese medicine (TCM) in single symptom curative effect comparison, the treatment group improves weak limbs less tired, low food, lumbar debility, dizziness, tinnitus, defecate pond, brown urine better than the control group. In TCM symptoms curative effect comparison of two groups,the total effective rate has significant difference (P<0.05), and the total effective rate in treatment group was higher than the control group. In traditional Chinese medicine symptom integral comparison, average score in treatment group after treatment is lower than the control group after treatment the average score, and the comparison between groups had significant difference (P<0.05). 5. Adverse reaction and safety of oral Chinese medicineIn the ALA PDT treatment process, some patientsl suffered loca mild pain and a burning sensation, but mostly bearable. If the pain is strong, with20%tetracaine hydrochloride spray outside affected,we can reduce it in5minutes. No system adverse reactions occurred.1patients suffered the urethral edema at the end of the first ALA-PDT.we used oral cefuroxime sodium3.0g/d in one week, the symptoms disappeared.2cases treated with traditional Chinese medicine (TCM) in the treatment group in the early time suffered occurrence defecate number increasing, qualitative rare,and abdominal pain,we let them continue to take medicine and the symptom can be tolerated.Oral treatment group centering remove warts soup combined treatment, including security level1is without any adverse reaction of patients for18cases (90%) in grade2that have adverse reactions, but don’t need to deal with, will not affect the treatment of2cases (10%), adverse reactions, and continue to treatment (i.e., level3or level4) to0cases. The centralizer remove warts soup the joint treatment of male urethral condyloma accuminatum and reliable safety.The orally Fuzheng Quyou decoction in the treatment group, the patients of the security1grade without any adverse reaction is18cases (90%),2with adverse reactions, but without treatment, and did not affect the continuation of treatment (10%);bad adverse reaction (3grade or4grade) had no one. The Fuzheng Quyou decoction combined treatment of Male Urethra Condyloma Acuminatum is reliable safety.Conclusion:Research confirmed that internal herbs "fuzhengquyou decoction" combined with ALA PDT can reduce the recurrence rate, extend the recurrence interval more effectively, and improve the clinical symptoms of traditional Chinese medicine, and has higher security, has less obvious adverse reactions than simply ALA-PDT therapy after CO2laser application in treating male urethra condyloma accuminatum.

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Observation of Effects of Internal Herbs Combined ALA-PDT Therapy on the Recurrence of Male Urethra Orifice Condyloma Acuminatum Based on CO2Laser Therapy

Abstract

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Observation of Effects of Internal Herbs Combined ALA-PDT Therapy on the Recurrence of Male Urethra Orifice Condyloma Acuminatum Based on CO₂Laser Therapy