免疫抑制剂及中药治疗外阴营养不良前后相关酶学及局部组织免疫复合物的研究及临床观察

目的:探讨外阴营养不良的病因与局部免疫的关系及局部组织酶学改变,探索新的治疗方法。方法:局部病变组织皮下注射重组人表皮生长因子、α-2b干扰素及中药苦参提取液,观察治疗前后的局部组织免疫复合物沉积、酶学改变及临床症状的改善情况。结果:局部病变组织皲裂及溃疡全部愈合,萎缩、瘙痒、色素脱失及增生等症状均有好转。大部分标本LDH、ACP值偏高,SDH、AKP、5'-N值偏低。TIC主要沉积在小血管壁、血管内皮及周围,基底膜亦可见,治疗前后TIC沉积率及抗C3统计学处理差异有显著性(P<0.05,P<0.01)。结论:外阴营养不良的病因与局部免疫异常有关,导致炎症反应,引起局部代谢障碍及酶学改变。应用免疫抑制剂及中药治疗可提高缓解率及治愈率,为其治疗开辟了一个新途径。

Study and clinical observation of connected enzymology and tissue immune complex (TIC) before and after therapy of vulvar dystrophy with immune inhibitor and traditional Chinese medicine

Objective:To explore the relationship between the cause of vulvar dystrophy and topical immune and tissue enzymological change and to find a new treatment method.Methods:Injected subcutaneously recombinant human epidermal growth factor(rhEGF),interferon α-2b and total saponins of panax Ginseng(TSPG) in the topical lesion to observe the change of the deposit rate of topical TIC,enzymology and the clinical symptom.Results:The rhagadia and ulcer were all healed,and the atrophy,pruritus,depigmentation and hyperplasia were all improved.The titres of lactate dehydrogenase(LDH) and acid phosphatase(ACP) in most of the specimen were higher,while the SDH,AKP,5'-N were lower in most of TIC deposit at the vessel wall and vascular endothelium,and it can also be found at the basement membrane.There were significantly statistical differences in the deposit rate of TIC(P<0.05) and anti-C3(P<0.01).Conclusion:The origin of vulvar dystrophy was connected with topical immune abnormality,which resulted in inflamatory reaction,metabolic disability and enzymological change.Using immune inhibitor and traditional Chinese medicine could increase the remission rate and the healing rate.