Effect of Jiedu Xiaoliu tang in treating cervical HR-HPV infection on viral load and IDO, Caspase-1 and IL-4 in cervical lesion tissues

OBJECTIVE To explore the effects of Jiedu Xiaoliu tang in treating cervical HR-HPV infection on the viral load and levels of indoleamine 2, 3-dioxygenase (IDO), cysteine protease-1 (Caspase-1), and interleukin-4 (IL-4) in cervical lesion tissues.

METHODS Seventy-eight patients with cervical HR-HPV infection admitted to Quzhou People′s Hospital from Jul. 2021 to Aug. 2023 were selected as the study subjects and were randomly divided into the study group and the control group, with 39 cases in each group. The control group was given recombinant human interferon α- 2b vaginal effervescent tablets, while the study group was given Jiedu Xiaoliu Tang on the basis of the treatment of the control group, both groups were treated for 3 menstrual cycles. The clinical efficacy, HR-HPV negative conversion and vaginal microenvironment recovery (after 3 menstrual cycles of treatment), the scores of traditional chinese medicine symptom, human papillomavirus (HPV) viral load, immune function, expression of IDO, Caspase-1, and IL-4 in cervical lesion tissues (before and after 3 menstrual cycles of treatment) and the safety (during the treatment period) between two groups were compared.

RESULTS After 3 menstrual cycles of treatment, the HR-HPV conversion and vaginal microenvironment normalization of the study group were 84.62%, and 84.62%, respectively, which were higher than the control group (P < 0.05). The efficacy of the study group was better than that of the control group (P=0.033). With the prolongation of treatment time, the scores of traditional Chinese medicine symptoms, HPV viral load, levels of peripheral blood CD₈⁺, helper T cell 17 (Th17)/regulatory T cell (Treg), and the positive expression rates of IDO, Caspase-1, and IL-4 in cervical lesion tissues showed a decreasing trend in both groups, and the study group showed a significant decrease compared with the control group. The levels of CD₃⁺, CD₄⁺, and CD₄⁺/CD₈⁺in the peripheral blood of the two groups showed an increasing trend, and the increase in the study group was significant compared with the control group (P < 0.05). During the treatment, there was no significant difference in the incidence of adverse effects between the study group and the control group (P=0.428).

CONCLUSION The Jiedu Xiaoliu tang can effectively alleviate traditional Chinese medicine symptoms in patients with cervical HR-HPV infection, reduce viral load, regulate the expression levels of IDO, Caspase-1, and IL-4 in cervical lesions, improve the vaginal microbiota and immune function of patients, alleviate inflammatory reactions, promote disease recovery and improve treatment effectiveness, and it has good safety.