Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5314400 http://repositorio.unifesp.br/handle/11600/49904 |
Resumo: | Objective: To evaluate acupuncture as a treatment for uterine cervical ectopy with analysis of risk factors that interfere with the metaplastic response. Specific objectives are to confirm the syndromic model used in the previous selection of acupuncture points; to compare conventional cytology Pap smear (CPS) versus Liquid-based cytology (LBC); to verify the incidence of high-risk Human Papillomavirus (HPV-HR), its relationship with ectopy size and metaplastic response; demonstrate the use of computerized planimetry. Methods: We selected 51 women with ectopy, without previous therapy, negative CPS and without signs suggestive of the HPV-induced effect, in Study group (S), treated with 10 sessions of acupuncture, weekly and Control group (C) under expectant management. The Ethics and Research Committee approved the project, and we offer a free and informed consent form. After anamnesis, we collected samples for LBC and DNA HPV-HR research and colposcopy with photograph, repeated at 90 days’ follow-up. We evaluated the therapeutic response, using planimetry, considering the differential of the percentages of the areas of ectopy (ΔPe). The data were analyzed statistically. Results: Study group had 23 women and C group had 28, mostly Caucasian, symptomatic and non-smokers. The mean age was 25.6 years. Group S had a higher mean age (p= 0.040), higher age of first sexual intercourse (p<0.001), longer time interval between menarche and first sexual intercourse (p<0.001) and used less hormonal contraceptive (HC) (p<0.001). Regarding age of menarche, number of sexual partners, sexual frequency/month and results of CPS and LBC, there was no difference between groups. Study group presented higher ΔPe than C (p<0.001). We confirmed the Internal Heat Syndrome Deficient of Yin and QI. HPV OT predominated in women younger than 25 years, unrelated to ectopy size and ΔPe. The use of HC had a relation with lower ΔPe (p= 0.006). Conclusion: Study group, treated with acupuncture, had a greater reduction of ΔPe and a probable stimulus to epithelialization. The pathophysiological model of ectopy, according to TCM, was confirmed. CPS confirmed the LBC. Prevalence of HPV OT in women younger than 25 years. The use of HC was associated with lower ΔPe. Planimetry proved to be appropriate, practical, and replicable. |
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Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásicoTreatment of the ectopy of the columnar epithelium of the cervix by the systemic acupuncture and analysis of the factors of interference in the metaplastic processAcupunctureHPVEctopiaCervix uteriUterine cervical neoplasmsEctopiaAcupunturaHPVColo do úteroNeoplasias do colo do úteroObjective: To evaluate acupuncture as a treatment for uterine cervical ectopy with analysis of risk factors that interfere with the metaplastic response. Specific objectives are to confirm the syndromic model used in the previous selection of acupuncture points; to compare conventional cytology Pap smear (CPS) versus Liquid-based cytology (LBC); to verify the incidence of high-risk Human Papillomavirus (HPV-HR), its relationship with ectopy size and metaplastic response; demonstrate the use of computerized planimetry. Methods: We selected 51 women with ectopy, without previous therapy, negative CPS and without signs suggestive of the HPV-induced effect, in Study group (S), treated with 10 sessions of acupuncture, weekly and Control group (C) under expectant management. The Ethics and Research Committee approved the project, and we offer a free and informed consent form. After anamnesis, we collected samples for LBC and DNA HPV-HR research and colposcopy with photograph, repeated at 90 days’ follow-up. We evaluated the therapeutic response, using planimetry, considering the differential of the percentages of the areas of ectopy (ΔPe). The data were analyzed statistically. Results: Study group had 23 women and C group had 28, mostly Caucasian, symptomatic and non-smokers. The mean age was 25.6 years. Group S had a higher mean age (p= 0.040), higher age of first sexual intercourse (p<0.001), longer time interval between menarche and first sexual intercourse (p<0.001) and used less hormonal contraceptive (HC) (p<0.001). Regarding age of menarche, number of sexual partners, sexual frequency/month and results of CPS and LBC, there was no difference between groups. Study group presented higher ΔPe than C (p<0.001). We confirmed the Internal Heat Syndrome Deficient of Yin and QI. HPV OT predominated in women younger than 25 years, unrelated to ectopy size and ΔPe. The use of HC had a relation with lower ΔPe (p= 0.006). Conclusion: Study group, treated with acupuncture, had a greater reduction of ΔPe and a probable stimulus to epithelialization. The pathophysiological model of ectopy, according to TCM, was confirmed. CPS confirmed the LBC. Prevalence of HPV OT in women younger than 25 years. The use of HC was associated with lower ΔPe. Planimetry proved to be appropriate, practical, and replicable.Objetivo: Avaliar a acupuntura como tratamento para ectopia cervical uterina com análise dos fatores de risco que interferem na resposta metaplásica. São objetivos específicos: confirmar o modelo sindrômico usado na seleção prévia dos pontos da acupuntura; confrontar os resultados citológicos convencional (COC) e em meio liquido (COL); verificar a incidência de Papilomavírus humano de alto risco (HPV-AR), sua relação com tamanho da ectopia e resposta metaplásica; demonstrar a utilização da planimetria computadorizada. Métodos: Randomizamos 51 mulheres com ectopia, sem terapêutica prévia, com COC negativa, sem sinais do efeito citopático HPV induzido, em grupo Estudo (E), tratadas com 10 sessões de acupuntura, semanalmente e grupo Controle (C) sob conduta expectante. O projeto foi aprovado pelo Comitê de Ética e Pesquisa e oferecemos termo de consentimento livre e esclarecido. Após anamnese, coletamos amostras para COL e pesquisa de DNA HPV-AR e realizamos colposcopia com fotografia, repetida no seguimento em noventa dias. Avaliamos a resposta terapêutica, por meio de planimetria, considerando o diferencial das porcentagens das áreas de ectopia (∆Pe). Os dados foram analisados estatisticamente. Resultados: O grupo E contou com 23 mulheres;o C com 28, de maioria caucasiana, sintomáticas e não tabagistas. A média etária foi 25,6 anos. O grupo E apresentou média etária maior (p=0,040), maior idade da coitarca (p<0,001), maior intervalo de tempo entre menarca e coitarca (p<0,001) e usava menos contraceptivo hormonal (CH) (p<0,001). Quanto à idade da menarca, ao número de parceiros sexuais, frequência sexual/mês e resultados da COC e COL não houve diferença entre os grupos. O grupo E apresentou maior ∆Pe que o C (p<0,001). Confirmamos a Síndrome Interna Calor Deficiente de Yin e QI. O HPV OT predominou em mulheres menores do que 25 anos, sem relação com o tamanho da ectopia e com o ∆Pe. O uso de CH teve relação com menor ∆Pe (p=0,006). Conclusão: O grupo E, tratado com acupuntura, teve maior redução do ∆Pe traduzindo um provável estímulo à reepitelização. O modelo fisiopatológico da ectopia segundo a MTC foi confirmado. A COL confirmou a COC. Predominou HPV OT em mulheres menores de 25 anos. O uso de CH relacionou-se com menor ∆Pe. A planimetria revelou-se apropriada, prática e replicável.Dados abertos - Sucupira - Teses e dissertações (2017)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP)Ribalta, Julisa Chamorro Lascasas [UNIFESP]Yamamura, Ysao [UNIFESP]Speck, Neila Maria de Gois [UNIFESP]Ysao Yamamura : http://lattes.cnpq.br/9962571777055066Neila Maria de Gois Speck : http://lattes.cnpq.br/8169544398769371http://lattes.cnpq.br/9709032217978701http://lattes.cnpq.br/6799566192352970Universidade Federal de São Paulo (UNIFESP)Fernandes, Silvana Maria Silva [UNIFESP]2019-06-19T14:57:05Z2019-06-19T14:57:05Z2017-08-31info:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/publishedVersion137 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5314400http://repositorio.unifesp.br/handle/11600/49904porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-10T10:07:50Zoai:repositorio.unifesp.br/:11600/49904Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-10T10:07:50Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico Treatment of the ectopy of the columnar epithelium of the cervix by the systemic acupuncture and analysis of the factors of interference in the metaplastic process |
title |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
spellingShingle |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico Fernandes, Silvana Maria Silva [UNIFESP] Acupuncture HPV Ectopia Cervix uteri Uterine cervical neoplasms Ectopia Acupuntura HPV Colo do útero Neoplasias do colo do útero |
title_short |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
title_full |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
title_fullStr |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
title_full_unstemmed |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
title_sort |
Tratamento da ectopia do epitélio colunar do colo do útero com acupuntura sistêmica e análise dos fatores de interferência no processo metaplásico |
author |
Fernandes, Silvana Maria Silva [UNIFESP] |
author_facet |
Fernandes, Silvana Maria Silva [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Ribalta, Julisa Chamorro Lascasas [UNIFESP] Yamamura, Ysao [UNIFESP] Speck, Neila Maria de Gois [UNIFESP] Ysao Yamamura : http://lattes.cnpq.br/9962571777055066 Neila Maria de Gois Speck : http://lattes.cnpq.br/8169544398769371 http://lattes.cnpq.br/9709032217978701 http://lattes.cnpq.br/6799566192352970 Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Fernandes, Silvana Maria Silva [UNIFESP] |
dc.subject.por.fl_str_mv |
Acupuncture HPV Ectopia Cervix uteri Uterine cervical neoplasms Ectopia Acupuntura HPV Colo do útero Neoplasias do colo do útero |
topic |
Acupuncture HPV Ectopia Cervix uteri Uterine cervical neoplasms Ectopia Acupuntura HPV Colo do útero Neoplasias do colo do útero |
description |
Objective: To evaluate acupuncture as a treatment for uterine cervical ectopy with analysis of risk factors that interfere with the metaplastic response. Specific objectives are to confirm the syndromic model used in the previous selection of acupuncture points; to compare conventional cytology Pap smear (CPS) versus Liquid-based cytology (LBC); to verify the incidence of high-risk Human Papillomavirus (HPV-HR), its relationship with ectopy size and metaplastic response; demonstrate the use of computerized planimetry. Methods: We selected 51 women with ectopy, without previous therapy, negative CPS and without signs suggestive of the HPV-induced effect, in Study group (S), treated with 10 sessions of acupuncture, weekly and Control group (C) under expectant management. The Ethics and Research Committee approved the project, and we offer a free and informed consent form. After anamnesis, we collected samples for LBC and DNA HPV-HR research and colposcopy with photograph, repeated at 90 days’ follow-up. We evaluated the therapeutic response, using planimetry, considering the differential of the percentages of the areas of ectopy (ΔPe). The data were analyzed statistically. Results: Study group had 23 women and C group had 28, mostly Caucasian, symptomatic and non-smokers. The mean age was 25.6 years. Group S had a higher mean age (p= 0.040), higher age of first sexual intercourse (p<0.001), longer time interval between menarche and first sexual intercourse (p<0.001) and used less hormonal contraceptive (HC) (p<0.001). Regarding age of menarche, number of sexual partners, sexual frequency/month and results of CPS and LBC, there was no difference between groups. Study group presented higher ΔPe than C (p<0.001). We confirmed the Internal Heat Syndrome Deficient of Yin and QI. HPV OT predominated in women younger than 25 years, unrelated to ectopy size and ΔPe. The use of HC had a relation with lower ΔPe (p= 0.006). Conclusion: Study group, treated with acupuncture, had a greater reduction of ΔPe and a probable stimulus to epithelialization. The pathophysiological model of ectopy, according to TCM, was confirmed. CPS confirmed the LBC. Prevalence of HPV OT in women younger than 25 years. The use of HC was associated with lower ΔPe. Planimetry proved to be appropriate, practical, and replicable. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-08-31 2019-06-19T14:57:05Z 2019-06-19T14:57:05Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5314400 http://repositorio.unifesp.br/handle/11600/49904 |
url |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5314400 http://repositorio.unifesp.br/handle/11600/49904 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
137 f. application/pdf |
dc.coverage.none.fl_str_mv |
São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1814268288445710336 |