High-risk human papilloma virus (HPV) infectious cervicitis is the main cause of cervical cancer and has become an important public health problem in China. Traditional Chinese Medicine(TCM) syndrome differentiation and treatment is of great significance for preventing, delaying or even blocking the further development of high-risk HPV infection, but there are few relevant studies at present, and there is a lack of standardized pattern determination and standardized treatment plans.

To explore the TCM syndromes, distribution and evolution of TCM syndromes, pattern elements and evolution patterns in the transformation of HPV infection with cervicitis, cervical intraepithelial neoplasia (CIN) and cervical cancer (CC).

A retrospective analysis was performed for 288 cases of high-risk HPV infection diagnosed by hysteroscopy and pathological tissue biopsy in Shanxi Institute of Traditional Chinese Medicine from January 2023 to June 2024. EpiData 3.1 was used to establish a database to record the general information of patients, auxiliary examination results and information of the four diagnoses of traditional Chinese medicine. The principal component analysis method was used to extract the common factors. The cumulative variance contribution rate and eigenvalue were comprehensively considered. The cumulative variance contribution rate≥70 or the eigenvalue ≥1 was selected as the common factor, and the maximum variance method standardized by Kaiser was used for factor rotation. The K-means clustering method was used for cluster analysis.

Taking the information of the four diagnoses with a frequency of ≥20% as the factor analysis items, 17 pieces of information on the four diagnoses of cervicitis-cancer malignant transformation of high-risk HPV infection were obtained, including 13 symptom information and 2 tongue information, 2 pulse information. There were significant differences in symptoms, tongue image and pulse in high-risk HPV patients with cervicitis, CIN and CC (P<0.001). The results of principal component and factor cluster analysis showed that the TCM syndromes of high-risk HPV infected patients with cervicitis, CIN and CC were divided into 6 types: spleen and kidney yang deficiency pattern, qi stagnation and blood stasis pattern, spleen deficiency and dampness pattern, damp-heat betting pattern, damp-toxin accumulation pattern and yin deficiency and dampness pattern. The pattern distribution of cervicitis patients was dominated by damp-heat betting pattern (28.47%). The distribution of pattern elements was mainly wet (71.18%) and hot (28.47%).The main location of the disease was in the uterus (77.43%), followed by liver (58.33%). The pattern distribution of CIN patients was mainly damp-heat betting pattern (24.65%). The distribution of pattern elements was mainly wet (69.18%) and hot (24.65%). The main disease location was in the uterine (67.81%), followed by liver (60.27%). The pattern distribution of CC patients was mainly spleen deficiency and dampness pattern (25.16%). The distribution of pattern elements was mainly dampness (69.88%) and qi deficiency (25.16%). The main location of the disease was the uterus (56.52%), followed by the spleen (55.59%). There were statistically significant differences in distribution of TCM syndromes, pattern elements and disease locations among patients with high-risk HPV infection cervicitis, CIN and CC (P<0.001).

High-risk HPV infection cervicitis-carcinoma is mainly located in the uterus during the malignant transformation, which is related to the liver in the early stage and often involves the spleen and kidney in the later stage. With the progress of the disease, the evolution of syndromes and pattern elements is generally characterized by "the mixture of virtual and real, from real to virtual, and damp and evil throughout".

高危型人乳头瘤病毒（HPV）感染性宫颈炎是导致宫颈癌（CC）发生的主要诱因，已经成为我国重要的公共卫生问题。中医辨证论治对于预防、延缓甚至阻断高危型HPV感染进一步发展具有重要意义，但目前相关研究较少，缺乏规范性证候判定及标准化治疗方案。

探索高危型HPV感染性宫颈炎、宫颈上皮内瘤变（CIN）、CC转化过程中的中医证候、证素分布情况及演变规律。

回顾性收集2023年1月—2024年6月在山西省中医药研究院收治住院的经病理组织活检确诊的高危型HPV感染性宫颈炎患者288例、CIN患者146例、CC患者322例。应用EpiData 3.1建立数据库，记录患者一般资料、辅助检查结果及中医四诊信息。采用主成分分析法提取公因子，综合考虑累积方差贡献率及特征值，选取累积方差贡献率≥70或特征值≥1为公因子，通过Kaiser标准化的最大方差法进行因子旋转，采用K-均值聚类法进行聚类分析。

以出现频数≥20%的四诊信息作为因子分析条目，获得高危型HPV感染性宫颈炎-癌恶性转化中医四诊信息17个，包括症状信息13个、舌象信息2个、脉象信息2个。高危型HPV感染性宫颈炎、CIN、CC患者症状、舌象和脉象比较，差异均有统计学意义（P<0.001）。主成分、因子聚类分析结果显示，高危型HPV感染性宫颈炎、CIN及CC患者的中医证候分为脾肾阳虚证、气滞血瘀证、脾虚湿盛证、湿热下注证、湿毒蕴结证、阴虚夹湿证共6种。高危型HPV感染性宫颈炎患者的证候分布以湿热下注证（28.47%）为主；证素分布以湿（71.18%）、热（28.47%）为主；病位主要在胞宫（77.43%），其次为肝（58.33%）。CIN患者的证候分布以湿热下注证（24.65%）为主；证素分布以湿（69.18%）、热（24.65%）为主；病位主要在胞宫（67.81%），其次为肝（60.27%）。CC患者的证候分布主要以脾虚湿盛证（25.16%）为主；证素分布以湿（69.88%）、气虚（25.16%）为主；病位主要在胞宫（56.52%），其次为脾（55.59%）。高危型HPV感染性宫颈炎、CIN和CC患者的中医证候、证素及病位分布比较，差异均有统计学意义（P<0.001）。

高危型HPV感染性宫颈炎-癌恶性转化过程中病位主要在胞宫，前期与肝相关，后期常累及脾、肾。随着病程进展，证候、证素演变规律总体表现为"虚实夹杂、由实至虚、湿邪贯穿始终"的特点。