中西医结合治疗1250例艾滋病前瞻性队列研究

Effect of Integrated Chinese Medicine and Antiretroviral Therapy on 1250 AIDS Patients:A Prospective Cohort Study

目的基于视觉模拟评分法评价中西医结合治疗1250例艾滋病患者的临床疗效。方法1250例2014年12月—2016年1月就诊于新疆艾滋病高发区疾控中心和抗病毒治疗点的艾滋病患者,根据患者意愿分为中药组、中药+HAART组、HAART组和空白组。中药组单纯服用平艾合剂1/2/5号方治疗,中药+HAART组采用口服1/2/5号方和抗病毒药物治疗,HAART组仅采用抗病毒药物治疗,空白组不采用任何治疗方法,治疗6个月。治疗后观察患者中医症状计分、CD3^(+)、CD4+、CD8+T细胞及HIV RNA淋巴细胞水平的变化情况,并进行安全性评价。结果与本组治疗前比较,4组治疗6个月后乏力、腰膝酸软、口干、健忘、头痛、心悸、肢体麻木、盗汗、失眠、自汗、眩晕、感冒、畏寒、消瘦、心情抑郁、口苦、咳嗽、耳鸣、咯痰等20个症状积分及总分均下降(P<0.05,P<0.01);与空白组同期比较,治疗6个月时HAART组乏力、健忘、畏寒、口苦、耳鸣及中药+HAART组肢体麻木、畏寒积分降低(P<0.05);与HAART组比较,治疗6个月时中药+HAART组乏力、健忘、烦躁、心悸、心情抑郁、口苦积分更高(P<0.05)。与本组治疗前及治疗3个月比较,治疗6个月时4组CD3^(+)T水平升高,中药+HARRT组CD8+T细胞水平升高(P<0.05)。与空白组和HAART组比较,中药组和中药+HAART组中CD3^(+)T淋巴细胞数值有所升高(P<0.05)。HIV-RNA数值治疗前后有一定差异,但差异无统计学意义(P>0.05)。结论平艾合剂系列方可改善艾滋病患者临床症状,中西医结合治疗对改善艾滋病患者免疫指标具有一定作用。

To evaluate the clinical efficacy of integrated Chinese medicine(CM)and Western medicine in the treatment of 1250 patients with human immunodeficiency virus(HIV)based on the Visual Analog scoring method.Methods A total of 1250 AIDS patients who were treated at the Centers for Disease Control(CDC)and antiretroviral treatment sites in AIDS high-incidence areas in Xinjiang,from December 2014 to January 2016 were divided into CM group,CM+HAART group,HAART group,and control group according to the patient’s wishes.The CM group was treated with Pingai Heji 1/2/5 prescription alone,the CM+HAART group with oral 1/2/5 prescription and antiviral drugs,the HAART group with antiviral drugs only,and the control group with no treatment methods for six months.After treatment,the patient’s CM symptom score,changes in the levels of CD3^(+),CD4;,CD8;T cells,and HIV RNA lymphocyte were observed,and safety evaluations were conducted.Results Compared with before treatment,after 6 months of treatment in the four groups,fatigue,sore waist and knees,dry mouth,forgetfulness,headache,heart palpitations,numbness of limbs,night sweats,insomnia,spontaneous sweating,dizziness,colds,chills,weight loss,depression,bitter mouth,cough,tinnitus,expectoration and other 20 symptom scores and total scores decreased(P<0.05,P<0.01).Additionally,compared with the control group,the symptom scores of fatigue,forgetfulness,chills,bitter mouth,and tinnitus in the HAART group decreased,and the scores of limb numbness and chills in the CM;HAART group were reduced after 6 months of treatment(P<0.05).Compared with the HAART group,the CM;HAART group at 6 months of treatment showed higher levels of fatigue,forgetfulness,irritability,palpitations,depression,and bitter mouth(P<0.05).Compared with before and after 3 months of treatment,the level of CD3^(+)T in the 4 groups increased at 6 months of treatment,and the level of CD8;T cells in the CM+HARRT group increased(P<0.05).Compared with the control group and the HAART group,the number of CD3^(+)T lymphocytes in the CM group and the CM+HAART group showed an increase(P<0.05).A statistically insignificant difference was observed before and after HIV-RNA numerical treatment(P>0.05).Conclusion Pingai Heji series could improve the clinical symptoms of AIDS patients,and integrated traditional Chinese and Western medicine treatment has a certain effect on improving the immune indicators of AIDS patients.