对120例艾滋病患者中医证候及其影响因素的分析

Relationship of Traditional Chinese Medical Syndrome Patterns in Acquired Immune Deficiency Syndrome Patients with Influencing Factors:An Analysis of 120 Cases

目的:探讨艾滋病患者中医证候分布规律及其与影响因素的关系。方法:采用《艾滋病中医证候调查表》对120例艾滋病患者进行调查分析,并检测CD4+T淋巴细胞。结果:肝经风火、湿毒蕴结型占30.0%,脾肾亏虚、湿邪阻滞型占20.8%,气郁痰阻、瘀血内停型占20.0%,气阴两虚、肺肾不足型占15.0%,热毒蕴结、痰热壅肺型占8.3%,此5型共占94.1%。5个中医证型在不同性别、消瘦程度方面,差异均有显著性意义(P<0.05);在不同年龄分段、感染途径方面,差异均有非常显著性意义(P<0.01)。不同中医证型的AIDS患者CD4计数(分组),差异均有非常显著性意义(P<0.01)。气阴两虚、肺肾不足型,气郁痰阻、瘀血内停型及脾肾亏虚、湿邪阻滞型患者以CD4<100/mm3多见;热毒蕴结、痰热壅肺型与肝经风火、湿毒蕴结型患者以CD4≥100/mm3多见。CD4<100/mm3的患者,症状总积分、全身状况积分、心脑系积分、肺系积分、脾胃系积分均高于CD4≥100/mm3的患者,差异有显著性或非常显著性意义(P<0.05,P<0.01)。结论:艾滋病患者以热证居多,又分为实热证、虚热证,其次以虚实夹杂证为主。中医辨证分型与性别、感染途径、消瘦、年龄段及CD4计数密切相关,CD4+T淋巴细胞可以作为判断中医证型的客观指标之一。

Objective:To explore the relationship of traditional Chinese medical syndrome patterns in acquired immune deficiency syndrome (AIDS) patients with influencing factors. Methods:A cross section investigation was carried out in 120 AIDS according to AIDS Traditional Chinese Medical Syndromes Questionnaire. The level of CD4 + T lymphocyte was also examined in all of the patients. Results:There were 5 dominant syndrome patterns, accounting for 94. 1% in total. They were:wind fire in liver meridian and accumulation of damp toxicity (pattern 1, accounting for 30. 0% ), spleen kidney deficiency and dampness stagnation (pattern 2, accounting for 20. 8% ), Qi stagnation with phlegm blockage and accumulation of blood stasis (pattern 3, accounting for 20. 0% ), Qi yin insufficiency and lung kidney deficiency (pattern 4, accounting for 15. 0% ), and accumulation of heat toxicity and phlegm heat stagnating in lung (pattern 5, account for 8. 3% ) . The differences of 5 patterns were significant between the gender and emaciation degree ( P < 0. 05 ), and were also significant between the age groups and the routine of infection ( P < 0. 01) . CD4 < 100 / mm3 was mainly shown in patterns 2, 3 and 4, and CD4≥100 / mm3 was mainly shown in patterns 5 and 1. In patients with CD4 < 100 / mm3, the scores of symptoms, general state, heart and brain system, lung system and spleen stomach system were higher that those in patients with CD4≥100 / mm3 ( P < 0. 05 or P < 0. 01 ). Conclusion:AIDS is dominated by heat syndrome which can be differentiated as excess heat and deficiency heat, and deficiency interweaved with excess syndrome comes next. Traditional Chinese medical syndrome patterns in AIDS patients are correlated with the gender, routine of infection, emaciation degree, age group and CD4 percentage. CD4 + T lymphocyte can be used as one of the diagnostic parameters for traditional Chinese medical syndrome patterns in AIDS patients.