2353例艾滋病患者中医药治疗4年保持率及影响因素研究

Study on the Four-year Retention Rate and Influencing Factors for 2 353 AIDS Patients by Chinese Medicine

目的对我国首批5个省中医药持续治疗艾滋病(HIV/AIDS)患者的4年治疗情况,以及保持治疗的影响因素进行分析。方法采用乘积极限法计算不同随访时间的治疗保持率,采用Cox比例风险回归模型,对可能影响中医药治疗时间的因素进行分析。结果共有2353例患者作为研究对象参加了为期4年的随访,其中男性1156例(49.1%),汉族2344例(99.6%),已婚2260例(96%),初中及以下文化程度2219例(94.3%),平均年龄为(41.52±8.98)岁,有偿供血1758例(74.7%),输血478例(20.3%),无症状期737例(31.3%),中西药合用患者963例(40.9%)。患者4年的中位治疗时间为44.84个月,治疗1、2、3、4年的保持率分别是86.6%、78.4%、72.2%、65.6%。Cox比例风险回归结果显示,合用西药患者(HR=0.805,P<0.01)和艾滋病期患者(HR=0.769,P<0.01)能减少患者治疗期间的脱失风险,感染途径为有偿供血患者(HR=1.373,P<0.01)会增加脱失的风险。结论我国首批5省中医药治疗艾滋病持续治疗患者,4年治疗保持率为65.6%,其中感染途径、是否合用西药和分期对中医药持续治疗时间有影响。

Objective To analyze the retention rate and its influencing factors of HIV/AIDS patients by Chinese medicine（CM） maintenance treatment in the first 5 provinces in China.Methods Kaplan-Meier method was used to analyze the retention rate of treatment in patients.Cox hazard regression model was used to assess factors that might influence the treatment time of Chinese medication.Results Totally 2 353 patients took part in this four-year study.Of them,1 156（49.1%） were male,2 344（99.6%） were Han nationality,2 260（96%） were married,2 219（94.3%） had junior middle-schooling or below,the average age was 41.52±8.98 years,1 758（74.7%） received paid blood donation,478（20.3%） received blood transfusion,737（31.3%） were absent of symptoms,963（40.9%） received combined treatment of CM and Western medicine.The median time within the four years was 44.84 months.The average retention rate for 1,2,3,4 years of CM treatment were 86.6%,78.4%,72.2%,65.6%,respectively.The results of Cox model indicated that the drop-out risk could be reduced in combined treatment of CM and Western medicine patients（HR=0.805,P0.01） and AIDS patients（HR=0.769,P0.01）.The drop-out risk could be increased by the infection route of paid blood donation（HR=1.373,P0.01）.Conclusions The four-year retention rate of the 2 353 patients by CM treatment in the first 5 provinces in China was 65.6%.Route of infection,whether or not in combination of Western medicine,and staging showed influence on CM maintenance treatment time.