高效联合抗逆转录病毒疗法结合中医分期辨证治疗HIV／AIDS29例临床研究

Clinical study on the treatment of 29 cases of HIV/AIDS with the traditional Chinese medicine combined with HAART

目的探索高效联合抗逆转录病毒疗法（HAART）结合中医分期辨证治疗HIV／AIDS患者的治疗方案，以达到重建HIV感染者、患者的免疫功能，抑制HIV病毒复制，减少并发症及HARRT药物不良反应的目的。方法29例HIV／AIDS患者依据国家《HIV／AIDS的诊断标准和处理原则》标准分组，将3例无症状HIV感染者列入HIV组，26例AIDS患者列入AIDS组，两组患者均采用自身对照方式进行观察，以实施中药治疗时间为界分为对照阶段和治疗阶段。HIV组：对照阶段进行严密观察后统计观察指标；治疗阶段辅以中药分期辨证施治，中药1剂／d。AIDS组：对照阶段采用HAART方案，治疗阶段辅以中药分期辨证施治，中药1剂／d。对照和治疗阶段疗程均为12个月。结果HIV组治疗后，自身对照结果显示免疫和病毒指标变化不大，但无任何毒副反应。AIDS组治疗阶段CD4^＋细胞计数[（425．54±205．39）个／ml]增加，与对照阶段[（172．85±102．14）个／ml]比较，差异有统计学意义（t=3．1990，P〈0．01）；临床症状方面，治疗阶段消化系统症状、呼吸系统症状改善明显，与对照阶段比较差异有统计学意义（X^2分别为4．9231、2．5000，P均〈0．05）；治疗阶段在骨髓抑制、胰腺炎、脂肪分布异常方面的毒副反应较对照阶段，差异有统计学意义（X^2分别为9．333、16．4091、10．2273，P均〈0．01）。结论HAART结合中医分期辨证治疗，可改善HIV／AIDS患者的临床症状，减少抗病毒药物的不良反应。

Objective To explore a reasonable therapeutic plan for treating HIV/AIDS with traditional Chinese medicine plus western medicine. Methods Twenty-nine patients with HIV/AIDS were selected and recruited into a HIV group and a AIDS group according to the clinical diagnosis. Each group was further divided into comparison stage and treatment stage. In HIV group, observations and statistics of observation indexes were performed during the comparison stage; while TCM treatment was applied in the treatment stage. In AIDS group, HAART was applied in the comparison stage, and HAART combined with TCM therapy were used in the treatment stage. Both comparison stage and the treatment stage lasted 12 months. Results In HIV group, self control results showed that immune and virus indexes did not have significant changes, but also with no side or toxic effects. In the AIDS group, contrasting between the comparison stage and the treatment stage showed that there were significant improvement of symptoms （X^2=4.9231, 2.5000, P〈0.05） , anti-toxic effects （X^2=9.333, 16.4091, 10.2273, P〈0.01 ） and immune indexed （t= 3.1990, P〈 0.01 ） after treated additionally with traditional Chinese medicine. Conclusion Traditional Chinese medicine could improve the immunity function and clinical symptoms, reduce side effect of HAART medicine and stabilize CD4^＋ T cells of patient with HIV/AIDS.