高效抗逆转录病毒疗法对艾滋病患者虚证证型分布的影响

Effect of Highly Active Antiretroviral Therapy on Distribution of TCM Deficiency Syndromes of AIDS Patients

目的探讨接受高效抗逆转录病毒疗法(HAART)药物干预后艾滋病(AIDS)患者中医虚证证型的分布。方法对243例接受HAART药物干预的AIDS患者进行了问卷调查,收集患者的一般资料和四诊信息,对中医虚证证候分布进行了描述性分析,筛选出频次出现较高的虚证证候,检测患者外周血CD3+、CD4+、CD8+T淋巴细胞计数和CD4+/CD8+比值。结果 AIDS患者虚证出现最多有124例占51.0%,主要为脾肺气虚证(23例),肺气虚弱证(17例),脾气亏虚证(8例);肺气亏虚患者的CD3+、CD4+、CD8+细胞计数以及CD4+/CD8+比值均最高,CD3+、CD4+计数与脾气亏虚和脾肺气虚患者差异有统计学意义(P<0.05)。肺气亏虚患者的病程最短,脾气亏虚和脾肺气虚患者的病程较长,3者间差异无统计学意义(P>0.05)。结论接受HAART治疗的AIDS患者虚证具有复杂的特点,涉及脏腑主要为脾肺两脏,脾肺气虚为最常见的虚证证型,肺气虚弱证患者疾病程度较轻。

Objective To explore the distribution of deficiency syndromes of acquired immune deficiency syndrome （AIDS） patients intervented by highly active antiretroviral therapy （HAART）. Methods Totally 243 AIDS cases received the medication of HAART were investigated with questionnaire. Their general data and information of four diagnostic methods were collected. A descriptive analysis was done on their TCM syndromes, especially the deficiency syndromes, to screen out the deficiency syndromes which appeared in high frequency. The peripheral blood CD3＋, CD4＋, CD8＋ T lymphocyte counts and CD4＋/CD8＋ of the patients were detected. Results The deficiency syndromes of patients was most frequently in the incidence, the deficiency syndromes were mainly of the spleen-lung qi deficiency, 29 cases, lung qi deficiency, 17 cases, and spleen qi deficiency, 8 cases. Of those lung qi deficiency patients, the CD3＋, CD4＋, CD8＋ counts and CD4＋/CD8＋ were all the highest. The difference in the CD3＋and CD4＋ counts between spleen qi deficiency and spleen-lung qi deficiency patients was statistically significant （P0.05）. The course of disease of those lung qi deficiency patients was the shortest, while that of those spleen qi deficiency and spleen-lung qi deficiency patients was longer, the difference among these three types was without statistical significance （P0.05）. Conclusion The deficiency syndromes of AIDS patients received HAART are complicated, and mainly the spleen and lung are involved. The most commonly seen deficiency syndrome is the spleen-lung qi deficiency. The severity of disease of the lung qi deficiency patients is relatively mild.