新疆地区艾滋病患者中医证型分布与CD4^+ T淋巴细胞计数的相关性

Correlation between the Distribution of Chinese Medicine Syndromes and CD4^+ T Lymphocyte Count in AIDS Patients in Xinjiang Region

目的探讨新疆地区艾滋病(acquired immune deficiency syndrome,AIDS)患者中医证型分布与CD4^+T淋巴细胞计数的关系。方法收集2011年5月—2012年3月新疆6个AIDS疫情较为集中地区(乌鲁木齐、阿克苏、吐鲁番、伊犁、喀什及巴州地区)共787例HIV抗体阳性患者的中医四诊信息并进行辨证分型,检测各证型AIDS患者CD4^+T淋巴细胞水平,分析CD4^+T淋巴细胞计数水平与中医证型分布的相关性。结果乌鲁木齐及阿克苏地区AIDS患者证型构成以气阴两虚及气虚湿阻为主;吐鲁番地区肝郁气滞证型患者略高于其他地区;伊犁地区患者以气虚湿阻证型多见;喀什地区患者以肝肾阴虚证型多见;巴州地区患者以气阴两虚证型多见。CD4^+T淋巴细胞计数在200个/μL以下者,证型以肺肾阴虚多见;计数在201~350个/μL者,证型以肺肾阴虚、气郁痰凝证多见;计数在351~500个/μL者,证型以气虚湿阻、气阴两虚证多见;计数在501个/μL以上者,证型以肺卫不固、脾气虚弱证多见(均P<0.05)。结论新疆地区不同中医证型AIDS患者T淋巴细胞水平存在差异,具有一定相关性。随着CD4^+T淋巴细胞计数的降低,患者中医证型出现由表证向里证、虚实夹杂证向虚证变化的过程。

Objective To observe the correlation between the distribution of Chinese medicine（ CM） syndromes and CD4^＋T lymphocyte counts of acquired immune deficiency syndrome（ AIDS） patients in Xinjiang region. Methods Totally data（ four diagnostic information of CM） of 787 HIV＋patients were collected and syndrome typed from 6 places with higher incidence of AIDS（ Urumqi region,Aksu region,Turpan region,Yili region,Kashi region,and Bazhou region）. CD4^＋T lymphocyte counts were detected in AIDS patients with each syndrome. The correlations of CD4^＋T lymphocyte counts and distributions of CM syndrome types were analyzed. Results Qi-yin deficiency syndrome（ QYDS） and qi deficiency and dampness resistance syndrome（ QDDRS） were dominant in AIDS patients in Urumqi region and Aksu region. Gan stagnation qi stasis syndrome（ GSQSS） was more often seen in AIDS patients in Turpan region. QDDRS was more often seen in AIDS patients in Yili Region. Gan-Shen yin deficiency syndrome（ GSYDS） was more often seen in AIDS patients in Kashi region. QYDS was more often seen in AIDS patients in Bazhou region. Fei-Shen yin deficiency syndrome（ FSYDS） was more often seen in AIDS patients with CD4^＋T lymphocytes less than 200 / μL. FSYDS and qi stagnation phlegm coagulation syndrome（ QSPCS） were more often seen in AIDS patients with CD4^＋T lymphocytes ranging 201-350 / μL. QDDRS and QYDS were more often seen in AIDS patients with CD4^＋T lymphocytes ranging 351-500 / μL. Unconsolidated Fei-qi syndrome（ UFQS） and Pi-qi deficiency syndrome（ PQDS） were more often seen in AIDS patients with CD4^＋T lymphocytes more than 501 / μL（P〈0. 05）. Conclusions There existed different T-lymphocyte lev-els in AIDS patients with various syndrome types of CM in Xinjiang region,with certain correlation. Along with decreased CD4^＋T lymphocyte counts,AIDS patients＇ CM syndromes manifested a changing process from superficiality to interior syndrome,and from intermingled syndromes of deficiency and excess to deficiency syndrome.