艾灸联合高效抗反转录病毒疗法对HIV感染者CD_4^+及γ链细胞因子的干预研究

Moxibustion combined with highly active antiretroviral therapy for CD_4^+ and γ chain cytokines of HIV infected patients

目的:比较艾灸联合高效抗反转录病毒疗法(HAART)与单纯HAART治疗人类免疫缺陷病毒(HIV)感染者的临床疗效差异。方法:将100例初始进行HAART的HIV感染者随机分为观察组和对照组,各50例,观察组予艾灸足三里、关元、三阴交等穴联合HAART(包含齐多夫定、拉米夫定、奈韦拉平、依非韦伦等药物)治疗,对照组予单纯HAART治疗,疗程及观察期均为18个月。于干预前后观察两组CD_4^+T淋巴细胞(CD_4^+)、CD_4^+T淋巴细胞/CD_8^+T淋巴细胞(CD_4^+/CD_8^+)、白细胞介素2(IL-2)、白细胞介素7(IL-7)变化情况及不良反应发生率、生存质量评分。结果:两组患者干预后CD_4^+、CD_4^+/CD_8^+、血清IL-2水平,生存质量评分中生理领域、心理领域、社会关系领域及综合评分均明显提高,血清IL-7明显降低(P<0.01,P<0.05);观察组干预后CD_4^+/CD_8^+、血清IL-2水平与生存质量评分中生理领域、心理领域、社会关系领域、综合评分均高于对照组,血清IL-7明显低于对照组(P<0.05,P<0.01)。观察组干预后HIV感染者胃肠道不良反应发生率及总不良反应发生率均低于对照组(14%(7/50)vs 32%(16/50),58%(29/50)vs 80%(40/50),均P<0.05)。结论:艾灸联合HAART能降低HIV感染者的不良反应发生率,提高服药依从性,又可改善CD_4^+/CD_8^+、IL-2、IL-7等免疫指标,提高生存质量,达到减毒增效之目的。

Objective To compare the effects of moxibustion combined with highly active antiretroviral therapy （HAART） and simple HAART for human immunodeficiency virus （HIV） infected patients. Methods A total of 100 patients with HIV receiving HAART were randomized into an observation group and a control group, 50 cases in each one. In the observation group, moxibustion was used at Zusanli （ST 36）, Guanyuan （CV 4） and Sanyinjiao （SP 6）, etc. used in the combined with HAART of zidovudine, lamivudine, nevirapine and efa^nzone, etc. Simple HAART wa~ control group. The patients were observed for 18 months. The indexes we~ GD4, CD4/CD~ mterleuki L 2 （IL-2）, interleukin 7 （IL-7）, the incidence Of side effects and the score of quality ef life. Results ＇ After treatment, CD~, CD^CD~ serum IL-2 and the scores of quality of life （physiological, psychological, social relation fields and comprehensive score） increased and serum IL-7 decreased compared with those before treatment in the two groups （P〈 0.01, P〈 0.05）, with better results except CD~ in the observation group （P〈 0.01, P〈 0.05）. The incidences of gastrointestinal side effects and total side effects in the observation group were lower than those, in the control group （14% （7/50） vs 32%（16/50）, 58% （29/50） vs 80% （40/50）, both P〈 0.05）. Conclusion Moxibustion combined with HAART for HIV infected patients could reduce the incidence of side effects, improve medication compliance, C IL-2, IL-7 and the quality of life.