中医药防治艾滋病肺部感染问题与对策

Problems and Countermeasures in the Research of Traditional Chinese Medicine Prevention and Treatment of AIDS Pulmonary Infectious

艾滋病患者免疫力低下,极易发生各种机会性感染,肺部感染是常见的并发症之一。中医药在艾滋病肺部感染的防治中存在的主要问题和对策如下:(1)临床应用及研究方面,中医药地位往往不高,在某种程度上只是作为一种辅助手段;传统中药使用起来比较麻烦,患者依从性较差;相关政策对中药颗粒剂的支持力度较差,患者不愿长期使用;临床研究课题设计不合理,缺乏准确性、客观性。为解决以上问题,首先临床中应该减少抗生素的使用,加强中药治疗;其次应加强科研人员素质培养,提高研究能力,完善研究实施方案、观察量表及疗效判定标准,保证临床研究的严谨性。(2)中药制剂方面,中药新药的研究方法及相应的技术手段、制作工艺比较落后;相关复方制剂均存在不同程度的相似药物,缺乏搭配的科学性和严谨性;大部分临床课题忽略了实验室数据的变化情况及药物的作用机理与实验室数据的关系;科研工作者缺乏创新性及同行业之间的沟通交流,造成重复研究泛滥。要解决以上问题,应该对重点、优势项目加大扶持力度;增加单味中药、复方、经方、验方的筛选范围,从历代医家经验中发现更多有用的信息;加强人员的沟通交流。(3)实验室研究方面,存在中药的抗炎作用研究尚未取得突破、艾滋病研究的理想模型尚未建立、影响相关实验室检查准确性的因素较多等问题。故在今后的研究中应加强对中草药有效成分的分析研究,并与其他优势专业相结合,以期有所突破;国家应对动物模型研究给予政策和资金支持,科学工作者也要结合现代基因研究,尽快建立一种合适的动物模型;同时尽可能考虑影响实验室检查准确性的各种因素,并予以避免。

Acquired immune deficiency syndrome（ AIDS） patients have hypoimmunity,easily prone to various opportunistic infections,pulmonary infection is one of the common complications. There are several problems and countermeasures in the prevention and treatment of AIDS by traditional Chinese medicine（ TCM） ： a. In clinical research,TCM is to an extent taken as one of the supplementary means; as it is not convenient to apply TCM,and patients generally show poor compliance with the treatment; there is not much political support for granules,so that patients are not willing to apply TCM for a long period; the clinical research projects lack reasonable design,precision and objectiveness. For the problems above,above all,the application of antibiotic shall be reduced in clinical practice,and TCM treatment shall be promoted; quality and abilities of researchers shall be reinforced,and the research plan,observation scale and therapeutic effect evaluation criteria shall be optimized to ensure the preciseness of clinical research. b. In the preparation of Chinese drugs,the research method and corresponding technical means and preparation process of new drugs are relatively backward; some compound prescriptions have similar products,not scientific and precise in combination;most of the clinical subjects pay little attention to the laboratory data and the relationship between the data and action mechanism of the drugs; there is poor innovativeness and communication among the researchers,so that repeated researches never stop. To solve the problems above,the support for key and dominant projects shall be enhanced; the scope of single Chinese medicine,compound prescription,classical prescription and proved prescription should be enlarged to cover the experiences of doctors of the years; the communication among researchers shall be increased as well. c. In laboratory research,the research on anti-inflammatory action of TCM has not yet made any breakthrough,the ideal model of AIDS study has not been established yet,and there are many factors that influence the precision of laboratory inspection. Therefore,the future studies shall lay emphasis on the analysis of the composition of Chinese herbal medicine,and shall combine with other dominant specialties to make some breakthrough; political and financial supports shall be given to the studies on animal model,and researchers are expected to establish an appropriate animal model in combination with modern gene researches; meanwhile,the factors influencing the precision of laboratory inspection shall be taken into consideration and prevented if possible.