广州市83例HAART免疫无应答AIDS病人的中医体质特点

TCM constitution of 83AIDS patients in Guangzhou with immunological non-responder after HAART

目的分析高效抗反转录病毒治疗（HAART）免疫无应答艾滋病（AIDS）病人的中医体质类型,为AIDS的中医体质干预提供参考。方法采用舌面脉中医体质辨识系统中医体质辨识系统DS01-A型舌面脉信息采集系统,对2015年1年1日至2017年12月31日在广州市第八人民医院门诊接受免费HAART 1年的AIDS病人进行数据采集,应用Logistic分析及卡方分析等统计学方法,分析患者的中医体质类型对HAART免疫应答的影响。结果共有139例病人纳入研究,其中免疫无应答组83例,前3位中医体质为湿热质31例（37.3%）,气虚质13例（15.7%）、痰湿质13例（15.7%）;免疫重建组56例,前3位中医体质类型为湿热质20例（35.7%）,气虚质19例（33.9%）,平和质6例（10.7%）,两组病人的中医体质差异无统计学意义（P〉0.05）,而两组病人的年龄差异有统计学意义（P〈0.05）。气虚质病人免疫重建成功率是非气虚质病人的2.77倍[比值比（OR）=2.77,P=0.01];痰湿质病人免疫重建成功率仅为非痰湿质病人的0.26倍（OR=0.26,P=0.04）。结论应重视及早开始HAART,体质可着重从祛湿化痰、健脾益气等方面切入进行调养。

Objective To analyze the TCM constitution of AIDS patients with immunological non-responder（INR）after HAART.Methods DS01-A tongue surface pulse information acquisition system was used to collect data of AIDS patients after one-year HAART and TCM constitution types were analyzed with statistical methods of logistic analysis and chi-square analysis.Results Data of 139 patients were collected in which 83 INR patients and56 immunological responder patients.In INR group,there were 31（37.3%）cases with constitution of dampness and heat,13（15.7%）cases with constitution of Qi deficiency and 13（15.7%）cases with constitution of phlegm and dampness.In immunological responder group,there were 20 cases with constitution of dampness and heat（35.7%）,19（33.9%）cases with constitution of Qi deficiency,and 6（10.70%）cases with constitution of balanced constitution.There was no significant difference of TCM constitution between the INR group and the immunological responder group（P〉0.05）while the age difference between the two groups was statistically significant（P〉0.05）.In addition,the success rate of immune reconstruction was 2.77 times in patients with constitution of Qi deficiency than that of the rest patients（OR=2.77,P=0.01）.The success rate of immune reconstruction in patients with constitution of phlegm was 0.26 times than that of the rest patients（OR=0.26,P=0.04）.Conclusion It is important to start HAART as early as possible,and the physical conditioning can focus on treatment of clearing-dampness,invigorating-spleen and supplementing Qi.