艾滋病合并肺部真菌感染中医证型及转归的临床研究

Clinical Research on Traditionl Chinese Medicine Syndromes and Outcomes in Patients of AIDS with Invasive Pulmonary Fungal Infection

目的通过研究艾滋病合并侵袭性肺部真菌感染患者的中医证型及转归相关性分析,为中医药治疗艾滋病合并肺部真菌感染者提供理论依据。方法对募集的200例AIDS合并IPFI患者的中医四诊资料进行收集和总结分析,判明其确诊时的中医证候,并运用SPSS 17.0软件进行分析。结果 AIDS合并IPFI多见于CD^(4+)T淋巴细胞计数小于200个/μL的患者;中医证候主要表现为干咳,无痰或少痰,口渴咽干,胸闷气短,神疲乏力,纳呆寐差,大便秘结和小便短赤等。舌象以舌质红,苔黄腻或少苔、无苔为主。脉象以滑数或弦细为主;AIDS合并IPFI的证型分布以痰热壅肺证(39%)和气阴两虚证(17.5%)为主。证型分布与患者的年龄及性别无相关性;AIDS合并IPFI的转归预后与证型分布具有相关性,热陷心包证的预后最差。结论艾滋病合并IPFI具有独特的证候学特征和证型分布,其转归与中医证型相关。

Objective To master the relevance of TCM syndromes and outcome analysis of AIDS with Invasive pulmonary fungal infection(IFPI),in order to approve theoretical basis for TCM treatment on it.Methods Collecting four diagnoses of traditional Chinese medicine of 200 cases of AIDS with IPFI,judge the TCM syndromes characteristics and prognosis of AIDS with IPFI.SPSS17.0 was used to conduct statistical analysis.Results ADIS with IPFI always happened in patients whose CD4+T cells less than 200μL.The main symptoms were dry cough,not much phlegm,chest tightness,weakness,dry throat,thirst,poor spirit to talk,poor appetite,sleeping disorders,constipation,scanty dark urine,etc.The color of tongue was red,and the coating was thin yellow greasy,less or no more.The pulse was stringer,thin,slippery,and rapid.The main syndromes types of AIDS with IPFI were phlegm-heat obstructing in lung and deficiency of both qi and yin,and the syndrome type distributions had no relationship with age and gender.The prognosis of AIDS with IPFI had great relationship with syndrome type,and the prognosis of evil being trapped syndrome was the worst.Conclusion ADIS with IPFI has unique characteristics of syndromes,and its outcomes have relationship with TCM syndrome types.