中药联合抗病毒药治疗艾滋病的临床疗效及安全性分析

Clinical efficacy and safety analysis of traditional Chinese medicine combined with antiviral drug in the treatment of acquired immune deficiency syndrome

目的:探讨中医药联合西药抗病毒治疗在艾滋病(AIDS)患者中的应用效果。方法:选取2019年8月—2020年8月本院就诊的76例AIDS患者,依照随机数字表法分成两组,各38例。对照组予以口服拉米夫定片300 mg/次,1次/d;富马酸替诺福韦酯片300 mg/次,1次/d;依非韦伦片600 mg/次,1次/d。观察组在西药抗病毒药治疗基础上加用调节免疫功能中药:熟地黄15 g、山药12 g、山萸肉12 g、党参12 g、白术12 g、茯苓12 g、生甘草3 g、黄芪12 g、陈皮6 g,冷水泡30 min,武火煮沸后文火慢煎15 min,取汁200 ml,1剂/d,于早晚分两次口服。两组均连续用药6个月。比较两组临床疗效、艾滋病病毒(HIV)病毒载量、CD4^(+)水平、肝功能指标及不良反应。结果:观察组治疗总有效率为94.74%,高于对照组的78.95%,差异有统计学意义(P<0.05)。治疗前,两组HIV病毒载量和CD4^(+)水平比较,差异无统计学意义(P>0.05);治疗后,两组HIV病毒载量降低,CD4^(+)水平提高,且观察组HIV病毒载量低于对照组,CD4^(+)水平高于对照组,差异有统计学意义(P<0.05)。治疗前,两组丙氨酸转氨酶(ALT)、总胆红素(TBIL)和谷草转氨酶(AST)水平比较,差异无统计学意义(P>0.05);治疗后,两组ALT、TBIL和AST水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中医药联合西药抗病毒治疗在AIDS患者中效果确切,能够降低HIV病毒载量,改善免疫功能,促进肝功能恢复,安全可靠。

Objective:To explore the application effect of traditional Chinese medicine combined with antiviral drug lamivudine in patients in acquired immune deficiency syndrome(AIDS)patients.Methods:According to the random number table methods,a total of 76 cases of AIDS patients in our hospital from August 2019 to August 2020 were selected and divided into two groups,with 38 cases in each group.The control group was given lamivudine tables(300 mg),tenofovir fumarate tablets(300 mg),efavirenz(600 mg)once a day.The observation group was additionally given Chinese medicine for regulating immune functions based on antiviral agents:rehmannia 15 g,yam 12 g,dogwood meat 12 g,white surgery 12 g,poria cocos 12 g,raw licorice 3 g,astragalus 12 g,tangerine peel 6 g.The mixture was soaked in cold water for 30 min and decocted using gentle fire for 15 min.The decoction was concentrated to 200 ml(1 dose),and patients in the observation group took the decoction orally in the morning and evening(1 dose/day).Both groups were treated for six months.Clinical efficacy,HIV viral load,CD4^(+)level,liver function indexes,and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 94.74%,which was significantly higher than 78.95%of the control group(P<0.05).Before treatment,there was no significant difference in HIV viral load and CD4^(+)level between the two groups(P>0.05).After treatment,the HIV viral load decreased,and the CD4^(+)level increased in both groups,and HIV viral load in the observation group was significantly lower than that in the control group,while the CD4^(+)level was significantly higher than that in the control group(P<0.05).Before treatment,there was no significant difference in alanine aminotransferase(ALT),total bilirubin(TBIL),and aspartate aminotransferase(AST)levels between both groups(P>0.05).After the treatment,ALT,TBIL,and AST levels were decreased,and the observation group was significantly lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:TCM combined with antiviral therapy is effective in AIDS patients.The combination therapy can reduce HIV load,improve immune function,and promote the recovery of liver function,and is safe and reliable.