灵参汤联合督灸对HIV感染者免疫重建及细胞因子TNF-α、IL-27、IL-15的影响

Impacts of Lingshen decoction combined with Du moxibustion on immune reconstruction and cytokines TNF-α,IL-27 and IL-15 in HIV-infected people

目的观察用灵参汤联合督灸治疗人类免疫缺陷病毒(HIV)感染者的效果,并初步探讨其对免疫重建及血清中相关细胞因子水平的影响。方法选取2021年1月至2022年1月于淄博市传染病医院就诊的100例HIV感染者,根据随机数表法分为对照组和观察组,每组各50例。对照组给予高效抗逆转录病毒(HARRT)治疗,观察组在对照组基础上给予灵参汤联合督灸治疗,连续治疗6个月。比较两组的总有效率、T淋巴细胞计数、肿瘤坏死因子-α(TNF-α)、白细胞介素-27(IL-27)、白细胞介素-15(IL-15)、主要症状、体征积分、世界卫生组织艾滋病生存质量测量简表(WHOQOL-HIV BREF)评分变化。结果治疗6个月后,观察组总有效率为42.00%,高于对照组的22.00%,差异有统计学意义(P<0.05);治疗3、6个月后,观察组CD4^(+)T淋巴细胞计数、CD4/CD8比值高于对照组,差异有统计学意义(P<0.05);治疗6个月后,观察组血清中TNF-α水平、症状体征总积分低于对照组,WHOQOL-HIV BREF评分、IL-27和IL-15水平高于对照组,差异有统计学意义(P<0.05)。结论灵参汤联合督灸治疗HIV感染有确切疗效,利于调节CD4^(+)T淋巴细胞分化和增殖,减轻症状,提高生存治疗,初步认为其起效可能与抑制血清中TNF-α分泌、促进IL-27、IL-15的合成和分泌以抗感染、促进免疫重建有关。

Objective To observe the efficacy of L ingshen decoction com bined with Du m oxibustion in the treatment of HIV-infected people,and to preliminarily investigate its impacts on immune reconstruction and the level of related cytokines in serum.Methods A total of 100 HIV-infected patients admitted to the Infectious Disease Hospital in Zibo City from January 2021 to January 2022 were randomly divided into the control group(n=50)and the observation group(n=50).The control group was treated with highly active anti-retroviral therapy(HAART),while the observation group was treated with Lingshen decoction combined with Du moxibustion on the basis of the control group for a continuous treatment of 6 months.The overall response rate,T lymphocyte count,serum cytokines tumor necrosis factor-α(TNF-α),interleukin-27(IL-27),interleukin-15(IL-15),scores of main symptoms and signs,and the World Health Organization quality of life questionnaire for HIV brief version(WHOQOL-HIV BREF)were compared between the two groups.Results After 6 months of treatment,the overall response rate of the observation group was 42.00%,significantly higher than 22.00%in the control group(P<0.05).After 3 months and 6 months of treatment,the CD4^(+)T lymphocyte count and CD4/CD8 ratio in the observation group were both significantly higher than those in the control group(P<0.05).After 6 months of treatment,the serum TNF-αlevel and the total scores of symptoms and signs in the observation group was significantly lower than that in the control group,the score of WHOQOL-HIV BREF,the level of IL-27 and IL-15 were significantly higher than that in the control group(P<0.05).Conclusion Lingshen decoction combined with Du mo xibustion has a definite therapeutic efficacy on HIV i nfection,which is beneficial to regulate the differentiation and proliferation of CD4^(+)T lymphocytes,relieve symptoms and improve survival treatment.It is preliminarily considered that its effect may be related to inhibiting the secretion of TNF-αin serum,promoting the synthesis and secretion of IL-27 and IL-15,thus resisting infection and promoting immune reconstruction.