Effectiveness of traditional Chinese medicine in treating AIDS related diarrhoea:a meta-analysis

Background:To evaluate the efficacy of traditional Chinese medicine(TCM)in treating Acquired Immune Deficiency Syndrome(AIDS)related diarrhoea.Methods:Chinese and English databases(CBM,CNKI,Wanfang Database,PubMed,Web of Science,Cochrane Library)were searched up to November 2021.Studies that compared TCM with western medicine were included.RevMan 5.4,Stata 17,and Grading of Recommendations Assessment Development and Evaluation system were used for data analyses.The inclusion and exclusion criteria,quality assessment process,and potential biases were specified.Result:24 randomized controlled trial with a total of 1,766 participants of TCM compared with western medicine were included,12 of which reported random assignment methods.Meta-analyses showed that,TCM was more effective than western medicine in treating AIDS-related diarrhoea[RR=1.32,95%CI(1.26,1.39),P<0.01],internal treatment of TCM[RR=1.37,95%CI(1.28,1.46),P<0.01],external treatment of TCM[RR=1.27,95%CI(1.17,1.39)],internal and external treatment of TCM[RR=1.21,95%CI(1.07,1.37),P<0.01],Shenlingbaizhu Powder/Pill[RR=1.25,95%CI(1.13,1.39),P<0.01],Xielikang Capsules[RR=1.57,95%CI(1.33,1.84),P<0.01],Jianpizhixie Recipe[RR=1.31,95%CI(1.05,1.65),P<0.01],Moxibustion[RR=1.19,95%CI(1.07,1.32),P<0.01],Ginger Moxibustion[RR=1.24,95%CI(1.04,1.47),P<0.01],when compared to using western medicine alone and with significant differences.Conclusion:Shenlingbaizhu Powder/Pill,Xielikang Capsules,Jianpizhixie Recipe,Moxibustion and Ginger Moxibustion had certain advantages in improving the effective rate of AIDS-related diarrhoea,they needed to be further validated by high quality clinical trials.

Efficacy of integrated Traditional Chinese Medicine and anti-retroviral therapy on immunological nonresponse in patients with human immunodeficiency virus/acquired immunodeficiency syndrome: a Meta-analysis of randomized controlled trials

OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment,on the immunological nonresponse(INR)in people living with human immunodeficiency virus(HIV)(PLWH).METHODS:Relevant literature in databases such as China National Knowledge Infrastructure Database(CNKI),Wanfang Digital Journal,Chinese Medical Journal Database(CMJD),Chinese Biomedical Literature Database(CBM),Pub Med,Cochrane,and Embase was reviewed by two independent investigators.Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.RESULTS:Nine randomized controlled trials(RCTs)with 1078 patients were analyzed.Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group[mean difference(MD)=13.51,95%confidence interval(CI):7.42-19.60,P<0.0001].There was no significant difference between the treated and control groups after 3 months(MD=25.31,95%CI:-2.78 to 53.41,P=0.08).However,after 6 and 12 months,the response of the treatment group was superior to the control group(MD=27.45,95%CI:7.09-47.81,P=0.008 and MD=27.34,95%CI:6.31–48.37,P=0.01,respectively).The clinical efficacy of the treatment group was also higher than that of the control group(RR=1.75,95%CI:1.16-2.65,P=0.007).However,CD45 RO and CD45 RA T cell counts did not differ significantly between the two groups(MD=12.37,95%CI:-6.71 to 31.45,P=0.20 and MD=5.67,95%CI:-3.00 to14.35,P=0.20,respectively).CONCLUSION:The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus,is beneficial and has potential use for improving INR in PLWH.However,large-scale RCTs are required to provide evidence for optimal intervention strategies.

Effect of Traditional Chinese Medicine for Treating Human Immunodeficiency Virus Infections and Acquired Immune Deficiency Syndrome:Boosting Immune and Alleviating Symptoms

To respond to the human immunodeficiency virus （HIV）/acquired immune deficiency syndrome （AIDS） epidemic in China, the integration of antiretroviral therapy （ART） and traditional Chinese medicine （TCM） has important implications in health outcomes, especially in China where the use of TCM is widespread. The National Free TCM Pilot Program for HIV Infected People began in 5 provinces （Henan, Hebei, Anhui, Hubei, and Guangdong） in 2004, and quickly scaled up to 19 provinces, autonomous regions, and municipalities in China including some places with high prevalence, 26,276 adults have been treated thus far. Usually, people with HIV infection seek TCM for four main reasons： to enhance immune function, to treat symptoms, to improve quality of life, and to reduce side effects related to medications. Evidences from randomized controlled clinical trials suggested some beneficial effects of use of traditional Chinese herbal medicine forHIV infections and AIDS. More proofs from large, well-designed, rigorous trials is needed to give firm support. Challenges include interaction between herbs and antiretroviral drugs, stigma and discrimination. The Free TCM Program has made considerable progress in providing the necessary alternative care and treatment for HIV-infected people in China, and has strong government support for continued improvement and expansion, establishing and improving a work mechanism integrating Chinese and Western medicines.

Wenshen Jianpi recipe(温肾健脾方) induced immune reconstruction and redistribution of natural killer cell subsets in immunological non-responders of human immunodeficiency virus/acquired immune deficiency syndrome:a randomized controlled trial

OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.