摘要
目的:目前艾滋病的治疗原则主要为抑制人类免疫缺陷病毒(HIV),抗机会性感染,抗相关肿瘤,增强机体免疫功能。西医高效抗病毒治疗(HAART疗法)已能使病毒载量大幅度下降、免疫重建和机会型感染明显减少,但HAART治疗不能完全消灭病毒,且药物价格昂贵,患者必须长期服用,产生的毒副反应很大,易产生赖药性病毒株,停药后会反弹,这些不利因素限制了HAART疗法的进一步推广。本课题通过对30例艾滋病患者用“艾可清”胶囊联合HAART治疗的临床观察,评价“艾可清”胶囊治疗艾滋病的疗效及安全性。
方法:选择2007年3月至2008年6月于深圳市第三人民医院艾滋病专科住院部或门诊进行HAART治疗的艾滋病患者30例为治疗组,从同期病例中选取病情相似、CD4+T淋巴细胞和治疗组相近,且单纯进行HAART治疗的病例30例为对照组。治疗组30例在进HAART治疗的同时加用中药复方“艾可清”胶囊(广州中医药大学热带疾病研究院研制);对照组30例进行单纯的HAART治疗。分别记录两组病例的观察起点,治疗6个月时,治疗12个月时的症状体征积分、卡洛夫斯基积分、HIV-RNA载量、CD4+T淋巴细胞计数,并检查肝功能、肾功能、血常规,通过两组的对比或治疗组自身前后对比来评价“艾可清”胶囊的有效性和安全性。
结果:(一)治疗组自身前后对照:①治疗组治疗6个月时和观察起点比较,其CD4+T淋巴细胞计数明显升高(P<0.01),症状体征积分下降(P<0.05),卡洛夫斯基积分升高(P<0.05);②治疗12个月时和观察起点比较,其CD4+T淋巴细胞计数明显升高(P<0.01),症状体征积分下降(P<0.01)、卡洛夫斯基积分升高(P<0.05);③治疗12个月时和治疗6个月时比较,其CD4+T淋巴细胞计数升高不明显(P>0.05),症状体征积分下降(P<0.05),卡洛夫斯基积分无明显变化(P>0.05)。整个治疗过程中,HIV-RNA载量有下降,但无统计学意义(P>0.05),治疗前后未见血常规、肝功能、肾功能明显的异常变化(P>0.05)。(二)治疗组和对照组的对比:治疗6个月时,两组的CD4+T淋巴细胞计数有明显的差异(P<0.05)。治疗12个月时,两组的CD4+T淋巴细胞计数有差异,但是无统计学意义(P>0.05)。
结论:中药复方“艾可清”胶囊联合HAART抗病毒治疗能有效改善艾滋病患者的临床症状,提高CD4+T淋巴细胞计数,减少单用西药引起的毒副作用,增加患者的依从性,但对降低HIV-RNA载量不明显,需要在以后的科研中进一步探索。
Objective:Currently the treatment principle of the AIDS mainly in order to repress the mankind the immunity blemish virus(HIV), the anti- opportunity sex appeal dye,the related tumor of the anti-,strengthen the machine body immunity function.The efficiently virus safe treatment(the HAART therapy) of the doctor has already can make the virus carried the quantity significant descend,the immunity reconstruction and the opportunity type infect the obvious decrease,but the HAART treatment can't completely exterminate the virus,and the medicine price is so expensive,so the sufferer has to take over a long period of time, and the output poisonous pair responds very greatly,and the easy creation depends on the poisonous stub of the medicine sexually transmitted disease,stopping the medicine future reunion rebound. These disadvantageous factors limit the further expansion of the HAART therapy.This topic passes the clinic observation to use "Ai Keqing" capsule consociation HAART treatment to 30 AIDS patients, and evaluates the "Ai Keqing " capsule curing the curative effect and the safety of the AIDS.
Method:Choose the AIDS patients that are treated from March of 2007 to June of 2008 in the third people hospital of Shenzhen City, especially staying in the department of the hospital or out-patient service to carry on the HAART treatment 30 in order to cure the set. The examples win election from the case of the same period to take the condition alike,the CD 4+T Lymphoid cell,and the simplicity carries on the case of the HAART treatment 30 examples matched controls.Curing the set 30 use the Chinese herbal medicine compound prescribe "Ai Keqing" capsule(developed by the tropical disease researching institute of Guangzhou university of Chinese medicine ),at the time of entering the HAART treatment;matched control 30 the examples carry on the pure HAART treatment.Then we should record two sets of observation point of departures of cases respectively,and record the symptom body solicits integral,the Karnovsky solicits integral,the carrying quantity of HIV-RNA and the count of CD4+ T Lymphoid cell which are cured 6 and 12 months. Besides checking the liver and the kidney function and blood normal regulations.According to the contrast ion of the two sets or the curing set itself,we can appraise the effection and safety of the "Ai Keqing" capsule.
Result:(a) The contrast ion of the curing set itself:①treating the curing set 6 months comparing with the observation point of departure,its count of CD 4+ T Lymphoid cell obviously goes up(P<0.01),the symptom integral calculus descend(P<0.05),the Karnovsky solicits integral go up(P<0.05);②treating the curing set 12 months comparing with the observation point of departure, its count of CD 4+ T Lymphoid cell obviously goes up(P<0.01),the symptom integral calculus descend(P<0.05),the Karnovsky solicits integral go up(P<0.05);③comparing the 6 and 12 months curing, its count of CD 4+ T Lymphoid cell goes up not obviously(P>0.05), the symptom integral calculus descend(P>0.05),the Karnovsky solicits integral has no to obviously change(P>0.05),and before or after the treatment the function of liver and kidney and blood normal regulations is not changed obviously.(b) The contrast ion of the two sets:curing 6 months,the count of CD 4+ T Lymphoid cell of the two sets has obviously differentiation(P<0.05).curing 12 months the count of CD 4+ T Lymphoid cell of the two sets has difference but no significance of statistics(P>0.05).
Conclusion:the Chinese herbal medicine compound prescribe "Ai Keqing" capsule consociating HAART treatment can improve clinical symptoms effectively of AIDS patients,improving the count of CD 4+ T Lymphoid cell,reducing the toxically side-effect when just using the medicine only,and enhancing the patients' complying. But the function of descending the carrying quantity of HIV-RNA is not obvious.It needs to be developed in the future research.
引文
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