复方芪术汤联合高效抗反转录病毒治疗脾虚湿盛型艾滋病的临床研究

发布时间：2018-03-09 14:03

本文选题：复方芪术汤　切入点：高效抗反转录病毒　出处：《复旦大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的：研究中药复方芪术汤联合高效联合抗反转录病毒治疗(HAART)对脾虚湿盛型艾滋病患者的临床疗效及安全性。研究方法：收集符合抗病毒标准的脾虚湿盛型艾滋病患者共90例,将其随机分为三组：第一组单用HAART组(30例)；第二组用唐草片联合HAART组(30例)：在HAART基础上,予唐草片每日三次,一次8粒口服；第三组用复方芪术汤联合HAART组(30例)：在HAART基础上,予复方芪术汤煎剂每日两次,一次300m1,饭后口服,或复方芪术汤颗粒,一天两次,一次一包冲服。每组均治疗6个月,观察3个月及6个月时三组患者中医证候积分变化、CD4+T淋巴细胞计数、体重变化及治疗过程中血常规、肝肾功能等安全指标的异常率。研究结果：1.中医症状体征积分：唐草片联合HAART组、复方芪术汤联合HAART组治疗3个月、6个月后积分较治疗前下降,差异均有统计学意义(P0.05或P0.01)；唐草片联合HAART组、复方芪术联合HAART组治疗3个月、6个月后对比单用HARRT组,差异均有统计学意义(P0.05或P0.01)。其中,唐草片联合HAART组与复方芪术联合HAART汤组两组之间治疗3、6个月后差异均无统计学意义。2.中医证候疗效：唐草片联合HAART组、复方芪术汤联合HAART组治疗后3个月较单用HAART组总有效率高,其差异有统计学意义(P0.01)。唐草片联合HAART组、复方芪术汤联合HAART组治疗后6个月较单用HAART组总有效率高,其差异有统计学意义(P0.01)。其中复方芪术汤联合HAART组和唐草片联合HAART组无明显差别。3、三组治疗后CD4+T淋巴细胞计数变化：相比治疗前,三组治疗3、6个月后CD4+T淋巴细胞计数差异均有统计学意义(P值0.05或P值0.01)；治疗6月后,唐草片联合HAART组、复方芪术汤联合HAART组对比HAART CD4+T淋巴细胞计数差异均有统计学意义(P值0.05)。其中复方芪术汤联合HAART组和唐草片联合HAART组无明显差别。4、体重变化：单用HAART组治疗3月、6月后体重下降,对比治疗前差异均有统计学意义(P值0.05或P值0.01)：治疗6个月较治疗3个月后进一步下降(P0.01)。5、安全性指标：各组患者治疗后一般体格检查、尿常规、粪常规、肾功能、心电图等检测均无明显异常变化。各组之间治疗期间发生WBC、Hb、PLT异常率差异均无统计学意义(P0.05)。各组之间治疗期间发生ALT、AST、TB异常率差异均无统计学意义(P0.05)。结论：复方芪术汤联合HAART治疗脾虚湿盛型艾滋病在改善中医症状体征、提高CD4+T淋巴细胞计数、增加体重等方面显示出较好的临床疗效；较单用HAART效果明显；其临床治疗效果与唐草片联合HAART相当。复方芪术汤联合HAART治疗艾滋病临床安全性较好,无明显不良反应。
[Abstract]:Objective: to study the clinical efficacy and safety of traditional Chinese medicine compound Qizu decoction combined with highly effective antiretrovirus therapy in the treatment of patients with spleen deficiency and dampness. Methods: to collect spleen deficiency dampness abundant type according to antiviral standard. There were 90 AIDS patients, They were randomly divided into three groups: the first group was treated with HAART alone, the second group was treated with Tangcao tablet combined with HAART group (30 cases): on the basis of HAART, 8 tablets of Tangcao tablet were given three times a day, and the third group was treated with compound Qizhutang combined with HAART group (30 cases) on the basis of HAART. Take compound Qizhutang decoction twice a day, 300ml once a day, take orally after meals, or compound Qizhutang granules, twice a day, one pack at a time. Each group is treated for 6 months. The changes of TCM syndromes integral and CD4 T lymphocyte count, weight change and blood routine during treatment were observed in three groups at 3 and 6 months. The abnormal rate of safety indexes such as liver and kidney function. Results: 1. Score of symptoms and signs of traditional Chinese medicine: Tangcao tablet combined with HAART group, compound Qizu decoction combined with HAART group for 3 months, the score after 6 months was lower than that before treatment. The differences were statistically significant (P 0.05 or P 0.01), Tangcao tablet combined with HAART group, compound astragalus injection combined with HAART group for 3 months, and after 6 months compared with HARRT group, the differences were statistically significant (P0.05 or P0.01). Tangcao tablet combined with HAART group and compound Qizu combined with HAART decoction group, there was no significant difference between the two groups after 6 months. 2.Therapeutic effect of TCM syndrome: Tangcao tablet combined with HAART group; Three months after treatment, the total effective rate of compound Qizu decoction combined with HAART group was higher than that of HAART group, and the difference was statistically significant (P 0.01). The total effective rate of Tangcao tablet combined with HAART group and Fufang Qizhutang combined HAART group was higher than that of HAART group at 6 months after treatment. The difference was statistically significant (P 0.01). There was no significant difference between compound Qizhutang combined with HAART group and Tangcao tablet combined with HAART group. The changes of CD4 T lymphocyte count in the three groups after treatment were as follows: compared with before treatment, there was no significant difference between the three groups. There were significant differences in CD4 T lymphocyte count between the three groups after 3 and 6 months of treatment (P 0. 05 or P 0. 01), and after June, Tangcao tablet combined with HAART group. There was significant difference in T lymphocyte count of HAART CD4 between the two groups (P < 0.05). There was no significant difference between the two groups. There was no significant difference between the two groups. 4. Weight change: HAART group was treated on March. Weight loss since June, The differences before treatment were statistically significant (P 0.05 or P 0.01): after 6 months of treatment compared with 3 months after treatment, there was a further decrease in P 0.01g. 5. Safety index: general physical examination, urine routine, routine fecal routine, renal function after treatment in each group, safety index: general physical examination after treatment, routine urine routine, routine fecal routine, renal function, and so on. There were no obvious abnormal changes in electrocardiogram and so on. There was no significant difference in the abnormal rate of WBCn HbP PLT between the groups during treatment. There was no significant difference in the abnormal rate of alt ASTT TB in all groups during the treatment period. Conclusion: there is no significant difference in the abnormal rate of alt ASTTTB in the treatment period. Conclusion: compound astragalus surgery has no significant difference in the abnormal rate. Decoction combined with HAART in the treatment of spleen deficiency and dampness of AIDS in improving the symptoms and signs of traditional Chinese medicine, Increasing CD4 T lymphocyte count and increasing body weight showed better clinical efficacy than that of HAART alone, and its clinical efficacy was similar to that of Tangcao tablet combined with HAART. Compound Qizu decoction combined with HAART had better clinical safety in the treatment of AIDS. There was no obvious adverse reaction.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91

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