2237例HIV/AIDS患者中医证候分布及演变规律  

Distribution and Development Rules of Chinese Medicine Syndromes in 2237 Cases of HIV/AIDS

作　　者：王健[1] 刘颖[1] 何丽云[1] 李洪娟[2] 邹雯[1] 岑玉文[3] 邓鑫[4] 王莉[5] 张国梁[6] 胡建华[7] 谢世平[8] 王江蓉[9] 王晓静[10] 颜迎春[11] 马艳萍 杨小平 李勇[14] 刘水清 李霞[16] 董继鹏[1] 

机构地区：[1]中国中医科学院中医药防治艾滋病研究中心、临床评价中心 [2]北京中医药大学 [3]广州市第八人民医院 [4]广西中医学院附属瑞康医院 [5]云南省中医中药研究院 [6]安徽中医学院第一附属医院 [7]首都医科大学附属北京佑安医院 [8]河南中医学院 [9]上海市公共卫生临床中心 [10]首都医科大学附属北京地坛医院 [11]沈阳市传染病医院 [12]新疆维吾尔自治区中医医院 [13]河南省中医中药研究院 [14]中国中医科学院广安门医院 [15]贵阳市第五人民医院 [16]首都医科大学

出　　处：《中医杂志》2012年第11期948-951,共4页Journal of Traditional Chinese Medicine

基　　金：“十一五”国家科技重大专项(2008ZX10005-001)

摘　　要：目的探索艾滋病(AIDS)中医证候及其分布和演变规律。方法选择我国AIDS流行的10个主要地区13家医疗单位2 237例患者,采用现场访谈的形式,根据艾滋病四诊信息采集表收集信息进行中医证候学调查。总结不同感染途径患者的中医证候分布情况,并根据不同病期、不同干预手段,采用潜变量转移模型分析患者证型的演变规律。结果 AIDS患者有偿供血者以脾气虚弱、脾肾阳虚为主;性传播者以肝郁气滞、脾肾阳虚为主;静脉吸毒者以脾气虚弱、气阴两虚为主。不同病期:人类免疫缺陷病毒(HIV)感染者中,所有证型在5个时点向气阴两虚证转移最多;AIDS患者中,所有证型在5个时点向脾肾阳虚证转移最多。不同干预手段:中药治疗的HIV感染者中,肝郁气滞、脾气虚弱、气阴两虚向湿热蕴结转移较少,湿热蕴结向肝郁气滞和气阴两虚转移较多;高效抗逆转录病毒治疗(HAART)后的AIDS患者各证型分类均以30%左右比例向气阴两虚证转移;中西医结合治疗的AIDS患者各证型分类均以30%～40%比例向气阴两虚证转移,10%左右比例向脾肾阳虚转移。结论 HIV感染者以脾气虚弱为主,AIDS患者以脾肾阳虚为主;证候演变呈气虚→气虚夹湿、阴虚火热→气阴两虚→阳虚过程。Objective To observe the distribution and development rules of Chinese medicine syndromes in human immunod- eficiency virus/acquired immune deficiency syndrome （HIV/AIDS） patients. Methods Totally 2 237 HIV/AIDS patients from 13 hospitals of 10 major AIDS epidemic regions in China were selected. Chinese medicine syndromes of AIDS were collected and surveyed with the diagnostic information collection form and field interviews. The distribution and development rules of Chinese medicine syndromes were analyzed according to the latent variable transfer model. Results The main syndromes in AIDS suf- fering from paid blood donors were spleen qi deficiency and spleen-kidney yang deficiency. The main syndrome in sexual trans- mission of AIDS was liver depression and qi stagnation. The main syndromes in intravenous drug abusers with AIDS were spleen qi deficiency and qi-yin deficiency. Most of HIV infected patients and AIDS patients shifted to qi-yin deficiency and spleen-kidney yang deficiency respectively at the five time points. Fewer HIV infected patients with syndromes of liver depression and qi stagnation, spleen qi deficiency and qi-yin deficiency shifted to damp-heat brewing and binding syndrome and most HIV infected persons with damp heat brewing and binding syndrome shifted to syndrome of liver depression and qi stagnation or qi-yin deficiency after Chinese medication. Thirty percent of AIDS shifted to qi-yin deficiency syndrome after the highly active antiretroviral therapy （HAART）. Thirty to forty percent of AIDS shifted to qi-yin deficiency syndrome and ten percent shifted to spleen-kidney yang deficiency syndrome after integrative medicine therapy. Conclusion The main Chinese medicine syndrome in HIV infected persons and AIDS patients is spleen qi deficiency and spleen-kidney yang deficiency respectively. The progress of Chinese medicine syndrome development is qi deficiency, qi deficiency with dampness, yin deficiency with fire heat, qi-yin deficiency and yang deficiency.

关 键 词：艾滋病 证候 横断面调查 潜变量转移模型 

分 类 号：R259[医药卫生—中西医结合]