艾滋病高效抗逆转录病毒治疗后肝损伤的中医疗效观察  

Clinical Observation of TCM Treatment of AIDS Liver Injury After Treatment of Highly Active Antiretroviral Therapy

作　　者：王炳恒[1] 姚自凤[2] 张晓华[2] WANG Bingheng;YAO Zifeng;ZHANG Xiaohua(The Third Affiliated Hospital to Henan University of Chinese Medicine, Zhengzhou Henan China 450008;The Sixth People＇s Hospital of Zhengzhou City,Zhengzhou Henan China 450061)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]郑州市第六人民医院,河南郑州450061

出　　处：《中医学报》2018年第5期697-700,共4页Acta Chinese Medicine

基　　金：国家中医药管理局全国名老中医传承工作室基金项目{国中医药人教函【2012】149号}

摘　　要：目的:观察中医药治疗艾滋病高效抗逆转录病毒治疗后肝损伤的临床效果。方法:收集80例艾滋病高效抗逆转录病毒治疗后肝损伤患者的临床资料,随机分为观察组和对照组,各40例,对照组采用常规西药还原型谷胱甘肽片治疗,观察组在对照组基础上联合化肝煎合茵陈蒿汤加减治疗,连续治疗4周后,观察两组患者丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血清总胆红素及直接胆红素表达水平的变化情况,记录两组患者中医证候积分变化及CD_4^+、病毒载量测定结果,评价患者疗效。结果:治疗后观察组患者丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血清总胆红素及直接胆红素表达水平较治疗前明显改善,且明显高于对照组,两组比较,差异有统计学意义(P<0.05);观察组患者中医证候积分下降率为27.3%,对照组中医证候积分下降率为20.4%,两组比较,差异有统计学意义(P<0.05);观察组患者临床有效率为97.5%,对照组为87.5%,两组比较,差异有统计学意义(P<0.05);两组患者治疗前后CD_4^+测定结果较为接近,差异无统计学意义(P>0.05)。结论:中医药治疗艾滋病高效抗逆转录病毒治疗后肝损伤疗效确切,患者肝功能恢复明显,用药安全、方便,且对高效抗逆转录病毒治疗无影响。Objective： To observe the clinical effect of traditional Chinese medicine(TCM） treatment of AIDS liver injury after treatment of highly active antiretroviral therapy. Methods： Eighty patients with HIV/AIDS liver injury treated were divided into observation group(n = 40） and control group(n = 40）. The control group was treated with conventional western medicine glutathione tablets. The observation group was treated with Huagan Decoction and Yinchenhao Decoction in addition to that of the control group. After 4 weeks of continuous treatment,the alanine aminotransferase and changes in expression levels of aspartate aminotransferase,serum total bilirubin,and direct bilirubin of the two groups of patients were observed. Changes in scores of TCM syndromes,CD4＋,and viral load in both groups to evaluate were recorded and the efficacy of the patients was evaluated. Results： After treatment,the expression levels of alanine aminotransferase,aspartate aminotransferase,serum total bilirubin and direct bilirubin in the observation group were significantly better than before treatment,and the improvement range was significantly higher than that in the control group. The difference between the two groups was statistically significant(P 〈 0. 05）. The decrease rate of TCM syndrome scores in the observation group was 27. 3%,and that of the control group was 20. 4%. There was a statistically significant difference between the two groups(P 〈 0. 05）. The effective rate was 97. 5% in the observation group and 87. 5% in the control group. There was a statistically significant difference between the two groups(P 〈 0. 05）. The CD4＋and viral load measurements were similar between the two groups before and after treatment. The difference was not statistically significant(P 〉 0. 05）. Conclusion： Chinese medicine has a definite curative effect on hepatic injury after AIDS treatment with highly effective antiretroviral therapy,with obvious liver function recovery,being safe and convenient in medication,and wit

关 键 词：艾滋病 高效抗逆转录病毒治疗 肝损伤 化肝煎合茵陈蒿汤 还原型谷胱甘肽片 中医药治疗 中西医结合 

分 类 号：R259.129.1[医药卫生—中西医结合]