内消瘰疬丸加减联合常规西医治疗AIDS合并淋巴结核疗效观察  

Clinical efficacy of modified Neixiao Luoli Pill combined with conventional Western medicine in the treatment of AIDS patients with lymphatic tuberculosis

作　　者：贾威 李丽[2] 蔡晓建 董宇[2] JIA Wei;LI Li;CAI Xiao-jian;DONG Yu(Department of Infectious Diseases,Zhoukou Hospital of Infectious Diseases,Zhoukou 466000,Henan,CHINA;Department of Infectious Diseases,Zhoukou Central Hospital,Zhoukou 466000,Henan,CHINA)

机构地区：[1]周口市传染病医院感染科,河南周口466000 [2]周口市中心医院感染科,河南周口466000

出　　处：《海南医学》2024年第17期2452-2458,共7页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建立项项目(编号:LHGJ20201096)。

摘　　要：目的观察内消瘰疬丸加减联合常规西医治疗艾滋病(AIDS)合并淋巴结核患者的临床效果。方法选取2020年4月至2023年6月周口市传染病医院收治的78例AIDS合并淋巴结核患者纳入研究,采用随机抽签法分为常规治疗组和中药联合组各39例。常规治疗组采用高效抗逆转录病毒(HAART)及抗结核药物治疗,中药联合组在此基础上联合内消瘰疬丸加减治疗,均治疗6个月。治疗2个月、6个月后,比较两组患者的抗结核疗效和免疫功能重建疗效,治疗前和治疗2个月、6个月后,比较两组患者的HIV-RNA载量、炎症反应[干扰素-γ释放试验(TB-IGRA)、骨桥蛋白(OPN)、触珠蛋白(HP)]和免疫指标(外周血Th17/Treg、CD4+T淋巴细胞),同时比较两组患者的毒副反应发生情况。结果治疗2个月后,中药联合组患者的抗结核总有效率、免疫功能重建总有效率分别为53.85%、51.28%,与常规治疗组的43.59%、43.59%比较差异均无统计学意义(P>0.05),治疗6个月后,中药联合组患者的抗结核总有效率、免疫功能重建总有效率分别为82.05%、79.49%,明显高于常规治疗组的61.54%、56.41%,差异均有统计学意义(P<0.05);治疗2个月、6个月后,中药联合组患者的HIV-RNA载量为(3.38±0.82)lg10copy/mL、(2.42±0.54)lg10copy/mL,明显低于常规治疗组的(3.95±0.78)lg10copy/mL、(3.05±0.69)lg10copy/mL,差异均有统计学意义(P<0.05);治疗2个月、6个月后,中药联合组患者的TB-IGRA、OPN、HP水平明显低于常规治疗组,差异均有统计学意义(P<0.05);治疗2个月、6个月后,中药联合组患者的Th17水平与Th17/Treg比值分别为(1.69±0.51)%、0.31±0.08和(1.35±0.34)%、0.22±0.05,明显低于常规治疗组的(1.98±0.53)%、0.39±0.09和(1.66±0.40)%、0.30±0.07,Treg、CD4+T水平分别为(5.98±1.14)%、(209.48±19.48)个/μL和(6.26±0.97)%、(219.32±21.24)个/μL,明显高于常规治疗组的(5.37±1.03)%、(197.45±18.65)个/μL和(5.59±1.06)%、(205.68±20.49)个/μLObjective To observe the clinical effect of modified Neixiao Luoli Pill combined with convention-al Western medicine on AIDS patients with lymphatic tuberculosis.Methods A total of 78 AIDS patients with lymphat-ic tuberculosis admitted to Zhoukou Hospital of Infectious Diseases from April 2020 to June 2023 were selected for the study.They were randomly divided into a conventional treatment group and a combined treatment group,with 39 pa-tients in each group.Patients in the conventional treatment group were treated with highly active antiretroviral therapy(HAART)and anti-tuberculosis drugs,while those in the combined treatment group were treated with the modified Neix-iao Luoli Pill on the basis of the treatment in the conventional treatment group,all for 6 months.After 2 and 6 months of treatment,the anti-tuberculosis efficacy and immune function reconstruction efficacy were compared between the two groups of patients.Before treatment,after 2 months and 6 months of treatment,the HIV-RNA load,inflammatory re-sponse(interferon-γrelease test,TB-IGRA;osteopontin,OPN;haptoglobin,HP),and immune indicators(peripheral blood Th17/Treg,CD4+T lymphocytes)were compared between the two groups,as well as the occurrence of toxic and side effects.Results After 2 months of treatment,the total effective rate of anti-tuberculosis and the total effective rate of immune function reconstruction in the combined treatment group were 53.85%and 51.28%,respectively,which were not significantly different from 43.59%and 43.59%in the conventional treatment group(P>0.05).After 6 months of treatment,the total effective rate of anti-tuberculosis and the total effective rate of immune function reconstruction in the combined treatment group were 82.05%and 79.49%,respectively,which were significantly higher than 61.54%and 56.41%in the conventional treatment group(P<0.05).After 2 and 6 months of treatment,the HIV-RNA load in the com-bined treatment group was(3.38±0.82)lg10copy/mL and(2.42±0.54)lg10copy/mL,which was significantly lower than(3.95±

关 键 词：艾滋病合并淋巴结核 内消瘰疬丸加减 高效抗逆转录病毒治疗 抗结核治疗 免疫功能重建 疗效 

分 类 号：R512.91[医药卫生—内科学]