Anastasi Joyce K, McMahon Donald J
Columbia University School of Nursing, New York, USA.
J Assoc Nurses AIDS Care. 2003 May-Jun;14(3):28-40. doi: 10.1177/1055329003014003003.
Diarrhea affects more than 60% of persons living with HIV/AIDS. Diarrhea can be caused by pathogens, neoplastic diseases, side effects of medications, malabsorption, and/or enteropathy. Activities of daily living and quality of life are often affected by HIV/AIDS-related diarrhea. Traditional Chinese medical interventions such as acupuncture and moxibustion show promise in the area of gastrointestinal symptom management. The purposes of this study were to (a) determine the influence of acupuncture and moxibustion in reducing the frequency of diarrhea and increasing stool consistency in HIV-infected men with chronic diarrhea (defined as three or more episodes of watery, liquid, or loose stools in a 24-hour period for 3 weeks or more), (b) ascertain the feasibility of the methodology for a future prospective randomized controlled trial, and (c) determine sample size estimate for a prospective randomized controlled trial. Using a time-series design, 15 HIV-positive men with chronic diarrhea received the same acupuncture/moxibustion treatment for six sessions over a 3-week period. Each participant maintained a daily stool frequency/consistency and medication diary. All treatments were administered by a licensed acupuncturist trained in traditional Chinese medicine. Based on the intent to treat analysis comparing the change in stool frequency from baseline (Week 1) to Week 3 and Week 4, stool frequency reduced approximately one episode per day (Week 3: p < .001; Week 4: p < .005). Stool consistency also improved, from baseline to Week 3 and Week 4, by more than 1 point on Hansen's stool consistency scale. Acupuncture and moxibustion are promising modalities for the symptom management of chronic diarrhea in HIV/AIDS. The results of this pilot study also establish the feasibility of a larger study and provide the empirical basis to serve as preliminary data from which to estimate statistical power and sample size for a larger efficacy study, inclusive of women as well as men.
腹泻影响超过60%的艾滋病毒/艾滋病感染者。腹泻可能由病原体、肿瘤性疾病、药物副作用、吸收不良和/或肠病引起。日常生活活动和生活质量常受到与艾滋病毒/艾滋病相关腹泻的影响。针灸和艾灸等中医干预措施在胃肠道症状管理领域显示出前景。本研究的目的是：(a) 确定针灸和艾灸对减少慢性腹泻（定义为24小时内出现三次或更多次水样、稀便或软便，持续3周或更长时间）的艾滋病毒感染男性腹泻频率和增加大便稠度的影响；(b) 确定未来前瞻性随机对照试验方法的可行性；(c) 确定前瞻性随机对照试验的样本量估计。采用时间序列设计，15名患有慢性腹泻的艾滋病毒阳性男性在3周内接受了6次相同的针灸/艾灸治疗。每位参与者记录每日大便频率/稠度和用药日记。所有治疗均由一名接受过中医培训的持牌针灸师进行。基于意向性分析，比较从基线（第1周）到第3周和第4周大便频率的变化，大便频率每天减少约一次（第3周：p <.001；第4周：p <.005）。从基线到第3周和第4周，大便稠度在汉森大便稠度量表上也提高了1分以上。针灸和艾灸是艾滋病毒/艾滋病慢性腹泻症状管理的有前景的方法。这项初步研究的结果还确定了进行更大规模研究的可行性，并提供了经验依据，作为初步数据，用于估计更大规模疗效研究（包括女性和男性）的统计效力和样本量。
