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阳虚体质与高效抗逆转录病毒治疗对 HIV 感染者临床结局的相关性研究。

The Association between Yang-Deficient Constitution and Clinical Outcome of Highly Active Antiretroviral Therapy on People Living with HIV.

机构信息

Department of Infectious Diseases, Guangzhou 8th People's Hospital, 627 Dongfeng Dong Road, Guangzhou 510060, China.

Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong.

出版信息

Evid Based Complement Alternat Med. 2013;2013:201857. doi: 10.1155/2013/201857. Epub 2013 Dec 30.

Abstract

Objective. To determine the association between Yang-Deficient Constitution and the clinical outcomes of HIV/AIDS patients who have initiated highly active antiretroviral therapy (HAART). Method. A total of 197 antiretroviral-naive adults who initiated HAART between 2009 and 2011 were recruited. The participants were asked to complete a questionnaire twice to assess their Yang-Deficient Constitution status before HAART. During the study, signs and symptoms and CD4 or CD8 T cell counts were recorded. Routine blood and biochemical tests were conducted. For the patients who were found to have infections, pathologic examination was performed. Statistical test of association of clinical attributes and demographic factors with Yang-Deficient Constitution was conducted. Result. Good test-retest reliability was observed for Yang-Deficient Constitution scoring. The median Yang-Deficient Constitution score of 142 eligible participants was 25. Female (score = 32.14, P < 0.05), hepatotoxicity (32.14, P < 0.1), nephrotoxicity (37.50, P < 0.1), total number of adverse events (P < 0.1), and mortality (39.29, P < 0.05) were associated with Yang-Deficient Consitution, while annual changes or nadir values of CD4 or CD8 T lymphocytes, and newly acquired infections after starting HAART were not. Mortality was also associated with total number of adverse events (P < 0.05), hepatotoxicity (P < 0.05), and nephrotoxicity (P < 0.05). Conclusion. Yang-Deficient Constitution score has a potential to be developed as a predictor for early HIV-related mortality and side effects. The interrelation and underlying mechanisms should be further investigated for evidence-based design of a more appropriate treatment strategy.

摘要

目的。探讨阳虚体质与接受高效抗逆转录病毒治疗(HAART)的艾滋病病毒(HIV)/艾滋病患者临床结局的相关性。方法。共纳入 197 名 2009 至 2011 年期间接受 HAART 的初治成年人。在 HAART 前,参与者被要求两次完成问卷以评估其阳虚体质状况。研究期间,记录了症状和体征以及 CD4 或 CD8 T 细胞计数。进行了常规血液和生化检查。对于发现有感染的患者,进行了病理检查。对临床特征和人口统计学因素与阳虚体质的相关性进行了统计学检验。结果。阳虚体质评分的测试重测信度良好。142 名合格参与者的中位阳虚体质评分得分为 25。女性(得分=32.14,P<0.05)、肝毒性(32.14,P<0.1)、肾毒性(37.50,P<0.1)、总不良事件数(P<0.1)和死亡率(39.29,P<0.05)与阳虚体质有关,而 CD4 或 CD8 T 淋巴细胞的年变化或最低点值以及开始 HAART 后新发感染与阳虚体质无关。死亡率还与总不良事件数(P<0.05)、肝毒性(P<0.05)和肾毒性(P<0.05)有关。结论。阳虚体质评分有可能成为预测 HIV 相关早期死亡率和副作用的指标。为了制定更合适的治疗策略,需要进一步研究其相互关系和潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fb2/3892935/32e0dbe5e1d4/ECAM2013-201857.001.jpg

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