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中医综合干预疗程对接受联合抗逆转录病毒治疗的获得性免疫缺陷综合征患者死亡率的影响

Effect of treatment course of comprehensive intervention with Traditional Chinese Medicine on mortality of acquired immunodeficiency syndrome patients treated with combined antiretroviral therapy.

作者信息

Guo Huijun, Wang Jian, Li Zhengwei, Jiang Ziqiang, Xu Qianlei, Xu Liran

出版信息

J Tradit Chin Med. 2016 Aug;36(4):411-7. doi: 10.1016/s0254-6272(16)30056-5.

DOI:10.1016/s0254-6272(16)30056-5
PMID:28459235
Abstract

OBJECTIVE

To investigate the effect of a treatment course of comprehensive intervention with Traditional Chinese Medicine (TCM) on the mortality of patients with acquired immunodeficiency syndrome (AIDS) treated with combined antiretroviral therapy (cART).

METHODS

AIDS patients who had taken cART in a national TCM human immunodeficiency virus treatment trial program (NTCMTP) before 2009 were enrolled in this study and followed for 36 months from November 2009. Patients enrolled in the NTCMTP in 2004 were taken as the first group, those enrolled in 2006 as the second group, and those enrolled in 2009 as the third group. Cumulative survival rates were calculated by the life table method. Survival curves for subgroups were compared by the log-rank test. Hazard ratios were calculated with a Cox proportional hazards model.

RESULTS

A total of 1443 AIDS patients were followed for 3 years (4198 person-years). During this period, 91 (6.3%) patients died and 13 (0.9%) were lost to follow-up. The total mortality rate was 2.17/ 100 person-years. The mortality rate of patients enrolled in the NTCMTP in 2004 was 1.49/100 person- years, which was lower than that of patients enrolled in 2006 (2.23/100 person-years) and 2009 (3.48/100 person-years). After adjusting for other factors, a shorter time of treatment with TCM, male sex, older age, lower CD4 + T-cell counts, and long-term treatment with cART were risk factors of mortality.

CONCLUSION

Long-term treatment with TCM decreased the mortality risk of AIDS patients. Factors such as being male, older age, CD4 + T-cell counts, and time of treatment with TCM and cART were correlated with mortality.

摘要

目的

探讨中医综合干预疗程对接受联合抗逆转录病毒治疗(cART)的获得性免疫缺陷综合征(AIDS)患者死亡率的影响。

方法

选取2009年以前参加过国家中医艾滋病治疗试点项目(NTCMTP)且接受cART治疗的AIDS患者,自2009年11月起进行36个月的随访。将2004年参加NTCMTP的患者作为第一组,2006年参加的作为第二组,2009年参加的作为第三组。采用寿命表法计算累积生存率。用对数秩检验比较亚组的生存曲线。用Cox比例风险模型计算风险比。

结果

共对1443例AIDS患者进行了3年随访(4198人年)。在此期间,91例(6.3%)患者死亡,13例(0.9%)失访。总死亡率为2.17/100人年。2004年参加NTCMTP的患者死亡率为1.49/100人年,低于2006年(2.23/100人年)和2009年(3.48/100人年)参加的患者。在调整其他因素后,中医治疗时间较短、男性、年龄较大、CD4+T细胞计数较低以及长期接受cART治疗是死亡的危险因素。

结论

长期中医治疗可降低AIDS患者的死亡风险。男性、年龄较大、CD4+T细胞计数、中医及cART治疗时间等因素与死亡率相关。

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