Exploration On Correlation Between Constitution Of Acquired Immunodeficiency Syndromes In Chinese Medicine And Immune Restoration After Highly Active Antiretroviral Therapy

In clinical studies we found that AIDS patients had different types of Traditional Chinese Medical,and immune reconstitution were individul differences after HAART.So far we had not found the reasons it varied.Under the same risk factors.the variation of constitation of TCM affect the trend of the disease. Also we found there were differernt syndrome in different groups of peoole.Therefore,it was proposed that the constitation of TCM maight affect the progression of disease and drug efficacy.In this study we made a follow-up survey for AIDS patients who would accept HAART with the scale of Constitution of TCM.the time was 12 months.The mainstream technologies,such as flow cytometry,were used to evaluate the structure and function of T cells for collecting multi-level information. To explore the relationship between TCM characteristics of body constitation and Immune restoration after Highly active antiretroviral therapy. In order to provide theoretycal basis for guiding individul HAART and Traditional Chinese Dug intervention.Research ObjectiveTo survey the constitation type of Traditional Chinese Medical in AIDS patients,and explore the relationship between TCM characteristics of body constitation and Immune restoration after Highly active antiretroviral therapy,in order to look for scientific basic to guide individualized HAART and TCM intervention.Research Contents1.To survey the TCM type of body constitation,and anlysis the relationship between TCM characteristics of body constitation and Immune restoration after Highly active antiretroviral therapy in AIDS patients.2.To exploring the status of immune retoration after HAART in AIDS patients. Research Methods 1.Patients collection(1) Diagnosis Standard To make diagnosis of the disease,according to《The guidelines for diagnosis and treatment of AIDS》, formulated by the Infection Epidemiology Association of Chinese Medical Association in 2005.(2)Inclusion Standard Accord with Diagnosis Standard of AIDS,he or she who accepts HAART upcomingly voluntary join the research with normal intelligence and at the age of 16-70 years old.(3)Exclusion Standard This person have accepted HAART at past,or can not accurately answer questions with abnormal intelligence or mind. (4)Number of samples The total number of sample is 100 cases. Observed Index(1)The scale of Constitution of TCM(Provided by the Basic Medical College affiliated Beijing University of TCM)The scale is composed by the establishment of type constitation of Traditional Chinese Medical, setting sub-scale,the collection item,the formation of item,selecting item,the formation of problem,and pre-investigation,consisted of 66 items.The scale is divied into nine sub-scale,namely the constitutions of balance,deficiency of Qi, deficiency of Yang, deficiency of Yin,phlegm-dampness,dampness-heat,blood stasis,stagnation of Qi,and specialty.Each of sub-scale is consisted of 7-11 items. These are two survey before HAART,and the interval time is one week.Respondents evaluate ownself physical condition six months ago,than complete the items,or with the help of investigators. Finally,investigators check the information one by one,in order to confirm it on qualified.(2)Clinical Diagnosis The Standard of the Classification System for HIV/AIDS Centers for Disease Control.1993 revised classification system for HIV infection and expanded Surveillance case definition for AIDS among adolescents and adults. MMW R Recomm Rep,1992. Dec 18; 41(RR-17):1-19 The Diagnosis Standard of Immune restoration French MA; Price P; Stone SF. Immune restoration disease after antiretroviral therapy.AIDS,2004,18(12):1621) To observed and analysis before treatment and after 1,3,6,9,12months.(3) Efficacy evaluationIncluding immune reconstitution success,immune reconstitution failure,and between in success and failure. (4)Adverse evnets and drug side effectsTo observed after 1,3,6,9,12months.(5)Laboratory Index Including CD4+ cell count and CD8+ cell count. To detect after 0,1,3,6,9,12months.(6)DrugsThe main program:D4T/AZT+3TC+NVP/EFV Statistical Methods SPSS 15.0 statistics software was uesd for statistical analysis.Research Results1.The distribution of the constitation type of Traditional Chinese Medical in 100 cases of AIDS patients The rate of deficiency of Qi was 49%,the constitutions of balance 34%,deficiency of Yang 26%, deficiency of Yin 29%,phlegm-dampness and dampness-heat 27%,blood stasis and stagnation of Qi 26%,and specialty 16%.2. The correlation between Constitution of Acquired immunodeficiency syndromes in Chinese Medicine and Immune restoration after Highly active antiretroviral therapy in 40 cases AIDS patients. CD4+ cell count was 200/ul t as the dividing line. CD4+ cell count was still lower than200/ul after long-term HAART,it was immunology treatment failure;also CD4+ cell count was higher than 200/ul,it was immunology treatment success.The research display that there were 11 cases stagnation of Qi in the cases of immunology treatment success,3 cases in cases of immunology treatment failure, they were all significantly different (f<0.05),and the others were not significantly different(f>0.05); 23 cases AIDS patient occurred drug side effects,mainly rash,lactic acidosis,drug-induced hepatitis and gastrointestinal reactions.There were 7 cases of constitutions of balance,13 cases of deficiency of Qi,5 cases of deficiency of Yang,6 cases ofdeficiency of Yin,8 cases phlegm-dampness,5 cases dampness-heat,6 cases of blood stasis,8 cases of stagnation of Qi,and 3cases of specialty,they were not significantly different(f>0.05).In cases of deficiency of Qi,one patient died.Two patients occurred opportunistic infection again, the constitation type of Traditional Chinese Medical were deficiency of Qi and constitutions of balance.Conclusions1.The main constitation type of Traditional Chinese Medical was deficiency of Qi,and it showed dificiency syndrome.On the basis of dificiency syndrome,than it mixed empirical syndrome.2.The rate of immunology treatment success in stagnation of Qi was higher than in non-Qi- stagnation.It had no correlation whether AIDS patients occurred drug side effects and opportunistic infection.