| Acquired Immune Deficiency Syndrome(AIDS)is a major infectious disease that seriously threatens human health.As the most effective treatment at present,Highly Active Antiretroviral Therapy(HAART)has been widely used in clinic,making AIDS a chronic controllable disease.However,it is undeniable that there will be some shortcomings after HAART,such as adverse drug reactions,virus resistance,and incomplete immune reconstitution.Among them,the problem of incomplete immune reconstruction in AIDS patients has been attracting much attention.Currently,the CD4+T lymphocyte count has not reached 350cells/μl,which can be considered as incomplete immune reconstruction.It has been reported in the past that the risk of infection,complications and death of patients with incomplete immune reconstruction is higher than those with complete immune reconstruction,and the situation is relatively serious.At present,it is generally believed that the reconstruction of immune after HAART is the research difficulty and focus in the field of AIDS.It can be said that human beings still have a long way to go to overcome AIDS.Therefore,it is imperative to explore new strategies and methods to improve the immune function of patients.There is no relevant record of AIDS in the ancient literature of TCM,but with the spread of AIDS,the knowledge of the disease in TCM is deepening,which can be attributed to plague,consumptive disease.So far,the treatment of AIDS by TCM has gone through more than 30 years,from the initial perceptual knowledge to the preliminary stage of research,and then continues to develop and mature.With the deepening and improvement of research,TCM has played an important role in the treatment of AIDS.Compared with the past,the research scale of TCM in the prevention and treatment of AIDS has been expanded,and the entry point of the research is more clear.Studies have shown that the combination of traditional Chinese and Western medicine can promote the immune of AIDS patients,improve clinical symptoms,delay the development of the disease,and its effect is better than the simple HAART treatment.Among them,the application of moxibustion in AIDS,a characteristic therapy of TCM.provides a new way for the treatment of AIDS.Moxibustion is a traditional and unique method of disease prevention and treatment.It is easy to operate,has little toxic and side effects,cheap and fine.It has the functions of WenJingSanHan,WenTongJingLuo,FuZhengGuBen.After consulting a large number of clinical literature,it was found that moxibustion has many advantages on the immune system,such as multi-target,multi-link,two-way regulation,and can promote the immune reconstruction.At present,promoting the reconstruction of immune after HAART has become a bottleneck problem in the field of AIDS.It is of great significance to improve the incomplete immune reconstruction of AIDS patients as the entry point of TCM intervention in AIDS.Therefore,moxibustion treatment plays an active role in AIDS patients with incomplete immune reconstruction.It can provide a new perspective and mechanism for the adjuvant treatment of AIDS with TCM,and provide a wider range of interventions for patients to achieve the goal of immune reconstruction.Relying on the national "13th Five-Year Plan" major scientific and technological project—a new program of TCM to promote the reconstruction of immune of AIDS after HAART.I participated in the project demonstration meeting,project initiation meeting,CRF table formulation,patient enrollment,case follow-up,data entry,project supervision and other work of "Clinical research on the effect of moxibustion on immune reconstruction of AIDS after HAART".As the subject is not yet finished,only part of the data can be sorted out,analyzed and discussed at present.ObjectiveTo observe the improvement of CD4+T lymphocytes count and clinical symptoms in patients with incomplete immune reconstitution after highly active antiretroviral therapy(HAART)by Moxibustion at Mingmen,Shenshu,Shanzhong,Shenque,Guanyuan and Zusanli points.Through clinical observation,to evaluate the safety and effectiveness of moxibustion in regulating immune function of the body,in order to provide a new method and a new basis for the clinical treatment of AIDS patients with incomplete immune reconstruction.MethodsAccording to the inclusion criteria,69 cases of AIDS with Yang deficiency of spleen and kidney patients were selected after HAART treatment with low viral load and incomplete immune reconstruction.All subjects were randomly divided into two groups:46 cases in the treatment group were treated with moxibustion combined with HAART,and 23 cases in the control group were treated with HAART.The clinical efficacy was observed for 12 weeks.The indicators of immune(CD4+T lymphocyte)and clinical symptoms(TCM symptoms,immune reconstruction related symptoms)were monitored before treatment and at the 4th and 12th weeks after treatment to evaluate the effectiveness of moxibustion therapy.At the same time,blood routine,urine routine,liver function,kidney function were monitored to observe whether the subjects had adverse reactions during the experiment,and to evaluate the safety of moxibustion therapy.After the completion of the experiment,the data were collected,sorted out and statistically analyzed.Results1 Efficacy evaluation of immune functionAfter 12 weeks of treatment,CD4+T lymphocyte count in the treatment group increased significantly,which was significantly different from that in the control group(P<0.05),suggesting that moxibustion can improve the immune function of the body.The ratio of CD4+/CD8+T lymphocyte in treatment group and control group was higher than that before treatment,but there was no statistical difference between the two groups(P>0.05).2 Efficacy evaluation of immune reconstruction efficiencyAfter 12 weeks of treatment,the effective rate of immune reconstruction was determined according to the changes of CD4+T lymphocytes.The results showed that the effective rate of immune reconstruction was 36.96%in 46 patients in the treatment group,of which 17 were effective and 29 were ineffective.The effective rate of immune reconstruction was 13.04%in 23 patients in the control group,of which 3 were effective and 20 were ineffective.The effective rate of immune reconstruction in the treatment group was significantly higher than that in the control group,and there was a statistical difference between the two groups(P<0.05),suggesting that moxibustion can promote the recovery of immune function and improve the poor state of immune reconstruction.3 Efficacy evaluation of TCM symptomsAfter 12 weeks of treatment,the efficacy was determined according to the overall symptom score.The results showed that the total effective rate of the treatment group was 54.34%,including 8 cases of clinically cured,1 case of markedly effective,16 cases of effective and 21 cases of ineffective,and the total effective rate of the control group was 26.09%,including 0 cases of clinically cured,0 cases of markedly effective,6 cases of effective and 17 cases of ineffective.The efficacy of TCM symptoms in the treatment group was better than that in the control group,and there was statistical difference between the two groups(P<0.05).It suggested that moxibustion could improve patients’ clinical symptoms and quality of life.After 12 weeks of treatment,according to the scores of symptoms,the scores of the treatment group decreased.The scores of chills,dawn diarrhea and loss of appetite in the treatment group decreased more significantly than those in the control group(P<0.05),suggesting that moxibustion has a better effect in improving some symptoms.4 Efficacy evaluation of immune reconstruction-related symptomsAfter 12 weeks of treatment,the efficacy was determined according to the overall immune reconstruction-related symptom score.The results showed that the total effective rate of the treatment group was 67.39%,including 7 cases of clinically cured,0 case of markedly effective,24 cases of effective and 15 cases of ineffective,and the total effective rate of the control group was 47.83%,including 1 cases of clinically cured,0 cases of markedly effective,10 cases of effective and 12 cases of ineffective.There was no significant difference between the treatment group and the control group in the efficacy of immune reconstruction-related symptoms(P>0.05).After 12 weeks of treatment,according to the scores of immune reconstruction-related symptoms,the scores of the treatment group decreased.The scores of cold and diarrhea in the treatment group decreased more significantly than those in the control group(P<0.05),suggesting that moxibustion has a better effect in improving some symptoms.5 Safety evaluation During the clinical observation period of this study,the subjects had good compliance,and no adverse reactions and toxicities related to this study occurred.During the clinical observation period of this study,the subjects had good compliance,and no adverse reactions and no toxic or side effects related to this study occurred.There was no significant change in the vital signs of the subjects before and after treatment.There were no significant abnormalities in blood routine,urine routine,liver function and kidney function before and after treatment,which indicated that moxibustion was a safe and reliable way in promoting immune function without obvious toxic and side effects.Conclusion The results of clinical observation in this study showed that:1 Promoting immune reconstruction:the CD4+T lymphocyte count increased in the treatment group,which was statistically significant compared with the control group(P<0.05).The ratio of CD4+/CD8+T lymphocyte in the treatment group showed an upward trend,but there was no statistical difference between the two groups(P>0.05)The effective rate of immune reconstruction was 36.96%in the treatment group and 13.04%in the control group.There was significant difference between the two groups(P<0.05).2 Improve clinical symptoms:the total effective rate of improving TCM symptoms was 54.34%in the treatment group and 26.09%in the control group.There was significant difference between the two groups(P<0.05).The total effective rate of improving immune reconstruction-related symptoms was 67.39%in the treatment group and 47.83%in the control group.There was no statistical difference between the two groups(P<0.05).The treatment group was superior to the control group in improving the symptoms of chills,dawn diarrhea,loss of appetite,colds and diarrhea.There were statistical differences between the two groups(P<0.05).3 During the clinical observation period of moxibustion treatment,there were no adverse reactions related to research,which was safe and effective. |
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