【摘要】 目的探索艾滋病(AIDS)中医证候及其分布和演变规律。方法选择我国AIDS流行的10个主要地区13家医疗单位2 237例患者,采用现场访谈的形式,根据艾滋病四诊信息采集表收集信息进行中医证候学调查。总结不同感染途径患者的中医证候分布情况,并根据不同病期、不同干预手段,采用潜变量转移模型分析患者证型的演变规律。结果 AIDS患者有偿供血者以脾气虚弱、脾肾阳虚为主;性传播者以肝郁气滞、脾肾阳虚为主;静脉吸毒者以脾气虚弱、气阴两虚为主。不同病期:人类免疫缺陷病毒(HIV)感染者中,所有证型在5个时点向气阴两虚证转移最多;AIDS患者中,所有证型在5个时点向脾肾阳虚证转移最多。不同干预手段:中药治疗的HIV感染者中,肝郁气滞、脾气虚弱、气阴两虚向湿热蕴结转移较少,湿热蕴结向肝郁气滞和气阴两虚转移较多;高效抗逆转录病毒治疗(HAART)后的AIDS患者各证型分类均以30%左右比例向气阴两虚证转移;中西医结合治疗的AIDS患者各证型分类均以30%～40%比例向气阴两虚证转移,10%左右比例向脾肾阳虚转移。结论 HIV感染者以脾气虚弱为主,AIDS患者以脾肾阳虚为主;证候演变呈气虚→气虚夹湿、阴虚火热→气阴两虚→阳虚过程。更多还原

【Abstract】 Objective To observe the distribution and development rules of Chinese medicine syndromes in human immunodeficiency virus/acquired immune deficiency sy ndrome(HIV/AIDS) patients.Methods Totally 2237 HIV/AI DS patients from 13 hospitals of 10 major AIDS epidemic regions in China were selected.Chinese medicine synd romes of AIDS were collected and surveyed with the diagnostic information collec tion form and field interviews.The distribution and development rules of Chines e medicine syndromes were analyzed according to the latent variable transfer mod el.Results The main syndromes in AIDS suffering from p aid blood donors were spl een qi deficiency and spleen-kidney yang deficiency.The main syndrome in sexua l transmission of AIDS was liver depression and qi stagnation.The main syndromes in intravenous drug abusers with AIDS were spleen qi deficiency and qi-yin def iciency.Most of HIV infected patients and AIDS patients shifted to qi-yin defic iency and spleen-kidney yang deficiency respectively at the five time points.Fe wer HIV infected patients with syndromes of liver depression and qi stagnation,s pleen qi deficiency and qi-yin deficiency shifted to damp-heat brewing and bin ding syndrome and most HIV infected persons with damp-heat brewing and binding sy ndrome shifted to syndrome of liver depression and qi stagnation or qi-yin defic iency after Chinese medication.Thirty percent of AIDS shifted to qi-yin deficie ncy syndrome after the highly active antiretroviral therapy(HAART).Thirty to fo rty percent of AIDS shifted to qi-yin deficiency syndrome and ten percent shift ed to spleen-kidney yang deficiency syndrome after integrative medicine therapy. Conclusion The main Chinese medicine syndrome in HIV i nfected persons and AIDS p atients is spleen qi deficiency and spleen-kidney yang deficiency respectively. The progress of Chinese medicine syndrome development is qi deficiency,qi defic iency with dampness,yin deficiency with fire heat,qi-yin deficiency and yang deficiency.更多还原