中医药治疗艾滋病生存剖析.docVIP

中医药治疗艾滋病生存剖析 　　【摘要】目的探讨中医药治疗HIV/AIDS的生存时间及其影响因素。方法对进行中医药治疗的469例HIV/AIDS患者的临床资料进行分析，采用寿命表法分析患者生存时间；运用Cox 等比例风险回归法分析影响患者生存时间的因素。结果患者的中位生存时间为：72.25个月。单因素分析显示，对生存时间有显著影响的因素有：血红蛋白、血肌酐（Cr）、谷草转氨酶（AST）、CD4、卡洛夫斯基积分、乏力、裂纹舌、细脉、中医辨证分型；多因素分析结果显示：血肌酐、AST、细脉和中医辨证分型更具有决定性意义。结论血红蛋白、CD4、卡洛夫斯基积分是艾滋病患者生存时间的保护因素，而血肌酐、AST、乏力、裂纹舌、细脉、中医辨证分型是危险因素，临床上应采取相应措施进行干预，以提高患者生存时间和生活质量，降低病死率。 　　【关键词】获得性免疫缺陷综合征；中医药疗法；生存分析；生存时间；影响因素 　　中图分类号：R512.91文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.06.003 　　【Abstract】ObjectiveTo explore the survival time of HIV/AIDS patients treated by traditional Chinese medicine（TCM）and its influencing factors.MethodsThe clinical data of 469 HIV/AIDS patients who were treated with TCM were analyzed.Then，the life table method was used to analyze the patients’ survival time，and the factors affecting the patients’ survival time were analyzed by Cox and other proportional risk regression.ResultsThe median survival time of the patients was 72.25 months.Univariate analysis showed that the factors that significantly influenced the survival time were hemoglobin，serum creatinine（Cr），aspartate aminotransferase（AST），CD4，Karovsky score，fatigue，wrinkled tongue，thready pulse and TCM syndrome differentiation. In addition，the results of multifactor analysis showed that Cr，AST，thready pulse and TCM syndrome differentiation were more decisive.Conclusion Hemoglobin，CD4 and Karovsky integral are protective factors for survival time of patients with AIDS，while Cr，AST，fatigue，wrinkled tongue，thready pulse and TCM syndrome differentiation are risk factors.In clinical pratice，corresponding measures should be taken to improve the survival time and quality of life，and reduce mortality. 　　【Key words】AIDS；TCM；survival analysis；survival time；influencing factors 　　目前，中医治疗艾滋病的疗效评价，多以改善临床症状和体征，提高生存质量为主，而对于中医药治疗艾滋病的生存期及其影响因素的研究即生存分析研究，国内外尚无报道。在前期的研究中，我们探索中医药治疗AIDS过程中影响患者生存的因素。通过采用回顾性队列研究方法，对“中医药治疗艾滋病数据库”及“艾滋病综合防治数据信息系统”的人口学特征和行为特征以及入组中医治疗前的实验室检查指标进行统计分析，结果发现病例死亡与CD4+T细胞、卡洛夫斯基积分、谷丙转氨酶（ALT）、谷草转氨酶（AST）、血红蛋