摘要
目的客观评价中药汤剂联合HAART对HIV/AIDS患者免疫重建的影响,为中西医协同治疗HIV/AIDS患者提供可靠的循证医学证据。方法检索PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普数据库以及中国生物医学数据库所有关于中药汤剂联合HAART HIV/AIDS患者的随机对照试验,时限为建库至2021年8月。两名研究员独立负责文献筛选、信息提取、质量评价,最后通过Review Manager 5.4以及Stata 16软件统计分析。结果共纳入20篇随机对照试验,包括1785例患者。相比单纯HAART,中药汤剂联合HAART显著提高HIV/AIDS患者CD4细胞计数(MD=48.96,95%CI:30.94~66.99,P<0.00001),治疗6、9和12个月,联合治疗组均优于单纯HAART组。中药汤剂联合HAART显著改善CD45RO细胞计数(MD=19.93,95%CI:5.92~33.94,P=0.005)、改善CD45RA细胞计数(MD=16.14,95%CI:4.94~27.34,P=0.005)及改善CD8细胞计数(MD=-22.55,95%CI:-33.57~-11.53,P<0.0001)。结论中药汤剂联合HAART以持续稳定的方式提高HIV/AIDS患者的CD4细胞计数,调节T淋巴细胞亚群,促进免疫功能的重建,但由于纳入研究的研究方法存在一定的局限性,上述结论需要更多高质量的临床研究来验证其可靠性。
Objective To evaluate the effect of Chinese herbal decoction combined with HAART on immune reconstruction among people living with HIV,aiming to provide evidence-based strategy development for the combination therapy of traditional Chinese and western medicine in the treatment of HIV/AIDS.Methods We searched all randomized controlled trials of Chinese herbal decoction combined with HAART in the treatment of HIV/AIDS among PubMed,Cochrane Library,Embase,CNKI,WanFang,VIP,and CBM databases from inception to August 2021.Two researchers processed literature screening,information extraction and quality assessment.Statistical analysis was performed through Review Manager 5.4 and Stata 16 software.Results A total of 20 randomized controlled trials involving 1,785 patients were included.Compared with the HAART alone,Chinese herbal decoction combined with HAART significantly increased CD4 cell count(MD=48.96,95%CI:30.94-66.99,P<0.00001).After 6,9 and 12 months of treatment,the combined treatment group was all better than the HAART alone group.Chinese herbal decoction combined with HAART significantly improved the CD45RO cell count(MD=19.93,95%CI:5.92-33.94,P=0.005),the CD45RA cell count(MD=16.14,95%CI:4.94-27.34,P=0.005),and the CD8 cell count(MD=-22.55,95%CI:-33.57--11.53,P<0.0001).Conclusions Chinese herbal decoction combined with HAART can increase the CD4 cell count in a consistent and stable manner,regulate T lymphocyte subset and promote immune reconstruction of people living with HIV.However,due to limitations of quantity and methodology of included studies,the above conclusions need more high-quality clinical trials to verify its reliability.
作者
钱珍珍
张予晋
谢小丽
王军文
QIAN Zhenzhen;ZHANG Yujin;XIE Xiaoli;WANG Junwen(Hunan University of Chinese Medicine,Changsha 410208,China;The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2022年第8期990-994,共5页
Chinese Journal of Aids & STD
基金
国家科技重大专项项目(2017ZX10205502-002-002)
湖南省中医药科研计划项目(2020010)。
