摘要
目的探讨中医药治疗对HIV感染者CD4^(+)T淋巴细胞计数长期变化的影响。方法以“艾滋病综合防治数据信息系统”和《中医中药治疗HIV感染者项目数据库》为数据来源,进行回顾性队列研究,收集河南省三个中医项目地区的HIV感染者的信息及随访期间的CD4^(+)T淋巴细胞计数。参与中医项目的HIV感染者为中医治疗组,未参与中医治疗的HIV感染者为非中医治疗组。队列开始时间为中医项目入组时间(2004年、2006年、2009年、2015年),队列结束时间为2021年10月1日或者随访15年,二者中先到的日期为队列结束时间,按照中医治疗组和非中医治疗组队列开始时间一致的匹配原则,1∶1随机匹配两组病例。通过构建多个线性混合效应模型选择出最优线性混合效应模型,并对最优模型进行诊断。运用优模型分析中医药对CD4^(+)T淋巴细胞计数变化的影响。结果本研究共纳入2078例HIV感染者,两组CD4^(+)T淋巴细胞计数年变化趋势图显示,CD4^(+)T淋巴细胞计数<200个/μL、200~349个/μL和350~500个/μL的HIV感染者随时间变化有缓慢上升趋势。以更符合正态分布的CD4^(+)T淋巴细胞计数平方根构建多种线性混合效应模型,通过赤池信息量准则筛选出最优模型为lm2模型。经过检验,最优线性混合效应模型拟合度良好。最优线性混合效应模型结果显示,组内相关系数ICC值为0.53,中医非中医组别系数为1.83,性别系数为0.81,文化程度系数为0.60,抗病毒治疗组别系数为0.04,参与中医治疗、女性、参与抗病毒治疗、文化程度高与CD4^(+)T细胞计数平方根呈正相关,且差异有统计学意义(P<0.05)。结论中医药治疗可提高艾滋病患者CD4^(+)T淋巴细胞计数。
Objective To investigate the effect of Traditional Chinese Medicine(TCM)on the long⁃term change of CD4^(+)T lymphocyte count in HIV⁃infected patients.Methods A retrospective cohort study was conducted to collect the information of HIV/AIDS patients and the CD4^(+)T lymphocyte count in three TCM project areas in Henan province,using AIDS Comprehensive Prevention Data Information System and TCM Treatment HIV/AIDS Project Database as data sources.The HIV⁃infected people who participated in the TCM project were the TCM treatment group,and the HIV⁃infected people who did not participate in the TCM treatment were the non⁃TCM treatment group.The start time of the cohort was the enrollment time of the Chinese medicine program(2004,2006,2009,2015),and the end time of the cohort was October 1,2021 or follow⁃up for 15 years.The first date of the two was the end time of the cohort,according to the matching principle that the start time of the TCM group and the non⁃TCM group was the same.The two groups were randomly matched 1∶1.The optimal linear mixed effect model is selected by constructing several linear mixed effect models,and the optimal model is diagnosed.The effect of TCM on CD4^(+)T lymphocyte count was analyzed by optimal model.Results A total of 2078 HIV⁃infected patients were included in this study.The annual change trend of CD4^(+)T lymphocyte count in the two groups showed that the CD4^(+)T lymphocyte count.The HIV infection rate of less than 200 cells/μL,200~349 cells/μL and 350~500 cells/μL increased slowly over time.A variety of linear mixed effect models were constructed with the count square root of CD4^(+)T lymphocytes more in line with normal distribution,and the optimal model was selected as lm2 model by Akaike information information criterion.The results show that the optimal linear mixed effect model has a good fit.The results of the optimal linear mixed effect model showed that the ICC value of the intra⁃group correlation coefficient was 0.53,the coefficient of TCM non⁃TCM group was 1.83,the coefficient of gender was 0.81,the coefficient of education level was 0.60,and the coefficient of antiviral treatment group was 0.04.Participation in TCM treatment,female participation in antiviral therapy,and high education level were positively correlated with the square root of CD4^(+)T cell count and had statistical significance(P<0.05).Conclusion Chinese medicine can increase the CD4^(+)T lymphocyte cell count in AIDS patients.
作者
贾皇超
刘学伟
金艳涛
许前磊
李鹏宇
马彦民
郭会军
JIA Huangchao;LIU Xuewei;JIN Yantao;XU Qianlei;LI Pengyu;MA Yanmin;GUO Huijun(The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China;Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China;Henan Center for Disease Control and Prevention,Zhengzhou 450000,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2024年第2期200-208,共9页
The Chinese Journal of Dermatovenereology
基金
国家自然科学基金项目(81873187)
中原领军人才项目(ZYYCYU202012119)
河南省中医药科学研究专项课题(No.2024ZY2034)
河南省科技攻关项目(232102311207)。
