张雪 蒋自强 陈丽华 孙燕 杨萱 王双利 安永辉 张晓华 焦敏 张静

摘要：目的 研究艾滋病癡呆复合征（ADC）各证型与不同病情程度、年龄、CD4+T细胞计数及感染途径的关系。方法 对186例ADC患者进行辨证，分析各证型在不同病情程度、不同年龄、不同CD4+T细胞计数及不同感染途径中的分布情况。结果 肾虚髓减证、肝肾阴虚证、心脾两虚证、痰浊阻窍证、气虚血瘀证分别为48、51、15、37、35例。病情程度以中、重度居多，肝肾阴虚证多见；不同病情程度中各证型分布比较，差异有统计学意义（χ2=82.495，P=0.000）。不同年龄段中以肾虚髓减证、肝肾阴虚证多见，患者多分布于>50～60岁和>60岁2个年龄段；不同年龄段中各证型分布比较，差异有统计学意义（χ2=72.710，P=0.000）。CD4+T细胞计数不同分层中各证型分布比较，差异有统计学意义（χ2=66.778，P=0.000）。血液途径感染以肾虚髓减证、气虚血瘀证为主，性途径感染以肝肾阴虚证为主。结论 CD4+T细胞计数分层、年龄段、病情程度和感染途径会影响ADC证型分布。

关键词：艾滋病痴呆复合征；中医证型

DOI：10.3969/j.issn.1005-5304.2017.03.004

中图分类号：R259.933 文献标识码：A 文章编号：1005-5304（2017）03-0014-04

TCM Syndrom Type Distribution Characteristics for 186 Cases of AIDS Dementia Complex ZHANG Xue1， JIANG Zi-qiang2， CHEN Li-hua2， SUN Yan1， YANG Xuan1， WANG Shuang-li1， AN Yong-hui1， ZHANG Xiao-hua1， JIAO Min1， ZHANG Jing1 （1. The Sixth Peoples Hospital of Zhengzhou， Zhengzhou 450000， China； 2. Institute of AIDS， The First Affiliated Hospital of Henan University of TCM， Zhengzhou 450000， China）

Abstract： Objective To study the relationship between different syndromes of AIDS dementia complex （ADC） and different disease severity， age， CD4+ T cell count and infection. Methods Totally 186 patients with ADC were classified into different syndrome types， and the distribution in different degree of disease， different age， different CD4+ T cell count and different routes of infection was analyzed. Results There were 48， 51， 15， 37 and 35 cases of deficiency of kidney and marrow， yin deficiency of liver and kidney， deficiency of heart and spleen， syndrome of phlegm obstruction， syndrome of qi deficiency and blood stasis， respectively. Moderate and severe degrees with yin deficiency of liver and kidney were more common. There was statistical significance in the distribution of different syndromes in different degree of disease （χ2=82.495， P=0.000）. Deficiency of kidney and marrow， yin deficiency of liver and kidney were more common in different age groups. The distribution of the syndrome types in different age groups was statistically significant （χ2=72.710， P=0.000）， the patients were mainly in two age groups of >50–60 years old and >60 years old. The distribution of the syndrom types in diffenrent CD4+ T cell count stratum was statistically significant （χ2=66.778， P=0.000）. Blood pathway infection mainly included deficiency of kidney and marrow and syndrome of qi deficiency and blood stasis， sexual pathogens mainly yin deficiency of liver and kidney. Conclusion CD4+T cells layers， age group， progression of disease and transmission way are the influencing factors of syndrom type.

Key words： AIDS dementia complex； TCM syndrom type

基金项目：河南省中医药科学研究专项课题（2014ZY02087）

通讯作者：杨萱，E-mail：xzh_0026@sina.com

艾滋病痴呆复合征（acquried immune deficiency syndrom dementia complex，ADC）是人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染中枢神经系统而引起，是获得性免疫缺陷综合征（acquried immune deficiency syndrom，AIDS）恶化的信号[1]。近年来，越来越多的AIDS患者接受了高效抗反转录病毒治疗（highly active antiretroviral therapy，HAART），生存期得到延长，ADC患者数量也逐年上升[2]。HAART是目前西医对ADC唯一有效的治疗方法，但只降低了病死率，无法改善大脑认知功能缺失，严重影响患者生活质量[3]。经过多年研究，中医在治疗AIDS方面积累了丰富的临床经验[4]，越来越受到医学界重视。我们……