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目前HAART(高效抗逆转录病毒)疗法的作用靶点主要是抑制HIV(艾滋病病毒)复制,起效顺序是:病毒学(病毒载量下降)、免疫学(CD4细胞升高)、症状学(机会性感染减少);而中药的主要是通过调节或改善患者机体免疫功能,延缓发病、减轻临床症状、提高生存质量;或者减轻抗病毒药的某些毒副作用;但对抑制病毒复制的疗效不明显。中药治疗后,免疫功能改善,临床症状减轻,但病毒载量是否下降,免疫学指标和病毒学指标不一致的现象如何解释,这是目前有关部门和学者关心的问题。该文从理论层面和文献2个方面进行分析,比较中西药治疗艾滋病的疗效作用点之异同,对免疫功能、病毒载量与症状等的相关性进行探讨;大量的中医药治疗艾滋病临床实践表明:免疫功能与病毒载量变化不是1个直接的反向关系(即免疫功能改善后,病毒载量一定会降低);更多的实际情况是免疫功能改善,症状减轻,生活质量提高;但病毒载量不会很快降低;但长期而持续的免疫功能稳定或改善能否使病毒载量不上升或逐步下降,有待于今后大样本、长时间临床观察进行证实。
The current HAART targets are mainly HIV (HIV) replication inhibition in the order of virology (viral load reduction), immunology (CD4 cell elevation), symptoms ( Reduce opportunistic infections); while traditional Chinese medicine is mainly through the regulation or improvement of immune function in patients, delay the onset, reduce clinical symptoms, improve quality of life; or reduce some of the toxic side effects of antiviral drugs; but the effect of inhibiting viral replication is not obvious. After the treatment of traditional Chinese medicine, the immune function is improved and the clinical symptoms are relieved. However, whether the viral load is decreased or not, and how the immunological and virological indexes are inconsistent are explained. This is a concern of the relevant departments and scholars at present. This article analyzes the similarities and differences between Chinese and western medicine in the treatment of AIDS by comparing the two aspects of theory and literature, and discusses the correlation between immune function, viral load and symptoms. A large number of Chinese medicine treatment of AIDS clinical practice shows : Immune function and viral load change is not a direct reverse relationship (ie, immune function improved, the viral load will be reduced); more practical situation is improved immune function, reduce symptoms and improve quality of life; but the virus However, the long-term and continuous improvement of immune function will not increase or decrease the viral load, which needs to be confirmed by large sample and long-term clinical observation in the future.