Effect Of Shenling Fuzheng Capsule Combined With HAART On Immune Activation Of CD4~+CD38~+T And CD8~+CD38~+T In Patients With Spleen Deficiency And Humidity

Objective:The aim of this study was to investigate the effects of Shenling Fuzheng Capsule on CD4~+T and CD8~+T cell counts and their immune activation marker CD38 in HAART-treated HIV/AIDS patients.Methods:According to the recommendation of clinical epidemiologists,110 patients with HIV/AIDS who met the inclusion criteria from July2017 to July 2018 were enrolled in the Outpatient Care Center of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine.They were divided into two groups by random number table,55 in each group of Chinese and Western medicine and 55 in HAART group.In the experiment,there were 1 migrant worker,3 drug side effects,1 poor compliance and 5 abscission in HAART group;2 migrant workers,1 drug side effect,2 automatic withdrawal,9 poor compliance and 14 abscission in Chinese and Western medicine group;91 cases completed the experiment,50 cases in HAART group and 41 cases in Chinese and Western medicine group.The HAART group was given a first-line treatment regimen AZT/TDF+3TC+EFV/NVP or a second-line treatment regimen AZT/TDF+3TC+LPV/r.Medication method:AZT,300mg,Bid;TDF,300mg,Qd;3TC,300mg,Qd;EFV,600mg,Qn taking on an empty stomach before bed;NVP,200mg,Qd first 14 days,Bid post;LPV/r(1 tablet with LPV 200 mg,RTV 50 mg),2 tablets/time,Bid.The Chinese and Western Medicine Group added Shenling Fuzheng Capsule(0.37g×4 tablets,Tid)on the basis of HAART.The course of treatment is 6 months.Flow cytometry was used to determine the frequency of CD4~+CD38~+T and CD8~+CD38~+T cells in peripheral blood before and after treatment,CD4~+T,CD8~+T cell count,HIVVL,blood routine,liver and kidney function of HIV infection were collected before and after treatment.The change of CD4~+T and CD8~+T cell counts and the expression of CD4~+CD38~+T and CD8~+CD38~+T cells were compared before and after treatment and the HIVVL,drug safety in the two groups were analyzed by using SPSS 22 software.Results:1.Before the intervention,the CD4~+T cell count of the HAART group was328.56±224.94/?l and the Chinese and Western medicine group was341.78±154.94/?l,the difference was not statistically significant(P>0.05).After intervention,the CD4~+T cell count in the HAART group was(603.54±245.31)/?l and the Chinese and Western medicine group was(613±259.07)/?l,The difference was not statistically significant(P>0.05).The HIV infection was compared between the two groups,The CD4~+T cell counts which before and after treatment in both groups were all increased,the differences were statistically significant(P<0.05).2.Before the intervention,the CD8~+T cell count of the HAART group was(1155.56±447.25)/?l and the Chinese and Western medicine group was(1077.90±441.42)/?l,the difference was not statistically significant(P>0.05).After intervention,the CD8~+T cell count in the HAART group was(806.24±441.42)/?l and the Chinese and Western medicine group was(784.17±497.19)/?l,The difference was not statistically significant(P>0.05).The HIV infection was compared between the two groups,The CD8~+T cell counts which before and after treatment in both groups were all decreased,the differences were statistically significant(P<0.05).3.Before the intervention,the frequency of CD8~+CD38~+T cells and CD4~+CD38~+T cells ware(21.57±7.26)%and(22.87±6.64)%in the HAART group,the frequency of CD8~+CD38~+T cells was(19.73±4.88)%and CD4~+CD38~+T cells was(21.20±7.34)%in the Chinese and Western,None of these were statistically significant(P>0.05).After intervention,the frequency of CD8~+CD38~+T cells and CD4~+CD38~+T cells ware(10.29±6.81)%and(11.23±6.37)%in the HAART group,the frequency of CD8~+CD38~+T cells was 8.79±4.76%and CD4~+CD38~+T cells was(9.51±6.23)%in the Chinese and Western,None of these were statistically significant(P>0.05).After treatment,the frequency of CD38 which expressed on CD8~+T and CD4~+T cells in both groups were decreased,These are statistically significant(P<0.05).4.After treatment,the HIVVL of the HAART group and the Western and Western medicine group were lower than the detection level(HIVVL<20copies/ml).5.After treatment,there were 2 cases of WBC abnormality,10 cases of HGB abnormality,3 cases of PLT abnormality,1 case of ALT abnormality and2 cases of Cr abnormality in HAART group,and there were 2 cases of WBC abnormality,13 cases of HGB abnormality,4 cases of PLT abnormality,1 case of ALT abnormality and 2 cases of Cr abnormality in Chinese and Western medicine group.These differences were not statistically significant(P>0.05).After treatment,18 cases of total bilirubin abnormality in HAART group and 6cases of total bilirubin in Chinese and Western medicine group were statistically significant(P<0.05).Conclusion:Shenling Fuzheng Capsule can improve the toxicity and side effects of HAART on liver,and does not weaken the inhibition of HAART on HIV replication.It has no significant effect on the increase of CD4+T,CD8+T cell count and the ratio of CD4+CD38+T and CD8+CD38+T cells related to immune activation in HIV/AIDS patients with spleen deficiency and dampness excess.