Clinical Observation On The Effect Of Regulating Intestinal Flora With Traditional Chinese Medicine On Improving The Immune Reconstitution Insufficiency Of AIDS

Objective:With the development of the related research on the therapy of AIDS(acquired immune deficiency syndrome,AIDS)with traditional Chinese medicine,increasing patients have improved their immune function,clinical symptoms and quality of life.Immune dysfunction is one of the difficulties in the treatment of AIDS,The relationship between intestinal microbial changes and immune dysfunction is also one of the research focuses.Therefore,in order to explore the effect of traditional Chinese medicine treatment on the intestinal flora and immune function of AIDS patients,based on the basis of previous work,this study selected Shenlingguben immune granule,Artesunate tablet and Moxibustion combined anti-retroviral therapy,respectively,to observe and analyze the changes of intestinal microflora in patients with incomplete immune reconstitution after ART(anti-retroviral therapy,ART),and to explore the way of adjusting intestinal microflora by traditional Chinese medicine,so as to provide a new way to treat AIDS patients with incomplete immune reconstitution.Methods:A total of 45 patients with post-ART immunodeficiency were selected by the order of visit from "The 13th five-year plan"—"Study on Chinese medicine promoting the new program of post-ART immune function reconstruction of AIDS patients".Among them,Guangzhou Eighth People’s Hospital:30 cases;The first affiliated hospital of Henan University of traditional Chinese medicine:15 cases.According to the different treatment plan,the patients were divided into three groups:Shenlingguben immune granule group(group A,n=15):Shenlingguben immune granule+ART;Artesunate tablet group(group B,n=15):Artesunate Tablet+ART;Moxibustion group(group C,n=15):Moxibustion+ART.The immune function index(CD4+T lymphocyte count),safety index and 16rRNA sequence of stool samples were detected at baseline and 24 weeks.At the end of the trial,we analyzed the immune function index and the safety index,and analyzed the diversity of the composition and abundance of each group of microbiome by gene sequencing technology and biological cloud platform,explore the relationship between the changes and immune function.Results:1.General Data:the body weight of group A and B showed a decreasing trend after treatment,there was no significant difference(P>0.05),and the body weight of group C increased significantly(P<0.05).2.Diversity of intestinal flora:1)effective sequences:after quality control screening,a total of 3907000 effective sequences were obtained,the average length was 18675,the minimum sequence number of samples was 42344 in group A,21391 in group B and 14232 in group C.2)Alpha diversity and Beta diversity:there was no significant difference in Alpha diversity and Beta diversity in group A or group B before and after treatment(P>O.05);sobs index was significantly higher in group C after treatment(P<0.05),chao and ace index were significantly higher(P<0.01),and Beta diversity was not significantly different before and after treatment(P>0.05).3)the dominant species at the level of phylum:group A:p_Bacteroidota,p_Firmicutes,p_Proteobacteria,p_Fusobacteriota,p_Actinobacteriota,etc;group B:p_Bacteroidota,p_Firmicutes,p_Proteobacteria,p_Fusobacteriota,p_Actinobacteriota,etc;group C:p_Firmicutes,p_Bacteroidota,p_Proteobacteria,p_Actinobacteriota,p_Fusobacteriota,et al.4)different species of intestinal flora before and after treatment:group A:p_Patescibacteria significantly decreased(P<0.05),g_Sutterella significantly increased(P<0.05);group B:p_Verrucomicrobiota significantly increased(P<0.05);group C:p_Fusobacteriota,g_Lachnoclostridium,g_Fusobacterium significantly increased(P<0.01)and g_Megamonas,g_Faecalibacterium,g_Roseburia significantly increased(P<0.05).3.Immune function:after 24 weeks of treatment,the count of CD4+T lymphocyte in group A was significantly increased(P<0.05),the effective rate of immune reconstruction was 23.08%,effective in 3 cases,stable in 6 cases,ineffective in 4 cases;There was no significant difference(P>0.05)in the count of CD4+T lymphocyte in group B,the effective rate of immune reconstitution was 30.77%,effective in 4 cases,stable in 5 cases,ineffective in 4 cases,and the count of CD4+T lymphocyte in group C was significantly decreased(P<0.05),the effective rate of immune reconstitution was 7.14%,effective in 1 case,stable in 2 cases and ineffective in 11 cases.4.Safety analysis:no serious adverse reactions related to the study occurred,and all vital signs were within the normal range.Conclusion:1.Compared with the dominant species in healthy population,the abundance of Fusobacteriota was higher in AIDS patients after ART.2.Shenlingguben immune granule can enhance the immune function,increase the CD4+T lymphocyte count and promote the growth of intestinal beneficial bacteria such as Sutterella.Artesunate tablets can promote growth of beneficial bacteria such as Verrucomicrobiota.Moxibustion can regulate the level of CD4+T lymphocyte in patients after ART and improve the diversity of intestinal flora.The aim of this study is to improve the level of CD4+T lymphocyte in patients with immune reconstitution insufficiency.Probiotics can alleviate patients’ gastrointestinal symptoms such as abdominal pain,diarrhea,nausea and vomiting,improve patients’intestinal immune function,reduce chronic inflammatory reaction,delay the disease process of AIDS.3.Shenlingguben immune granule,Artesunate tablet and Moxibustion had no serious adverse reactions,which was safe and feasible.