Aids Common Tcm Syndromes

ObjectiveStudy of syndromes is the base of TCM therapy. At present study of syndromes of AIDS still stays at personal experiences of doctors, and lacks a clinical epidemiologic survey. This study is supported by NSFC and it aims to research symptoms, syndromes and characteristics of tongues of different AIDS people, so as to provide some evidences for the treatment of TCM and know more information of AIDS.Methods1 Theoretical studyIn order to provide the inspiration to the treatment of TCM, theory of hidden exogenous seasonal disease is researched compared with AIDS from pathogenesis, course of invasion and clinical appearances.Literatures are analyzed on syndromes of AIDS available, so to get the present common syndromes.2 Clinical studyAfter the retrospective study on the Africa AIDS people, based on the method of cross-sectional study, 334 AIDS people infected from blood-supply and 175 AIDS people infected from drug abuse are investigated. A questionnaire and a software of syndrome evaluation are used in the research. Meanwhile tongue demonstration is researched through picture-taking combined with analyze of experts. Different people of AIDS are compared on the syndromes, symptoms and characteristics of tongues. At last, discriminate analysis is used on the quantitative diagnosis of AIDS syndromes.Results1 Theoretical study1.1 Theory of hidden exogenous seasonal disease could explain the pathogenesis of AIDS reasonably. The clinical manifestation of AIDS is alike with the hidden exogenous seasonal diseases. Meanwhile it has its own specificity. The theory indicates that to clear the heat, support healthy energy, smooth the Qi of the body and promote blood circulation to remove stagnations of blood should be take attention in the treatment of TCM1.2 Through searching and analyzing the literature from 1988 to 2005 on syndrome of AIDS, we could know that research on syndromes of AIDS is still not enough, and most of the research are based on personal experiences. In the 15 papers 58 types of syndrome appear. 2 Clinical study2.1 249 AIDS samples in Africa are analyzed on the relationships of their WBC,Hb,LY,LY%,CD₄⁺,CD₄⁺%,CD₈⁺,CD₈⁺%,CD₄⁺/CD₈⁺ and the 11 symptoms. The retrospective study appears that LY,LY%,WBC,Hb decline with the decrease of CD₄⁺ cell count and the LY were significantly correlated with CD₄⁺ cell count. Besides, the total scores of the symptoms increase with the decrease of CD₄⁺ cell count and most of the score of single symptoms increase with the decrease of CD₄⁺ cell count. Symptoms of AIDS people in Africa appear debilitation, lymphadenectasis, cough, fever, etc. in order.2.2 In the comparisons among AIDS people in Africa, AIDS people infected from blood-supply and from drug abuse, people infected from blood-supply appear the most severe symptoms. And in the comparison between AIDS people infected from blood-supply and from drug abuse, most the frequencies of syndromes of the latter are lower than the former except damp syndrome and damp-heat syndrome.2.3 Tongue demonstrations of the AIDS people infected from blood-supply and from drug abuse are similar. The two group of AIDS people appear 63.64% and 65.71% separately in the kind of red tongue, 33.64% and 41.14% in the kind of stagnant tongue, 40.45% and 45.14% in the kind of puffy tongue or teech-printed tongue, 35.00% and 26.86% in the kind of fissured tongue. And the two group of AIDS people appear more white fur (71.82% and 69.14% separately) than yellow fur (23.18% and 28% separately). And greasy fur and thick fur are common.2.4 Step by step discriminate analysis is used to set up equations for each syndrome, including syndrome of deficiency of vital energy, deficiency of blood, syndrome with yin asthenia, pulmonasthenia, splenasthenic syndrome, nephrasthenia syndrome, damp syndrome.Conclusions1 Theoretical study1.1 From the whole duration of AIDS, it have many similarities with hidden exogenous seasonal diseases. The theory of hidden exogenous seasonal disease could help us to understand the pathogenesy of AIDS, and to search for more ways in the treatment of TCM. Meanwhile , the theory also provides some way on the early treatment of AIDS.1.2 At present there are only a few clinical researches on the syndromes of AIDS. A consensus on syndromes of AIDS hasn't been formed. Distribution of the syndromes in the literature is disordered and a clinical epidemiologic survey is badly in need.2 Clinical study2.1 CD₄⁺ cell count could be used to estimate pathogenetic condition and prognosis of the patients. LY is an important index to measure immune level. When CD₄⁺ cell count can't be detected LY could take the place.2.2 The characteristics of TCM syndromes of AIDS people infected from blood-supply and from drug abuse are similar. Both of them appear deficiency syndrome accompanied with excess syndrome. Deficient syndromes include deficiency of vital energy, splenic asthenia, renal deficiency, pulmonasthenia, yin asthenia, blood deficiency, hepatic asthenia and deficiency of heart, etc. Sthenia syndromes include phlegmatic hygrosis, toxic heat, humid heat and blood stasis. Different AIDS people could be a little different in symptoms and syndromes because of the period of disease and other factors. And appearances of deficient syndromes will be more obvious with the time goes by.2.3 Tongue demonstrations of the AIDS people infected from blood-supply and from drug abuse are similar. The characteristics could be summarized as four points:red, greasy and thick fur, most of which are white fur, puffy or teech-printed, and stagnant.2.4 From the coefficient of the symptoms in the regression equations, influence of them to the syndrome could be estimated. It could provide evidence for evaluate the diagnostic value of the symptoms and establish some groundwork for standardization of syndromes of AIDS.