Background:To evaluate the efficacy of traditional Chinese medicine(TCM)in treating Acquired Immune Deficiency Syndrome(AIDS)related diarrhoea.Methods:Chinese and English databases(CBM,CNKI,Wanfang Database,PubMed,Web...Background:To evaluate the efficacy of traditional Chinese medicine(TCM)in treating Acquired Immune Deficiency Syndrome(AIDS)related diarrhoea.Methods:Chinese and English databases(CBM,CNKI,Wanfang Database,PubMed,Web of Science,Cochrane Library)were searched up to November 2021.Studies that compared TCM with western medicine were included.RevMan 5.4,Stata 17,and Grading of Recommendations Assessment Development and Evaluation system were used for data analyses.The inclusion and exclusion criteria,quality assessment process,and potential biases were specified.Result:24 randomized controlled trial with a total of 1,766 participants of TCM compared with western medicine were included,12 of which reported random assignment methods.Meta-analyses showed that,TCM was more effective than western medicine in treating AIDS-related diarrhoea[RR=1.32,95%CI(1.26,1.39),P<0.01],internal treatment of TCM[RR=1.37,95%CI(1.28,1.46),P<0.01],external treatment of TCM[RR=1.27,95%CI(1.17,1.39)],internal and external treatment of TCM[RR=1.21,95%CI(1.07,1.37),P<0.01],Shenlingbaizhu Powder/Pill[RR=1.25,95%CI(1.13,1.39),P<0.01],Xielikang Capsules[RR=1.57,95%CI(1.33,1.84),P<0.01],Jianpizhixie Recipe[RR=1.31,95%CI(1.05,1.65),P<0.01],Moxibustion[RR=1.19,95%CI(1.07,1.32),P<0.01],Ginger Moxibustion[RR=1.24,95%CI(1.04,1.47),P<0.01],when compared to using western medicine alone and with significant differences.Conclusion:Shenlingbaizhu Powder/Pill,Xielikang Capsules,Jianpizhixie Recipe,Moxibustion and Ginger Moxibustion had certain advantages in improving the effective rate of AIDS-related diarrhoea,they needed to be further validated by high quality clinical trials.展开更多
OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment...OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment,on the immunological nonresponse(INR)in people living with human immunodeficiency virus(HIV)(PLWH).METHODS:Relevant literature in databases such as China National Knowledge Infrastructure Database(CNKI),Wanfang Digital Journal,Chinese Medical Journal Database(CMJD),Chinese Biomedical Literature Database(CBM),Pub Med,Cochrane,and Embase was reviewed by two independent investigators.Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.RESULTS:Nine randomized controlled trials(RCTs)with 1078 patients were analyzed.Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group[mean difference(MD)=13.51,95%confidence interval(CI):7.42-19.60,P<0.0001].There was no significant difference between the treated and control groups after 3 months(MD=25.31,95%CI:-2.78 to 53.41,P=0.08).However,after 6 and 12 months,the response of the treatment group was superior to the control group(MD=27.45,95%CI:7.09-47.81,P=0.008 and MD=27.34,95%CI:6.31–48.37,P=0.01,respectively).The clinical efficacy of the treatment group was also higher than that of the control group(RR=1.75,95%CI:1.16-2.65,P=0.007).However,CD45 RO and CD45 RA T cell counts did not differ significantly between the two groups(MD=12.37,95%CI:-6.71 to 31.45,P=0.20 and MD=5.67,95%CI:-3.00 to14.35,P=0.20,respectively).CONCLUSION:The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus,is beneficial and has potential use for improving INR in PLWH.However,large-scale RCTs are required to provide evidence for optimal intervention strategies.展开更多
Background:Even with long-term complete suppression of the virus through antiretroviral therapy(ART),people infected with HIV cannot attain optimal immune reconstitution.This phenomenon is called immune reconstitution...Background:Even with long-term complete suppression of the virus through antiretroviral therapy(ART),people infected with HIV cannot attain optimal immune reconstitution.This phenomenon is called immune reconstitution deficiency,there are no effective therapeutic interventions for immune reconstitution deficiency in modern medicine.Objective:To evaluate the efficacy and safety of ART with Shenling Guben Granules Traditional Chinese medicine in boosting immunological reconstitution compared with ART alone.Methods:This was a randomized,double-blind,placebo-controlled,multicenter clinical trial evaluating the efficacy and safety of ART combined with Chinese medicine.The individuals aged 18–65 years with poor immune reconstitution following ART were included in this trial.The primary outcome was a change in the absolute value of CD4^(+)T lymphocytes after 72 weeks of combined ART and Chinese medicine administration.Secondary outcomes included changes in CD4^(+)T lymphocyte functional subpopulations,activated T lymphocyte subpopulations,CD4^(+)T lymphocyte proliferation,and T lymphocyte apoptosis from baseline to after 72 weeks.We also evaluated efficacy at 24-and 48-week intervals to better understand the dynamics of the trial drug’s efficacy.Results:There was a significant increase in CD4^(+)cell counts in groups treated with the Shenling Guben Granules after 24,48,and 72 weeks of treatment(P<0.05),and the difference in CD4^(+)cell counts at 24 weeks of treatment was statistically significant(P=0.010).After 48 and 72 weeks of therapy,the CD4^(+)CD38^(+)cell counts in the Shenling Guben Granules group were significantly higher than in the control group(P<0.05).In the subgroup analysis of CD4^(+)cell counts≥200 cells/mm^(3),the CD4^(+)cell counts in the treatment group were higher than the control group after treatment for 24,48,and 72 weeks(P<0.05).Discussion:CD4 cell counts in HIV/AIDS patients with immunological reconstitution insufficiency can be improved to a certain extent using Shenling Guben Granules.The greater the CD4 cell count at the start,the better the therapy response.Furthermore,Shenling Guben Granules have the efficacy and safety to prevent aberrant immunological activation.A large sample size,long-term follow-up,and multiple efficacy indicators were employed to assess the therapy’s safety.Our findings will lead to new therapeutic alternatives for HIV/AIDS patients suffering from immune reconstitution deficiency.Clinical Trial Registry:Name of the registry:Sundy on promote the reconstruction of Inadequate responders in HIV/AIDS patients after combined antiretroviral therapy by Shen Ling Gu Ben Granules;Chictr.org.cn Identifier:ChiCTR1800015290,registered on March 21,2018(http://www.chictr.org.cn/registry.aspx).展开更多
Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort...Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort study.Methods:Patients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group.The non-moxibustion group received standard western treatment,including 48 weeks of antiretroviral therapy(ART).The moxibustion group received ART combined with moxibusion therapy,administered three times weekly.Each treatment lasted 10 weeks,with four courses completed over 48 weeks,separated by 2-week breaks.At different time points,plasma levels of CD4^(+),CD8^(+),CD45RAt,CD45RO^(+),CD4^(+)CD28^(+),CD8^(+)CD38^(+),and CD4^(+)CD38^(+)were compared between the two groups.Results:A total of 200 eligible patients were included and divided into two groups,with 100 in the non-moxibustion group and 100 in the moxibustion group.At Week 24,the CD4^(+)T cell count was(180.71±79.62)cells/μL in the non-moxibustion group and(218.22±82.02)cells/μL in the moxibustion group.By Week 36,the counts were(204.83±96.78)cells/μuL and(239.35±81.90)cells/μL,respectively.At Weeks 24 and 48,the CD8^(+)T cell and CD45RO^(+)counts were higher in the moxibustion group than in the non-moxibustion group(P<0.05).By Week 48,the CD45RA^(+)count was also higher in the moxibustion group(P<0.05).At Week 24,the CD4^(+)CD25^(+)count was lower in the moxibustion group than in the non-moxibustion group(P<0.05).展开更多
OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency viru...OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.展开更多
基金Supported by National Major Science and Technology Projects of China During the 13th Five-year Plan Period:New Adjuvant Strategies of Traditional Chinese Medicine on Immune Reconstruction for Long-term ART-treated People Living with HIV(No.2017ZX10205501)Science and Technology Project of Hebei Education Department(No.QN2020272)Research Project of Hebei Provincial Administration of Traditional Chinese Medicine(No.2021176).
文摘Background:To evaluate the efficacy of traditional Chinese medicine(TCM)in treating Acquired Immune Deficiency Syndrome(AIDS)related diarrhoea.Methods:Chinese and English databases(CBM,CNKI,Wanfang Database,PubMed,Web of Science,Cochrane Library)were searched up to November 2021.Studies that compared TCM with western medicine were included.RevMan 5.4,Stata 17,and Grading of Recommendations Assessment Development and Evaluation system were used for data analyses.The inclusion and exclusion criteria,quality assessment process,and potential biases were specified.Result:24 randomized controlled trial with a total of 1,766 participants of TCM compared with western medicine were included,12 of which reported random assignment methods.Meta-analyses showed that,TCM was more effective than western medicine in treating AIDS-related diarrhoea[RR=1.32,95%CI(1.26,1.39),P<0.01],internal treatment of TCM[RR=1.37,95%CI(1.28,1.46),P<0.01],external treatment of TCM[RR=1.27,95%CI(1.17,1.39)],internal and external treatment of TCM[RR=1.21,95%CI(1.07,1.37),P<0.01],Shenlingbaizhu Powder/Pill[RR=1.25,95%CI(1.13,1.39),P<0.01],Xielikang Capsules[RR=1.57,95%CI(1.33,1.84),P<0.01],Jianpizhixie Recipe[RR=1.31,95%CI(1.05,1.65),P<0.01],Moxibustion[RR=1.19,95%CI(1.07,1.32),P<0.01],Ginger Moxibustion[RR=1.24,95%CI(1.04,1.47),P<0.01],when compared to using western medicine alone and with significant differences.Conclusion:Shenlingbaizhu Powder/Pill,Xielikang Capsules,Jianpizhixie Recipe,Moxibustion and Ginger Moxibustion had certain advantages in improving the effective rate of AIDS-related diarrhoea,they needed to be further validated by high quality clinical trials.
基金Supported by National Science and Technology Major Project of China During the 13th Five-year Plan Period:New Adjuvant Strategies of Traditional Chinese Medicine on Immune Reconstruction for Long-term ART-treated People Living with HIV(No.2017ZX10205501)Study of AIDS-related Early Biomarkers for Disease Progression and Epidemic Predicting Model(No.2017ZX10201101)the Beijing Excellent Talent Plan(No.2018000021223ZK04)。
文摘OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment,on the immunological nonresponse(INR)in people living with human immunodeficiency virus(HIV)(PLWH).METHODS:Relevant literature in databases such as China National Knowledge Infrastructure Database(CNKI),Wanfang Digital Journal,Chinese Medical Journal Database(CMJD),Chinese Biomedical Literature Database(CBM),Pub Med,Cochrane,and Embase was reviewed by two independent investigators.Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.RESULTS:Nine randomized controlled trials(RCTs)with 1078 patients were analyzed.Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group[mean difference(MD)=13.51,95%confidence interval(CI):7.42-19.60,P<0.0001].There was no significant difference between the treated and control groups after 3 months(MD=25.31,95%CI:-2.78 to 53.41,P=0.08).However,after 6 and 12 months,the response of the treatment group was superior to the control group(MD=27.45,95%CI:7.09-47.81,P=0.008 and MD=27.34,95%CI:6.31–48.37,P=0.01,respectively).The clinical efficacy of the treatment group was also higher than that of the control group(RR=1.75,95%CI:1.16-2.65,P=0.007).However,CD45 RO and CD45 RA T cell counts did not differ significantly between the two groups(MD=12.37,95%CI:-6.71 to 31.45,P=0.20 and MD=5.67,95%CI:-3.00 to14.35,P=0.20,respectively).CONCLUSION:The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus,is beneficial and has potential use for improving INR in PLWH.However,large-scale RCTs are required to provide evidence for optimal intervention strategies.
基金Supported by the State Major Science&Technology Specific Projects(2017ZX10205501)National Nature Science Foundation of China(82174221).
文摘Background:Even with long-term complete suppression of the virus through antiretroviral therapy(ART),people infected with HIV cannot attain optimal immune reconstitution.This phenomenon is called immune reconstitution deficiency,there are no effective therapeutic interventions for immune reconstitution deficiency in modern medicine.Objective:To evaluate the efficacy and safety of ART with Shenling Guben Granules Traditional Chinese medicine in boosting immunological reconstitution compared with ART alone.Methods:This was a randomized,double-blind,placebo-controlled,multicenter clinical trial evaluating the efficacy and safety of ART combined with Chinese medicine.The individuals aged 18–65 years with poor immune reconstitution following ART were included in this trial.The primary outcome was a change in the absolute value of CD4^(+)T lymphocytes after 72 weeks of combined ART and Chinese medicine administration.Secondary outcomes included changes in CD4^(+)T lymphocyte functional subpopulations,activated T lymphocyte subpopulations,CD4^(+)T lymphocyte proliferation,and T lymphocyte apoptosis from baseline to after 72 weeks.We also evaluated efficacy at 24-and 48-week intervals to better understand the dynamics of the trial drug’s efficacy.Results:There was a significant increase in CD4^(+)cell counts in groups treated with the Shenling Guben Granules after 24,48,and 72 weeks of treatment(P<0.05),and the difference in CD4^(+)cell counts at 24 weeks of treatment was statistically significant(P=0.010).After 48 and 72 weeks of therapy,the CD4^(+)CD38^(+)cell counts in the Shenling Guben Granules group were significantly higher than in the control group(P<0.05).In the subgroup analysis of CD4^(+)cell counts≥200 cells/mm^(3),the CD4^(+)cell counts in the treatment group were higher than the control group after treatment for 24,48,and 72 weeks(P<0.05).Discussion:CD4 cell counts in HIV/AIDS patients with immunological reconstitution insufficiency can be improved to a certain extent using Shenling Guben Granules.The greater the CD4 cell count at the start,the better the therapy response.Furthermore,Shenling Guben Granules have the efficacy and safety to prevent aberrant immunological activation.A large sample size,long-term follow-up,and multiple efficacy indicators were employed to assess the therapy’s safety.Our findings will lead to new therapeutic alternatives for HIV/AIDS patients suffering from immune reconstitution deficiency.Clinical Trial Registry:Name of the registry:Sundy on promote the reconstruction of Inadequate responders in HIV/AIDS patients after combined antiretroviral therapy by Shen Ling Gu Ben Granules;Chictr.org.cn Identifier:ChiCTR1800015290,registered on March 21,2018(http://www.chictr.org.cn/registry.aspx).
基金Supported by National Major Science and Technology Projects:2017zX10205501National Public Welfare Industry Scientific Research Special:201507005+1 种基金2023 Beijing TCM Science and Technology Development Fund Project-Youth Project:BjzYQN-2023-05China Academy of Chinese Medical Sciences Outstanding Youth Program:ZZ15-YQ-048.
文摘Objective:To assess the effects of moxibustion on immune reconstitution inflammatory syndrome(IRIS)in patients with acquired immune deficiency syndrome(AIDS)by tracking T-cell subsets over a 48-week prospective cohort study.Methods:Patients with AIDS who had low viral loads and weakened immune systems were divided into a moxibustion group and a non-moxibustion group.The non-moxibustion group received standard western treatment,including 48 weeks of antiretroviral therapy(ART).The moxibustion group received ART combined with moxibusion therapy,administered three times weekly.Each treatment lasted 10 weeks,with four courses completed over 48 weeks,separated by 2-week breaks.At different time points,plasma levels of CD4^(+),CD8^(+),CD45RAt,CD45RO^(+),CD4^(+)CD28^(+),CD8^(+)CD38^(+),and CD4^(+)CD38^(+)were compared between the two groups.Results:A total of 200 eligible patients were included and divided into two groups,with 100 in the non-moxibustion group and 100 in the moxibustion group.At Week 24,the CD4^(+)T cell count was(180.71±79.62)cells/μL in the non-moxibustion group and(218.22±82.02)cells/μL in the moxibustion group.By Week 36,the counts were(204.83±96.78)cells/μuL and(239.35±81.90)cells/μL,respectively.At Weeks 24 and 48,the CD8^(+)T cell and CD45RO^(+)counts were higher in the moxibustion group than in the non-moxibustion group(P<0.05).By Week 48,the CD45RA^(+)count was also higher in the moxibustion group(P<0.05).At Week 24,the CD4^(+)CD25^(+)count was lower in the moxibustion group than in the non-moxibustion group(P<0.05).
基金Supported by National Science and Technology Major Project of China During the 13th Five-year Plan Period:New Adjuvant Strategies of Traditional Chinese Medicine on Immune Reconstruction for Longterm ART-treated People Living with HIV(2017ZX10205501)Effects of Traditional Chinese Medicine on Intestinal Bacterial Community Structure of AIDS Patients(2017ZX10205501-001-010)National Natural Science Foundation of China:Immune Mechanism of Immunological Non-responders of HIV/AIDS Treated with Traditional Chinese Medicine from Immune Activation and Toll like Receptor Signal Pathway(No.81503571)。
文摘OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.
