用中医治疗艾滋病.ppt

FundamentalTherapeuticPrinciplesintheTreatmentofAIDSUsingChineseMedicine JohnF MooreSIOMSecondYearPresentation2007 用中医治疗艾滋病 Objective TointroducetheetiologyandpathophysiologyofAIDSfromabiomedicalandChineseMedicalperspectiveusingportionsoftheClassicsandmodernclinicaldiscussion TodiscussthemostfrequentlyseenclinicalpresentationsofAIDS Tointroduceclinicallyrelevantherbaltreatmentmethodsforthesepresentations Pandemic AIDSisachronic incurable viraldiseasewhichdestroysthebody sadaptive acquired immunesystem leavingitvulnerabletomyriadopportunisticinfections HIV HumanImmunodeficiencyVirus thevirusthatcausesAIDS istransmittedviabodyfluids blood semen vaginalfluid pre ejaculate breastmilk fromoneinfectedpersontoanother Modesoftransmission unprotectedsexualintercourse IVneedlestick MTCT mothertochildtransmissionviabirth breastfeeding SomeSoberingAIDSStatistics Globally between33 4and46millionpeoplecurrentlylivewithHIV UNAIDSandtheWHOestimatethatAIDShaskilledmorethan25millionpeoplesinceitwasfirstrecognizedin1981 makingitoneofthemostdestructiveepidemicsinrecordedhistory Morethan64 ofallpeoplelivingwithHIVareinsub SaharanAfrica asaremorethanthreequarters 76 ofallwomenlivingwithHIV InNorthAmerica anestimated1 4millionpeopleareinfected TheU S had1 2millionpeoplelivingwithHIVlastyear TheU S thereforeranksamongthetop10countriesintermsofinfectedpeople http en wikipedia org wiki AIDS http en wikipedia org wiki Image HIV Epidem png PrevalenceofAdultHIVInfectionWorldwide 2005 JointUnitedNationsProgramonHIV AIDS WhatexactlyisImmunity Strictdefinition Nonsusceptibilitytotheinvasiveorpathogeniceffectsofforeignmicroorganisms ortothetoxiceffectofantigenicsubstances 1 Aconditionofbeingabletoresistaparticulardisease especiallythroughpreventingdevelopmentofapathogenicmicroorganism orbycounteractingtheeffectsofitsproducts 21 http www online medical dictionary org omd asp q immunity2 http www nlm nih gov medlineplus mplusdictionary html HIV AIDS Immunity InordertounderstandthepathomechanismofHIV AIDS weneedtounderstandthebasicsoftheimmunesystem StructureoftheImmuneSystem IMMUNESYSTEM INNATEIMMUNITYGenericImmunitycommontoallanimalandplantlife Immediatedefenseagainstinfection Short termprotection ACQUIRED ADAPTIVE IMMUNITYImmunitywith memory thatprovideslong lastingprotectionforthehostagainstfuturepathogens NATURALLY ARTIFICIALLY MATERNAL PASSIVE INFECTION ACTIVE ANTIBODYTRANSFER PASSIVE IMMUNIZATION ACTIVE AcquiredImmunity Cell MediatedImmunity theaspectoftheimmunesystemthatinvolvestheactivationofmacrophages naturalkiller NK cells specificcell destroyingT lymphocytes andthereleaseofvarioussecretionsinthedefenseofthehostagainstapathogen Immunitywith memory Inordertofunctionproperly thecell mediatedimmunesystemreliesuponthechemicaldirectionoftheT Helper CD4 cellstohuntdownanddestroyinfectiousorganisms ImmuneSystemAgents Interferon Interferon naturalproteinsproducedbythecellsoftheimmunesystemofmostvertebratesinresponsetochallengesbyforeignagentssuchasviruses bacteria parasites andtumorcells Interferonassiststheimmuneresponsebyinhibitingviralreplicationwithinothercellsofthebody Itcanalsostimulatetheactivityoflymphocytes ImmuneSystemAgents T Cells T Cells Whitebloodcellsknownaslymphocytesthatplayacrucialroleincell mediatedimmunity T HelperCells NaturalKillerCells T MemoryCells etc Thefoundationoftheacquired adaptiveimmunesystem T Helper CD4 cellsareresponsibleforgoverningtheactivityofotherlymphocytesandassuchareacrucialpartoftheimmunesystem ImmuneSystemAgents Phagocytes Phagocyte acellthatingestsanddestroysforeignmattersuchasmicroorganismsordebrisviaaprocessknownasphagocytosis Theycanalsoinduceapoptosisofnormalandtumorcellsandproduceotherimmunestimulating modulatingsubstances The frontline ofthebody sdefensesagainstimmuneinfection HIV T Helper CD4 Cells HIV thevirusthatcausesAIDS replicatesitselfbyinvadingahostT HelperCell exploitingitsgeneticmaterial reproducingviralreplicatesofitself andkillingthehostcellintheprocess WithoutadequatenumbersofT HelperCells thebody scell mediatedimmunesystemfailsandopportunisticinfectionsproliferate Astheviruscontinuestoreproduce moreT Cellsaredestroyed ultimatelyleadingtotheircompleteannihilationandthefunctionaldestructionoftheentireimmunesystem http www wellesley edu Chemistry Chem101 hiv tcells hiv jpg HIVTransmissionMechanism T Helper CD4 Cell HIVParticle HIVViralLoadvs CD4 TLymphocyteCountOvertheUntreatedCourseofDisease http en wikipedia org wiki Image Hiv timecourse png CD4 TLymphocytecount cells mm HIVRNAcopiespermLofplasma TheStagesofAIDS In1990 theWorldHealthOrganization WHO groupedtheseinfectionsandconditionstogetherbyintroducingastagingsystemforpatientsinfectedwithHIV 1 Mostoftheseconditionsareopportunisticinfectionsthatareeasilytreatableinhealthypeople StageI HIVdiseaseisasymptomaticandnotcategorizedasAIDSStageII includesrecurrentupperrespiratorytractinfectionsStageIII includesunexplainedchronicdiarrheaforlongerthanamonth severebacterialinfectionsandpulmonarytuberculosisStageIV includestoxoplasmosisofthebrain candidiasisoftheesophagus trachea bronchiorlungsandKaposi ssarcoma thesediseasesareindicatorsofAIDS AIDScannotbecured onlymanagedviaacomplexcocktailofpharmaceuticaldrugswhichinhibitstheactivityofHIV preventingitfrompenetratingtheT Helperhostcellandreplicating ThistherapyiscalledHighlyActiveAnti RetroviralTherapy orHAART Todate thisismostwidely usedtherapyintreatingAIDS Newdrugsareconstantlyunderdevelopmentbypharmaceuticalcompanies PrescriptionDrugTherapy TheCocktail WhatisHAART ThedrugcocktailinHAARTincludesProteaseInhibitors ReverseTranscriptaseInhibitors NRTI ssuchasAZT Non NucleosideReverseTranscriptaseInhibitors NNRTI s andEntry FusionInhibitors InconcertthesedrugsareeffectiveatstabilizingT Cellcounts CD4count andreducingthereplicationofHIV viralload However theyareveryexpensiveandcanhavemanysideeffects Theymustbetakentogetherinordertowork PrescriptionDrugTherapy Side effectsofHAARTincludefatigue gastrointestinaldistress CNSdisorders peripheralpolyneuropathy renalproblems hepatotoxicity changesinbloodcount allergies lacticacidosis pancreatitis avascularnecrosis osteopenia osteoporosis etc PrescriptionDrugTherapy HAARTisalsoexpensive Amonth ssupplyofthedrugswhichcompriseHAARTcancostbetween 1 000 1 400USD Oneyearofdrugtherapyalone notcountingdoctor scallsorofficevisits cancostupto 16 800 用中医治疗艾滋病 HIV AIDS ChineseMedicine 用中医治疗艾滋病 Peoplewithstrongzhengqidonotsuccumbtoepidemicinfections HuangDiNeiJing DefiningAIDSinTCM AIDS AcquiredImmuneDeficiencySyndrome isreferredtophoneticallyas艾滋病 aizibing inChinese 1 AIDScanbedefinedinseveraldifferentwaysaccordingtoTCMpatternidentification BecauseAIDSisa new disease havingonlybeenidentifiedin1981 thereisnospecificresearchonthediseasefromthepastorintheClassics TCMdoespossessalargebodyofinformationaboutinfectiousdiseasesandepidemics andwaystodescribethesymptomsofthosesufferingfromAIDS http web mit edu tidor www research aids virus dh jpg Terminology AIDScanbecomparedtootherconditionswhichhavebeencopiouslyresearchedanddocumentedintheChineseMedicalTradition ChineseMedicineusestheterm infectiousepidemicdiseases 疫病 yibing todescribeepidemicdiseasessuchasAIDS whicharecausedbyinvadingevils viruses TheChinesetermfor virus isbingdu病毒 literally toxic poisondisease AIDScanalsobethoughtofasa pestilence or plague TheChinesetermforthisis温疫 wenyi Suchadiseasewasthoughttohavealonglatency suddenonset andseveresymptoms WenBing温病Differentiation AccordingtoChineseMedicine AIDSiscausedbyexternalviralevilsinvadinginwardandtakingadvantageofsomepre existingdeficiency Theevilhidesinthexueluo血络 bloodconnectingvessels andtheyingfen营分 nutritivelevel likeotherwenrebing温热病 warmheatdiseases Thisdiseasecanalsobereferredtoasafuqiwenbing伏气温病 hiddenqiwarmdisease Thisdiseaseisaccompaniedbysymptomsofxulao虚劳 deficiencytaxation http www cbc ca news sars gfx epidemic1 jpg Symptomsoffuqiwenbing伏气温病 WeaknessofyuanqiDamagetojing qiinsufficiencyProgressiveemaciationFatigueNightsweatsPoorappetiteDiarrhea http kanji sapp org img 05 0595 gif ClassicText JinGuiYaoLue金柜药锊方论HanDynastyc 206 220BC JinGuiYaoLue EssentialsfromtheGoldenCabinet chapter TheTheoryofVacuityTaxation xulao虚劳 Emptypulse facecolorpale facecolorwhite palpitations emaciation inabilitytowalkduetosoreandthinskin blurredvision witheredhair subaxillarylymphadenopthy nightsweats loosestools diarrhea crampingordistensioninthelowerabdomenorevendiarrheawithundigestedfoodinthestools nocturnalemissions etc http library thinkquest org 03oct 02088 images zhangzhong jpg ZhangZhong jing150 219A D ClassicText 温疫论WenYiLun TreatiseonWarmEpidemicDiseases byWuYao ke MingDynastyc 1642AD Warmepidemicsarenotcausedbywind cold summerheat ordampnessbutbyastrangesortofqiaffectingthespacebetweenheavenandearth emphasisadded referringtoapestilentialqiandnotaclimacticorotherexternalcausativefactor etc ClassicText 温疫论WenYiLun TreatiseonWarmEpidemicDiseases byWuYao ke MingDynastyc 1642AD WuYou keconsideredepidemicqiinthebodyasapestilentialtoxinhecalledliqi疬气 Infectious Pathogencanbetransmittedfromonepersontoanother unlikewind cold ordampness Communicable Doesnotmanifestsymptomssoonaftertheexposuretothepathogen Latent Epidemicqiinvades resides andlurksinthemembranesource moyuan膜原 Chronic OneConceptofImmunityinChineseMedicine FuZhengYuQuXie 扶正与去邪 Supporttherighteousandeliminatetheevil pathogen Fuzheng supporttherighteousqi strengthenthebody sresistance andimproveimmunefunctionQuXie eliminate inhibit andexpelthediseasecausingfactors bingyin病因 suchastheAIDSvirus RootTreatmentofAIDS FuZhengPeiBen扶正培本 SupportingtheRighteous CultivatingtheRoot Emptinessshouldbesupplementedandfullnessshouldbedrained LingShu TheSpiritualPivot Supporting assistingtherighteous cultivatingtherootisindicatedinthecaseofemptinessdamagetotherighteousqi Treatment balanceandsupplementthelungs spleen kidneys improvedeficiencyofqiandblood yinandyang TheConceptofImmunityinTCM Supportingtherighteousenablesthebodytoeliminatetheevil Eliminatingtheevilsimultaneouslypreservestherighteouswhilegettingridofthepathogen BothmethodsshouldbeusedinthetreatmentofAIDS 扶正与去邪 CommonlyUsedTreatmentMethods FuZhengPeiBen SupportingtheRighteous CultivatingtheRoot BuPi SupplementingtheSpleen BuShen SupplementingtheKidneys QingReJieDu ClearingHeat ResolvingToxins HuoXueHuaYu ActivatingtheBlood TransformingStasis 扶正培本 清热解毒 活血化瘀 BuPi SupplementingtheSpleen InjurytotheSpleen Stomachisthemostcommoncauseofdeficientrighteousqi Spleenqiiseasilydamagedbyexternalevils includingviruses HerbsthatstrengthentheSpleenalsoimproveimmunity 补脾 BuShen SupplementingtheKidneys Kidneyjingdeficiencycanleadtoweaknessinallotherareasofthebodyandviceversa AIDSpatientsgenerallypresentwithkidneyyinoryangdeficiency orwithboth InKidneydeficientpatients metabolism cellularimmunity andhumoralimmunityarealllowerthaninnormalpatients Kidneyyinenrichmentcanimprovethebody simmunitywhileprolongingthesurvivalofantibodies Kidneyyangenrichmentcanexcitethenervesandhumoralreaction strengthenbodyresistance andpromotetheformationofnewantibodies 补肾 Research Numerousclinicalstudies mostfromChina reportthatCD4cellcountincreaseswhileviralloaddecreasesafterpatientsreceiveChineseMedicaltreatments MostseriousAIDSresearchinvolvingChineseMedicineisconductedbyChineseresearchers TanzaniaStudy Awidely citedstudyconductedbyChineseresearchersinTanzaniausingChineseherbaltherapyshowedpromisingresults Thestudy whichbeganin1989andendedin1991 measuredtheeffectivenessofTCMherbalformulasin158infectedpeople TanzaniaStudyResults 3casesreportingexcellentresults 36casesreportinggoodresults 24casesreportingpartialeffect 95casesreportednochange with13deathsattheendofthestudy 7casesattheendofthestudytestednegativeforthevirusonELISAandWesternblottests withonlyonecaserevertingbacktopositivewithinoneyear Theresults whilenotoverwhelminglypositive suggestthatherbaltherapyhasimmune modulatingandantiviraleffects andthatfurtherstudyiswarranted TraditionalChineseMedicineTumorHospital Shenzhen OBJECTIVE TostudythetherapeuticeffectofChinesemedicinalherbsonHIVpatients METHODS WeadoptedthecombinedChinesemedicinalherbsfortreatment thechiefcomponentsofwhichistoenhancehumanimmunitywhilelighteningtheclinicalsymptoms Theclinicalaspects theCD4 CD8lymphocytenumbersandtheplasmaviralloadofthepatientswerecomparedbeforeandafterthetreatment RESULTS Of28patientsexamined allexperiencedincreasedbodyweight averageincrease5 4kgaftertreatment Symptomsabatedcompletelyin7caseshavinglong timefever 4casesofdiarrhea 2casesoflargescaleskinulcerand1caseofskinrashafteronemonthtreatment After5monthsoftreatment 3caseswithlymphadenopathyhadsymptomscompletelyabate in7additionalcasesthesymptomsdiminishedordecreasedinnumber CD4lymphocytesincreasedin42 9 and50 0 patientsandviralloaddecreasedin71 4 and80 0 patientsaftertwomonthsandfivemonthstreatmentwithChinesemedicinalherbsrespectively Takingclinicalsymptomsandlaboratoryindicesintoconsideration thetotaleffectiverateofChinesemedicinalherbsreached94 0 CONCLUSION TheChinesemedicinalherbsusedinthisstudycanobviouslyimproveclinicalsymptoms increaseCD4lymphocytesanddecreaseserumviralloadofHIVpatients Source ZhonghuaShiYanHeLinChuangBingDuXueZaZhi 1999Sep30 13 3 291 4 BeijingUniversityofTechnology Beijing OBJECTIVE ToevaluatethetherapeuticeffectofQuDuZengNingCapsuleonAIDS METHODS QuDuZengNingCapsuleisacapsulecontainingextractsfrom4Chinesemedicinalherbs Totally1 000AIDSpatientsweretreated amongthem60patientswereclinicallyobservedweekly Bloodroutinetests liver heartandkidneyfunction X ray CD4 CD8cellswereexaminedbeforeandaftertreatmentat1 3 6month Thepatientsweretreatedwith4capsulest i dfor6months RESULTS Thesymptomswereimprovedinmostofthepatients theCD4cellsincreasedfrom115 0to295 2 ulandtheviralload RNAcopies ml inmostpatientsreducedmarkedlyormaintainedatthesamelevel CONCLUSION ThesedataindicatedthatQuDuZengNingCapsulewaseffectivefortreatmentofAIDSpatients Source ZhonghuaShiYanHeLinChuangBingDuXueZaZhi 2004Dec 18 4 305 7 ChineseHerbalTherapyandHIV AIDS 中医药治疗与艾滋病 KidneyYin BloodTonics ImproveImmunityandProlongAntibodySurvival Shudi Heshouwu Nuzhenzi Gouqizi Guiban Biejia Tianmendong Sangjisheng etc KidneyYangTonics Strengthenbodyresistance andpromotetheformationofnewantibodies Yinyanghuo Bajitian Xianmao Roucongrong Dongchongxiacao Buguzhi Suoyang Duzhong etc http www anti aging pflanzen de 5edf946c96abacd060119fab4afaef3b ziegenkraut jpg QingReJieDu ClearingHeat ResolvingToxins AIDSisapestilentialinfectiousdiseasecausedbyexternallyinvadingevilsthatcangeneratestagnationandtheaccumulationofhottoxins Heattoxinsusuallymanifestonthesurface i e intheformofskineruptions Kaposi ssarcoma boils macules etc MostAIDSpatientssufferfromdebilitatingfevers sweating anddehydration Treatment clearheat resolvetoxinstosupporttherighteousandeliminateevil Herbswhichclearheatandresolvetoxinsarealsoanti inflammatory antiviral andantibacterial 清热解毒 HerbsforClearingHeat ResolvingToxins Becausemostheat clearing toxin resolvingherbsarebothbitterandcold theyaretraditionallycontraindicatedinxulaodisorders Reminder Xulao Emptypulse facecolorpale facecolorwhite palpitations emaciation inabilitytowalkduetosoreandthinskin blurredvision witheredhair subaxillarylymphadenopthy nightsweats loosestools diarrhea crampingordistensioninthelowerabdomenorevendiarrheawithundigestedfoodinthestools nocturnalemissions Bitter coldherbsmustbecombinedwithsweet warmherbstosupporttherighteouswhileeliminatingtheevil simultaneoustreatmentofthedeficiencyandexcess HerbsforClearingHeat ResolvingToxins ClearHeat Toxicity Jinyinhua Lianqiao Daqingye Banlangen Pugongying XiaKuCao Huangqin Huanglian Huangbai etc HerbsforClearingHeat ResolvingToxins Yeast Fungalinhibitingfunction Kushen Baixianpi Dahuang Shegan Baitouweng Jiegeng Yuxingcao Dingxiang Shiliupi Huangbai Huangqin etc HerbsforClearingHeat ResolvingToxins Tumorinhibitingfunction Quanshen Fenweicao Banzhilian Baihuasheshecao Shemei Zicao etc HuoXueHuaYu ActivatingtheBlood TransformingStasis If qiandbloodarenotharmonious then100diseaseschangeandarise HuangDiNeiJing黄帝内经 Ifqimoves bloodmoves Ifqistagnates bloodbecomesstatic BecauseqiandbloodarebothdeficientinAIDSpatients thebodylacksthestrengthtomovebloodandfluids Fluidstagnationcanleadtoabdominalmasses tumors ascites lymphedema etc Herbsthatmovethebloodcanreducecapillarypermeability areanti inflammatory activatetheabsorptionofinflammation andregulatetheimmunesystem Treatment Invigoratetheblood transformstasis 活血化瘀 HerbsforInvigoratingtheBloodandDispellingStasis TheseherbsshouldnotbeusedcarelesslyorunnecessarilyinAIDSpatients Herbstosupplementtheqi dangshen huangqi etc shouldaccompanytheseherbstoactivatethebloodbyactivatingtheflowofqi Usebothdrainingandsupplementingsimultaneously Chuanxiong Chishao Taoren Honghua Danshen Yujin Sanqi Yanhusuo etc Revivo ChinesePatentHerbalMedicineforAIDS RevivoisanblendofChineseherbswhichhasrecentlygrowninpopularityforthetreatmentofAIDS relatedopportunisticdiseases Somelimitedclinicalresearchhasciteditsimmunoprotectiveeffects Thereisalsoconsiderableanecdotalevidence yetlarge scaleclinicaltestshaveyettobeundertaken Itisadministeredasanherbalpowderaddedtohotwaterandcontains Niubangzi牛蒡子 burdockseed Yiyiren意苡仁 Job stears Kugua苦瓜 bittermelon HypericumchinensisLianzi濂子 Lotus Xiakucao夏枯草 prunella Dazao大枣 jujubedate Gancao甘草 licoriceroot CBA Revivovs HAART CostofRevivopermonth 130 42AverageCostofHAARTpermonth 1 200 00 Revivoviralloadreduction Source RevivoCD4countincrease Source HerbsthatBoosttheZhengQi Interferon PartialListofHerbsthatcanIncreaseProductionofInterferon huomarenjinyinhuajuhualianqiaolongyanroumahuangmaimendongmantuoluomudanpimutongqingfengtengrenshenrouguisangyeshanyaoshanzhashengdihuangshengmashudihuangsuanzaorentianmatianmendongwumeiwuzhuyuxiakucaoxiangfuxinyihuaxuanshenyiyiren ChineseHerbs InterferonProduction HerbsthatBoosttheZhengQi T Cells PartialListofHerbsthatcanIncreaseProductionofT Cells lingzhilugenpugongyingrenshensangjishengsangyeshanyaoshengdihuangshudihuangsuanzaorenwuweiziyinyanghuo baishaobaizhuchaihuchuanxiongdangguidangshenduhuohanliancaoheshouwuhuangqihuangqinjinyinhua ChineseHerbsandT CellProduction HerbsthatBoosttheZhengQi Phagocytes PartialListofHerbsthatcanIncreaseProductionofPhagocyticLeukocytes baizhubohebuguzhichuanxiongdaqingyedangguidangshenduhuoduzhonggancaoguizhihangfangjihuangqihuangqinjiegengjinyinhuajuhualingzhimantuoluorenshensangyeshanyaoyinyanghuo ChineseHerbsandPhagocyticLeukocytes ChineseHerbsthatStimulatetheProductionofInterferonandT Cells ChineseHerbsthatStimulatetheProductionofInterferonandPhagocytes ChineseHerbsthatStimulatetheProductionofT CellsandPhagocytes ChineseHerbsthatStimulatetheProductionofInterferon T Cells andPhagocytes HerbAnalysis Inall3categories theherbgroupswiththemostactivity interferon T Cells phagocyticleukocytes weretonicherbsandherbsthatclearheatorreleasetheexterior Tonificationandheatclearingmethodsillustratetheeffectivenessofthetreatmentprinciplefuzhengyuquxie扶正与去邪 supportingtherighteous tonifying whileeliminatingtheevil clearing Redux EfficacyofHerbsbyType 9tonicherbs alltypes 5releaseexteriorherbs2clearheat toxicityherbs2nourishheart calmshenherbs1draindampnessherb1dispelwind dampnessherb1invigoratebloodherb1miscellaneous mantuoluo TheFutureofTreatingHIV AIDSUsingChineseMedicine TheFutureofTreatmentofHIV AIDS AMixedBag Doctorsarenowdiscoveringthatcertainpatientsareinfectedwithdrug resistantstrainsofHIV Aclusterof4infectedmenwasdiscoveredinKingCounty Seattle inJanuary2007 Allareinfectedwithahighlyvirulent drug resistantstrainofHIV ItispossiblethatHIVcancontinuetomutateintomorevirulentstrains increasingtheirinfectiousnessandresistingalleffortstocontrol eradicatethem HIVreversetranscriptasemakesatleastonereplicationerror mutation ineveryHIVgenomeperroundofreplicationinacell ThesuppressionofthevirusbyHAARTisnoguaranteethattheviruswillcontinuetobesuppressed Chinesemedicinecanprovideanaffordable sustainablesupportivetreatmentforAIDSHIV AIDSpatientswhodonorespondtoorwhocannotaffordbiomedicalinterventions Relevance TreatingpatientswithChineseMedicinewillhelpthemf