Treatmemt of AIDS with TCM

Acquired Immunodeficiency Syndrome (AIDS)

AIDS is a worldwide infectious disease discovered in recent years. Its fatality rate is very high. As the etiology is concerned, AIDS is known as to be caused by viral infection. Western medicine has not yet made any effective treatment for it. AIDS is frequently found in homosexuals and drug addicts. It could be also infected to infants and children. AIDS is mainly transmitted by means of sexual contacts, transfusion, injection and mother-infant channel. This disease, in TCM, could be classified to the categories of “Wen Re Bing (epidemic febrile diseases)”, “Xu Lao (consumptive diseases)”, etc.

Key Points of Diagnosis

1.Chief clinical manifestations

l) A marked loss of weight: the decrease could be up to 10 percent or even more of the normal weight;

2) Remarkable debility, tiredness and fatigue;

3) Severe diarrhea persisting for more than one month;

4) Persistent or intermittent fever lasting for more than one month;

2.Secondary clinical manifestations;

1) Multiple hemorrhagic and sarcomatoid lesions of the skin;

2) Candida albicans infection on the oral and pharyngeal mucosae;

3) Herpetic skin diseases or just even herpes zoster persisting for more than one month;

4) General pruritus of the skin;

5) Pulmonary infections (pneumocystic carinii pneumonia commonly seen);

6) General lymphadenectasis;

7) Presence of neurological signs;

8) Meningitis not significantly responding to treatment.

3.Laboratory tests

l) Immunological tests show a defect and hypofunction in cellular immunity, while in humoral immunity indices e.g. IgG, IgA and IgM are increased. The cause of the immunological changes is not clearly known.

2) Virological examinations may find the infection of HTLA-III virus.

If three chief and one secondary manifestations are found in a suspected case, serumal immunological tests should be performed to confirm the diagnosis.

Syndrome Differentiation

1. Prodrome Stage

Deficiency of both Qi and Yin

Chief Symptoms and Signs: Low-grade fever, night sweating, fatigue and weakness, headache, poor appetite, nausea, reddish tongue with little coating, and thready-rapid pulse

Treating Principle: To replenish Qi and nourish Yin.

Formula: The combination of “Sheng Mai San (Pulse-activating Powder)” and “Zhi Bai Dihuang Wan (Pill of Anemarrhena, Phellodendron and Rehmannia)” (modified):

pseudostellarua root 15g, ophiopogon root 12g, schisandra fruit 10g , dried rehmannia root 20g, prepared rehmannia root 20, dogwood fruit 12g, Chinese yam 12, alismatis rhizome 6g, moutan bark 12g, poria 10g, anemarrhena rhizome 12g, phellodendron bark 12g, wolfberry fruit l2g, glossy privet fruit 12g, astragalus root 15g, sweet wormwood 12g, parched hawthorn fruit 10g, parched germinated barley 10g, and parched medicated leaven 10g.

All the above materials are decocted in water for oral administration.

2. Stage of attack

1) The flaring- fire resulting from Yin-deficiency

Chief Symptoms and Signs: Low-grade fever, lassitude and listlessness, emaciation, cough, dyspnea, shortness of breath, night sweating, sore throat, dry mouth and tongue, red tongue with yellow coating, and deep-thready-rapid pulse.

Treating Principle: To nourish Yin to clear heat, cool blood and remove the toxic materials.

Formula: “Da Ding Feng Zhu (Great Pearl for Subsidence of Wind) ” (modified):

dried rehmannia 15—30g, ophiopogon root 12g, scrophularia root 15g, tortoise plastron 20g, fresh-water turtle shell 15g, donkey-hide gelatin 12g (melted in the finished decoction), fresh egg yolk 2 pieces, ginseng 6g, schisandra fruit 10g, glossy privet fruit 12g, astragalus root 15g, moutan bark 12g, sweet wormwood 12g, and barbat skullcap 15g .

All the above materials, except donkey-hide gelatin which is melted and mixed in the finished decoction, are decocted in water for oral administration.

When treating lymphadenectasis, 12 grams of airpotato yam and 10 grams of batryticated silkworm are added.

When to treat symptoms of poor appetite, nausea and diarrhea, 12 grams of Chinese yam, 20 grams of parched coix seed, and 10 grams of pinellia tuber, parched germinated barley, parched hawthorn fruit, and parched medicated leaven are combined.

When to treat cough with dyspnea, l5 grams of stemona root and 10 grams of Sichuan fritillary bulb are supplemented.

When to treat the ulceration in mouth, thrush and herpes, 10 grams of coptis root and 30 grams of isatis leaf are prescribed.

When there are such symptoms of exterior syndrome as fever, chills,and body ache, the treatment should be concentrated on expelling the heat and easing the muscles. The formula is the modified “Chai Ge Jie Ji Tang (Bupleurum and Pueraria Decoction for Relieving the Exterior)”, including: bupleurumroot 10g, pueraria roots 18g, scutellaria root 10g, gypsum 30g, isatis root 30g, notopterygium root 6g, honeysuckle flower 15g, and prepared licorice root 6g.

All the above materials are decocted in water for oral administration.

2) Invasion of heat into Ying-Blood-Systems

Chief Symptoms and Signs: High fever, mucocutaneous hemorrhage, epistaxis, hemoptysis, hematemesis, hematuria, hematochezia or tarry stool, to be more severe, even the presence of unconsciousness and delirium, convulsion, dementia or epilepsy-like paroxysm, deep-red tongue, and thready-rapid pulse.

Treating Principle: To clearing up the heat from Ying and cool the blood for antipyresis and detoxification

Formula: “Qing Wen Bai Du Yin (Antipyretic and Antitoxic Decoction)” (modified):

Powder of baffalo horn 10g (to be taken by being infused in the finished decoction) dried rehmannia root 10 to 30g, white peony root 12g, moutan bark 12g, scrophularia root 12g, ophiopogon root 12g, arnebia or lithosperm 12g, honeysuckle flower 30g, forsythia fruit 15g, coptis root 10g, lophatherum 10g, and oldenlandia 30g.

The above materials except the powder of baffalo horn are decocted in water for oral administration.

When there is high fever, 30 grams of gypsum and 10 grams of anemarrhena rhizome are combined.

When there appears convulsion, 15-30 grams of uncaria stem with hooks are added.

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