ABSTRACT
Objective To evaluate the efficacy of Shenfu Decoction in treatment of critically ill patients with spleen-kidney yang deficiency type low triiodothyronine syndrome (LT3S). Methods Totally 110 critically ill patients with spleen-kidney yang deficiency type LT3S were randomized into two groups. Control group used standard Western treatment; Treatment group was given the combination of Western treatment and Shenfu Decoction; each group was treated for 7 d. The therapeutic effect indexes were serum T3, serum T4, serum TSH, APACHE II score, hospital day, results of treatment, and therapeutic efficacy of TCM syndromes. Results After treatment, the APACHE II score in control and treatment groups have been significantly improved (P < 0.05, 0.001). Compared with control group, the score in treatment group declined more drastically, and difference between two groups was statistically significant (P < 0.05); The serum T3 levels have been significantly improved in both groups and improved more in treatment group, and the difference between two groups was statistically significant (P < 0.05); The hospital day of treatment group was shorter than control group after treatment, and the difference between two groups was statistically significant (P < 0.05); The symptoms score progressed in both groups after treatment and have been significantly improved in treatment group, and the difference between two groups was statistically significant (P < 0.05); The treatment group had more significant clinical curative effect after treatment (P < 0.05). Conclusion Shenfu Decoction in critically ill patients with spleen-kidney yang deficiency type LT3S could improve the clinical curative effect, progress the TCM syndromes and results of treatment, and shorten the hospital stay.
ABSTRACT
La presente invetsigación tuvo como objetivo principal evaluar, desde el punto de vista clínico-terapéutico al paciente con infección por virus de inmunodeficiencia humana (VIH) en la consulta de infectología. Complejo Hospitalario Universitario "Ruiz y Páez". Marzo-Octubre 2010. Se realizó un estudio prospectivo, descriptivo, longitudinal, de campo, no experimental en el cual se estudiaron 200 pacientes adultos. De estos, 140 (70,00%) tenáin infección por VIH, siendo el grupo etario en edad productiva (31-40 años) con 40% (n=84) lo frecuente. En el espectro clínico, se evidenció fiebre con 25% (n=35) y pérdida de peso en 11,4% (n=16) como síntomas y signos generales más frecuentes; además se encontró pacientes con diarrea en 18,5% (n=26), placas blanquesinas orofaíngea con 10,7% (n=15) y cefalea en 6,4% (n=9). Los hallazgos de laboratorio: anemia con 7,4% (n=10), leucocitosis con 5,7% (n=8), y serología para toxoplasmosis positivos con 7,8% (n=11). Las infecciones asociadas: infecciones respiratorias 25% (n=35), seguido de parasitosis intestinal 12,1% (n=17) y candidiasis orofaríngea 10,7% (n=15). En el seguimiento del contaje linfocitario CD4+, la mayoría de los pacientes que asistían a la consulta de infectología tenían el último contaje de CD4+ dentro del rango de 201-500 células/mm³ con una frecuencia 30% (n=42). Con relación a la carga viral en la última consulta se encontraba dentro del rango de <50 copias de ARN/mL en un 28,5% (n=40). Encuanto al estadio clínico la mayoría de los pacientes se ubicaron en el estudio asintomático (A2) con 25,7% (n=36). Del tratamiento antirretroviral, las que se utilizan con mayor frecuencia son combinaciones de IP reforzadas + análogos nucleótidos con 65,7% (n=92). Se logró evidenciar múltiples dificultades y limitantes que impiden que la consulta de infectología se lleve a cabo con éxito y poder evaluar a los pacientes de manera completa. Entre las dificultades se pueden destacar que 38,5% (n=54) de los pacientes...
This study has as a principal objective to evaluate, patient infected with the Human Immnodeficiency Virus (HIV), from the standpoint of view of the clinical and therapeutic aspects. All patients were treated at the University Hospital "Ruiz y Páez". March to October 2010. We performed a prospective, descriptive, longitudinal, field and non experimental study in which were studied 200 adult patients. 140 of 200 (70.00%) patients had HIV infection, being patients mostly included in teh working age group (31-40 years) with 40% (n=56) and 60% of them being male (n=84). In the clinical spectrum was evidenced fever 25% (n=35) and weight loss 11,4% (n=16) as the general signs and symptoms most frequently seen. We also found patients with diarrhea in 18,5% (n=26), oropharyngeal white plaques 10,7% (n=15), headache 6,4% (n=9). Laboratory findings were: anemia 7,4% (n=10), leukocytosis 5,7% (n=8) and positive serology for toxoplasmosis 7,8% (n=11). Associated ¡nfections were: respiratory infections 25% (n=35), intestinal parasitosis 12,1% (n=17) and 10,7% oropharyngeal candidiasis (n=15). Most of the patients, 30% (n=42), attending infectious Diseases Consulting had the latter CD4 + count in the range of 201-500 cells/mm³. Regarding the viral load in the last vist, it was found to be at <50 copies / mL, in 28.5% (n=40) of the patients. Clinical stage of most of the patients was (A2) (asymptomatic) in 25,7% (n=36). Most often used antiretroviral therapy were combinations of reinforced IP plus nucleotide analogues in 65,7% (n=92). We found a lot of trobubles and limitations for the infectious diseases consultation. Among the difficulties can be noted that 38,5% (n=54) of patients arrives to consultation without history, laboratory test and with/without a scheduled appointment. Regarding the limitations, the most significant one was the excess of patients attending consultation and lack of general and microbiology laboratory at the institution...