摘要
目的探讨辨证施护对改善维持性血液透析(MHD)患者营养不良的影响,为临床应用中医改善MHD患者营养不良提供参考。方法选择京东誉美中西医结合肾病医院血液净化室2014年2月~2015年12月收治的94例MHD患者,随机分为治疗组和对照组,各47例。对照组予基础治疗,治疗组在基础治疗的基础上,给予辨证施护:脾肾气虚、阳虚型予透析日足三里注射黄芪注射液;气阴两虚型同时脐贴左归丸(8 h/d);阴阳两虚型予穴位艾灸;肝肾阴虚型在穴位艾灸的同时配合饮用旱莲草大枣汤;治疗3个月,比较两组患者人体测量指标、改良SGA评分、部分生化指标、主要临床症状的改善情况等,分析、评价辨证施护改善MHD患者营养不良的临床疗效。结果辨证施护提高了MHD患者体质量指数、血白蛋白、血红蛋白、尿素氮的水平。治疗后,治疗组BMI[(21.15±1.28)kg/m^2]、Hb[(114.83±14.82)g/L]、Alb[(41.56±3.24)g/L]、BUN[(30.27±2.93)mmol/L]与对照组比较,差异有统计学意义(P<0.05)。治疗组治疗后改良SGA评分有效率高于对照组(P<0.05)。两组中医主要症状疗效率比较,治疗组效果更明显(P<0.05)。结论辨证施护对维持性血液透析(MHD)患者的营养不良状态有明显的改善效果,值得临床推广。
Objective To discuss the effects of dialectical nursing in improving malnutrition in the patients receiving maintenance hemodialysis （MHD）, in order to provide references for clinical application of TCM in improving malnutri- tion in the patients receiving MHD. Methods 94 MHD patients in Hemodialysis Room of Jingdong Yumei Nephropathy Hospital of Integrated Chinese and Western Medicine were selected from February 2014 to December 2015. They were randomly assigned to 2 groups, with 47 patients in the treatment group and the control group. The control group was given fundamental treatment ,and the treatment group was given dialectical nursing on the basis of fundamental treatment; the patients with deficiency of vital energy of spleen and kidney and deficiency of yang were given the injection of astragalus injection in zusanli point on the day of hemodialysis; the patients with the deficiency of vital energy and yin were given navel pastes of zuogui pills （8 hours per day）; the patients with the deficiency of yin and yang were given point moxibustion; the patients with the deficiency of yin of liver and spleen were also given eclipta alba and date decoction while being given point moxibustion; 3 months after the treatment, anthropometry indices, modified SGA scores, part of biochemical indices and improvement of main clinical symptoms were compared between the two groups of patients, and the clinical effects of dialectical nursing in improving malnutrition in the patients receiving MHD were analyzed and evaluated. Results Dialectical nursing was able to improve BMI, blood albumin, hemoglobin and urea nitrogen levels in the MHD patients. After the treatment, BMI was（21.15±1.28） kg/m^2, Hb was（114.83±14.82） g/L, Alb was （41.56±3.24） g/L, BUN was（30.27±2.93） mmol/L in the treatment group, and the differences were statistically significant compared with the control group （P〈0.05）. The effective rate of modified SGA scores in the treatment group was higher than that in the control group（P〈0.05）. The curative rate of main symptoms of TCM was compared, and the effects were significant in the treatment group. Conclusion Dialectical nursing has significant improving effects on malnutrition in the patients receiving MHD, which is worthy of clinicpromotion.
出处
《中国现代医生》
2016年第25期132-135,139,共5页
China Modern Doctor
基金
河北省中医药管理局科研计划(2013293)
关键词
辨证施护
维持性血液透析
营养不良
临床观察
Dialectical nursing
Maintenance hemodialysis （MHD）
Malnutrition
Clinical observation
