中国中医科学院广安门医院肾病科
纸质出版:2011
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[1]李深,熊仁芬,张改华,刘文军,岳玉和.维持性血液透析对尿毒症患者证候转化的影响[J].中医杂志,2011,52(17):1475-1478.
LI Shen, XIONG Renfen, ZHANG Gaihua, et al. Effect of Maintenance Hemodialysis on the TCM Syndrome Transformation in Uremic Patients[J]. Journal of Traditional Chinese Medicine2011, 52(17): 1475-1478.
[1]李深,熊仁芬,张改华,刘文军,岳玉和.维持性血液透析对尿毒症患者证候转化的影响[J].中医杂志,2011,52(17):1475-1478. DOI: 10.13288/j.11-2166/r.2011.17.035.
LI Shen, XIONG Renfen, ZHANG Gaihua, et al. Effect of Maintenance Hemodialysis on the TCM Syndrome Transformation in Uremic Patients[J]. Journal of Traditional Chinese Medicine2011, 52(17): 1475-1478. DOI: 10.13288/j.11-2166/r.2011.17.035.
目的观察维持性血液透析(MHD)对尿毒症患者中医证候转化的影响
为中医药干预改善透析患者预后提供初步依据。方法对164例MHD患者进行12个月随访调查
自拟中医辨证量表每月对患者进行一次中医辨证以及全血细胞分析及透析治疗前后的生化检测
取与纳入及随访终点(随访至12个月或死亡)最近一次的中医辨证结果及实验室检查作为观察内容
对患者中医证候演变情况与随访期内的临床指标以及预后变化的关系进行分析。结果接受MHD治疗后
部分年轻患者转向无虚损证表现
而大多数MHD患者仍呈现"本虚标实"特点。新进入MHD治疗的患者中发生证候转变的比例较高
其中呈现从脾肾阳虚向其他证型转化的患者死亡率降低;长期MHD患者中肝肾阴虚证所占比例较高
肝肾阴虚证向阴阳两虚证转化的死亡率增高。不同虚损证患者在预后、透析充分性和营养状态方面存在差异(P<0.05)
肝肾阴虚证患者优于脾肾阳虚证和阴阳两虚证患者(P<0.05)。结论尿毒症患者进入MHD后中医证候的演变伴随着预后发生变化
主动采取适当的中医药干预对提高MHD患者的生存率和生活质量有益。
Objective To observe the effect of maintenance hemodialysis(MHD)on the TCM syndrome transformation in uremic patients for providing basis of TCM intervention to improve the prognosis of such patients.Methods Totally 164 MHD patients involved in this 12-month follow-up study were monthly diagnosed with TCM syndrome differentiation with a self-made TCM syndrome scale and determined with an analysis on whole blood cells as well as biochemical detections before and after hemodialysis.The most recent TCM diagnosis and laboratory examination to the follow-up finishing point(followed to the end of 12th month or death)were taken as the observation contents to analyze the relation between the development of TCM syndromes and the changes of clinical indices within the follow-up period and the prognosis of patients.Results After accepting MHD
the health state of some younger patients improved significantly and changed to non-deficiency syndrome
while most MHD patients presented Ben-root deficiency with Biao-symptom excess syndrome.The higher percentage of syndrome transformation occurred in the patients newly accepted MHD
of it
yang deficiency of spleen and kidney transformed to other syndromes got lower mortality.The higher percentage of yin deficiency of liver and kidney was in the long-term MHD patients
and the mortality was getting higher when yin deficiency of liver and kidney transformed to both yin and yang deficiency.There existed difference in the prognosis
full hemodialysis or not
and nourishment condition of the patients with deficiency syndrome(P<0.05).The effect of the yin deficiency of liver and kidney group was better than that of the yang deficiency of spleen and kidney and both yin and yang deficiency(P<0.05).Conclusion The TCM syndromes of uremic patients after entering into MHD get developed with the changes of prognosis.Applying proper TCM intervention will benefit the improvement of survival rate and quality of life of MHD patients.
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