不同透析龄维持性血液透析患者中医证候特征  

Traditional Chinese Medicine （TCM） syndrome transfornmtion of patients undergoing maintenance hemodialysis with different dialysis period

作　　者：张春伶[1] 王娴娴[1] 沈沛成[1] 梁婷玉[1] 孙川[1] 姜健[1] 何立群[1] Zhang Chunling;Wang Xianxian;Shen Peicheng;Liang Tingyu;Sun Chuan;Jiang Jian;He Liqun.(Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China)

机构地区：[1]上海中医药大学附属曙光医院肾内科上海中医临床重点实验室,200021

出　　处：《国际移植与血液净化杂志》2018年第2期37-41,共5页International Journal of Transplantation and Hemopurification

基　　金：上海市科委中医临床重点项目（14401972203）和中医引导项目（15401930100）;上海市卫生和计划生育委员会科研课题（201440488）;上海市中医药事业发展三年行动计划（ZY3-JSFC-2-1029）;上海市中医临床肾病基地（ZY3-LCPT-1006）

摘　　要：目的研究维持性血液透析（maintenance hemodialysis，MnD）对尿毒症患者中医证候变化的影响，为中医药介入维持性血液透析治疗提供初步的理论支持。方法选择80例MHD患者，根据中医辨证分型每3个月观察一次患者的证候改变，完成12个月随访调查，对患者中医证候转化规律进行分析。结果透析龄≤1年的MHD患者中医本证以肝肾阴虚、气阴两虚为主。透析龄〉1年的MHD患者中医本证以气阴两虚、阴阳两虚为主。透析龄〉1年的MHD患者证型转化率较高。不同透析龄患者中，脾肾阳虚及阴阳两虚患者预后较其他证型差。透析龄≤1年的脾肾阳虚证患者及透析龄〉1年的阴阳两虚患者未能发生证型转化，则死亡风险上升。结论MHD患者的中医证候有其自身特点，及早干预对改善患者透析生存率和生活质量、减少并发症发生率有一定作用。Objective To study the changes of traditional Chinese medicine（TCM） syndrome in patients undergoing maintenance hemodialysis （MHD）, so as to provide basic support for TCM intervention to the treatment of MHD. Methods 80 cases of MHD patients were involved in this 12-month follow-up study. According to syndrome differentiation of TCM, observed and analysed those patients＇ symptom changes every 3 months. Results In this study, The most frequently TCM syndromes of MHD patients whose dialysis age ≤ 1 years were yin deficiency of liver and kidney syndromes, followed by qi and yin deficiency syndromes. Tile most frequently TCM syndromes of MHD patients whose dialysis age 〉 1 years were qi and yin deficiency syndromes, followed by yin and yang deficiency syndromes. Among the patients with different duration of dialysis, there were two groups of patients whose prognosis worse than the others, which were the patients with yang deficiency of spleen and kidney syndromes and yin and yang deficiency syndromes. Patients with yang deficiency of spleen and kidney syndromes whose dialysis age ≤ 1 years failed to change to other TCM syndromes, than they had a increased risk of death, as same as patients with yin and yang deficiency syndromes whose dialysis age 〉 1 years. Conclusions TCM syndromes of MHD patients had special characteristics. Traditional Chinese medicine treatment can be initiatively taken, in order to improve survival and quality of life, and reduce the incidence of complications

关 键 词：维持性血液透析 中医辨证 证候转化 

分 类 号：R277.5[医药卫生—中医学]