中医健康管理对终末期肾脏病患者症状负担的影响  

Effects of Traditional Chinese Medicine Health Management on Symptom Burden in Patients with End Stage Renal Disease

作　　者：张建东[1] 陈刚毅[1] 汤水福[1] ZHANG Jian-Dong;CHEN Gang-Yi;TANG Shui-Fu(Dept.of Nephrology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院肾病科,广东广州510405

出　　处：《广州中医药大学学报》2023年第4期845-850,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20191112);广东省医学科学技术研究基金项目(编号:A2017153);广州中医药大学第一附属医院院级护理科研课题。

摘　　要：【目的】评价中医健康管理对终末期肾脏病(ESRD)患者的症状负担、抑郁状况和生活质量的影响。【方法】将181例ESRD湿浊瘀阻、脾肾气虚证患者随机分为对照组90例和观察组91例。对照组给予西医标准方案治疗,观察组在对照组的基础上给予中医健康管理方案(包括中医情志调护、膳食调养、穴位按摩等)干预治疗,共随访12个月。使用透析症状指数(DSI)、抑郁症自评量表(PHQ-9)和简明健康状况调查表(SF-36)分别评估2组ESRD患者治疗前后症状负担、抑郁状况和生活质量的变化情况。【结果】(1)症状负担方面:治疗后,2组患者的DSI总评分均较治疗前降低(P<0.05),且观察组对DSI总评分的降低作用明显优于对照组(P<0.05)。(2)抑郁状况方面:治疗后,观察组的抑郁程度较治疗前明显改善(P<0.05),而对照组有改善趋势,但差异无统计学意义(P>0.05);组间比较,观察组对抑郁程度的改善作用明显优于对照组(P<0.05)。(3)生活质量方面:治疗后,除对照组的精神健康评分外,2组患者SF-36量表的各维度评分均较治疗前改善(P<0.05),且观察组对SF-36量表各维度评分的改善作用均明显优于对照组(P<0.05)。【结论】中医健康管理可以显著减轻ESRD患者的症状负担,改善患者的抑郁状况,提高患者的生活质量。Objective To evaluate the impact of traditional Chinese medicine(TCM) health management on symptom burden,depressive status and quality of life in patients with end stage renal disease(ESRD). Methods A total of 181 ESRD patients with the syndrome of dampness-turbidity and blood stasis obstruction and spleenkidney qi deficiency were randomly divided into the control group of 90 cases and the observation group of 91 cases.The control group was intervened with the standard western medicine protocol,while the observation group was intervened with the TCM health management protocol(including TCM emotional regulation,dietary therapy and acupressure)on the basis of treatment for the control group. The two groups were followed up for 12 months.Changes in symptom burden,depressive status and quality of life in the two groups of ESRD patients before and after treatment were assessed using the dialysis symptom index(DSI),patient health questionnaire-9(PHQ-9)and the 36-item short-form health survey(SF-36)respectively. Results(1)After treatment,the total DSI scores for symptom burden in both groups were decreased compared with those before treatment(P<0.05), and the effect of the observation group on decreasing the total DSI scores was significantly superior to that of the control group(P<0.05).(2)After treatment,the degree of depression in the observation group was significantly improved compared with that before treatment(P<0.05),while the control group only showed a trend of improvement and the difference was not statistically significant(P>0.05). The intergroup comparison showed that the effect on improving the degree of depression in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the scores of all dimensions of the SF-36 scale were improved in both groups compared with those before treatment(P<0.05),except for the mental health scores in the control group. The intergroup comparison showed that the effect of the observation group on improving the scores of all dime

关 键 词：中医健康管理 终末期肾脏病 湿浊瘀阻 脾肾气虚 症状负担 抑郁 生活质量 

分 类 号：R692.5[医药卫生—泌尿科学]