中药保留灌肠结合辨证施护对慢性肾功能衰竭患者肾功能、炎症反应及液体摄入依从性的影响  

Influence of TCM Retention Enema Combined with Syndrome Differentiation and Care on Renal Function,Inflammatory Response and Fluid Intake Compliance of Patients with Chronic Renal Failure

作　　者：王娟 袁毅 茹雪 李雪 陈玉琼 WANG Juan;YUAN Yi;RU Xue;LI Xue;CHEN Yuqiong(Affiliated Hospital of Panzhihua University,Panzhihua 617000,China;Chengdu Xindu District Hospital of Traditional Chinese Medicine,Chengdu 610000,China)

机构地区：[1]攀枝花学院附属医院,四川攀枝花617000 [2]成都新都区中医院,四川成都610000

出　　处：《西部中医药》2023年第6期117-121,共5页Western Journal of Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术项目(2021MS373)。

摘　　要：目的:分析中药保留灌肠结合辨证施护对慢性肾功能衰竭患者肾功能、炎症反应及液体摄入依从性的影响。方法:回顾性分析258例CRF患者临床资料,按照是否接受中医辨证施护分为观察组(130例)和对照组(128例)。两组均给予中药保留灌肠,对照组给予肾内科常规护理,观察组在常规护理基础上根据中医理论辨证施护。比较两组干预前后肾功能指标水平[血肌酐(serum creatinine,SCR)、尿素氮(usea nitrogen,BUN)、肾小球滤过率(glomerular filtration rate,eGFR)]及炎性因子水平[白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和C反应蛋白(C-reactive protein,CRP)]变化,临床疗效、舒适状况量表(general comfort questionnaire,GCQ)和摄入液体依从性评分及护理满意度。结果:干预后两组SCR、BUN水平均低于干预前,eGFR水平高于干预前(P<0.05);且观察组SCR、BUN水平低于对照组,eGFR水平高于对照组(P<0.05)。观察组干预后临床总有效率[72.31%(94/130)]高于对照组[51.56%(66/128)](P<0.05)。干预后观察组IL-6、CRP及TNF-α水平均较治疗前明显下降,同时低于对照组(P<0.05)。干预后,两组GCQ和依从性评分均高于干预前,且观察组GCQ和依从性评分高于对照组(P<0.05)。观察组总护理满意度[89.23%(116/130)]高于对照组[78.13%(100/128)](P<0.05)。结论:中药保留灌肠结合辨证施护可有效保护CRF患者残余肾功能,改善机体微炎状态,提高其液体摄入依从性和舒适度,改善护患关系。Objective:To analyze the effects of TCM retention enema combined with syndrome differentiation and care on renal function,inflammatory response and fluid intake compliance of patients with chronic renal failure.Methods:Clinical data of 258 CRF patients were retrospectively analyzed,and the patients were allocated to the observation group(130 cases)and the control group(128 cases)according to whether to accept syndrome differentiation and care.Both groups accepted TCM retention enema,the control group was given routine care of nephrology department,and the observation group adopted syndrome differentiation and care in light of TCM theory on the foundation of routine care.To compare the level of renal function indicators(SCR,BUN,eGFR),and the levels of inflammatory factors(IL-6,TNF-αand CRP)before and after the intervention between both groups,clinical effects,GCQ,the scores of fluid intake compliance and nursing satisfaction degree.Results:After the intervention,the levels of SCR and BUN in both groups were lower than these before the intervention,the level of eGFR higher than that before the intervention(P<0.05);and the levels of SCR and BUN in the observation group were lower than these of the control group,the level of eGFR higher than that of the control group(P<0.05).After the intervention,clinical total effective rate of the observation group was[72.31%(94/130)]after the intervention,higher than[51.56%(66/128)]of the control group(P<0.05).After the intervention,the levels of IL-6,CRP and TNF-αof the observation group decreased significantly compared with before the treatment,simultaneously lower than these of the control group(P<0.05).After the intervention,GCQ and the scores of the compliance of both groups were higher than these before the intervention,GCQ and the scores of the compliance of the observation group were higher than these of the control group(P<0.05).Total nursing satisfaction degree of the observation group was[89.23%(116/130)],higher than[78.13%(100/128)]of the control group(P<0.05).Concl

关 键 词：肾功能衰竭 慢性 中药保留灌肠 辨证施护 肾功能 炎症反应 液体摄入依从性 

分 类 号：R692.5[医药卫生—泌尿科学]