中药灌肠治疗终末期肾脏病维持性血液透析患者睡眠障碍的临床研究  

Effect of traditional Chinese medicine enema on dyssomnia in end-stage renal disease patients undergoing maintenance hemodialysis

作　　者：王艳霞 戴立恒 刘小翠 WANG Yanxia;DAI Liheng;LIU Xiaocui(Department of Hemodialysis,Tianjin Beichen Traditional Chinese Medicine Hospital,Tianjin 300400;Department of Nephrology,Tianjin Beichen Traditional Chinese Medicine Hospital,Tianjin 300400;ICU,Tianjin Beichen Traditional Chinese Medicine Hospital,Tianjin 300400)

机构地区：[1]天津市北辰区中医医院血液透析科,天津300400 [2]天津市北辰区中医医院肾内科,天津300400 [3]天津市北辰区中医医院ICU,天津300400

出　　处：《河北中医》2024年第11期1789-1792,1796,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：天津市北辰区科学技术局科研项目(编号:SHGY-2021032)。

摘　　要：目的观察中药灌肠对终末期肾脏病维持性血液透析(MHD)患者睡眠障碍的影响。方法选取2022年1月至2022年9月天津市北辰区中医医院收治的终末期肾脏病MHD伴睡眠障碍患者30例,随机分为对照组15例和治疗组15例。对照组予常规MHD治疗,治疗组在对照组基础上加用自拟中药方灌肠治疗,2组治疗疗程均为8周。疗程结束后,观察2组患者匹兹堡睡眠质量指数量表(PSQI)评分、阿森斯失眠量表(AIS)评分、神经递质[包括5-羟色胺(5-HT)及β-内啡肽(β-EP)]表达水平及中医证候疗效情况。结果治疗4周和8周后,治疗组PSQI评分、AIS评分明显低于治疗前(P<0.05),且与对照组治疗后同期相比,治疗组PSQI评分、AIS评分更低(P<0.05);对照组治疗前与治疗4、8周后PSQI评分、AIS评分变化比较差异均无统计学意义(P>0.05)。治疗8周后,治疗组血清5-HT、β-EP水平明显高于治疗前(P<0.05),且与对照组治疗8周后同期相比,治疗组血清5-HT、β-EP水平更高(P<0.05);对照组治疗前与治疗8周后血清5-HT、β-EP水平变化比较差异均无统计学意义(P>0.05)。与对照组相比,治疗组治疗4、8周后中医证候疗效总有效率均明显高于对照组(P<0.05)。结论中药灌肠可有效改善终末期肾脏病MHD患者的睡眠障碍,提高生活质量,且安全性良好,其作用机制可能与增加机体内神经递质5-HT和β-EP的水平有关。Objective To investigate the effect of traditional Chinese medicine(TCM)enema on dyssomnia in end-stage renal disease(ESRD)patients on maintenance hemodialysis(MHD).Methods Thirty ESRD patients on MHD with dyssomnia treated in Tianjin Beichen Traditional Chinese Medicine Hospital from January 2022 to September 2022 were randomly assigned into treatment group(n=15)and control group(n=15).All patients were managed by conventional MHD,and those in treatment group were additionally given enema with TCM.Treated for 8 weeks,the aim was to compare Pittsburgh Sleep Quality Index(PSQI),Athens Insomnia Scale(AIS),neurotransmitter(5-hydroxytryptamine[5-HT],β-endorphin[β-EP]),curative effect of TCM syndrome.Results PSQI and AIS scores at weeks 4 and 8 in the treatment group were significantly decreased than those before treatment(P<0.05),which were significantly lower than those in the control group(P<0.05).PSQI and AIS scores in the control group were found no significant difference on day 0 versus at weeks 4 and 8(P>0.05).5-HT andβ-EP levels at week 8 in the treatment group were significantly increased than those before treatment(P<0.05),which were significantly higher than those in the control group(P<0.05).5-HT andβ-EP levels in the control group were found no significant difference between day 0 and week 8(P>0.05).The total effective rate of TCM syndrome at weeks 4 and 8 in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion TCM enema can effectively improve dyssomnia and enhance the quality of life of ESRD patients on MHD by increasing the levels of 5-HT andβ-EP,it has good safety.

关 键 词：终末期肾脏病 维持性血液透析 中药灌肠 睡眠障碍 

分 类 号：R473[医药卫生—护理学]