基于中医体质类型的中医营养护理方案在肝硬化腹水患者中的应用

Application of traditional Chinese medicine nutrition nursing plan based on traditional Chinese medicine constitutional type in patients with liver cirrhosis and ascites

目的 观察基于中医体质类型的中医营养护理方案在肝硬化腹水患者中的应用效果.方法 选取2017年9月—2018年2月上海曙光医院收治的肝硬化腹水患者120例,随机分为观察组和对照组,每组各60例.对照组采取西医营养护理,观察组在对照组的基础上结合中医体质类型制定个性化中医营养护理方案.比较两组患者腹水消失时间,干预前后中医体质分型的改善情况和血清白蛋白（ALB）变化.结果 干预2周后,观察组患者中8例改善为平和质,改善率为33.33%,对照组改善率为16.67%,差异有统计学意义（χ2=4.444,P〈0.05）;观察组腹水消失时间为（9.88±2.94）d,对照组（11.04±3.00）d,差异有统计学意义（t=2.139,P〈0.05）;观察组ALB（35.65±3.21）g/L,高于对照组,差异有统计学意义（t=3.841,P〈0.05）.结论 基于中医体质类型的中医营养护理方案具有针对性,可改善体质、促进腹水消退,为患者提供营养支持,值得推广应用.

Objective To explore the effects of traditional Chinese medicine （TCM） nutrition nursing plan based on TCM constitutional type in patients with liver cirrhosis and ascites. Methods From September 2017 to February 2018, we selected 120 patients with liver cirrhosis and ascites at Shanghai Shuguang Hospital. All of the patients were randomly divided into observation group and control group, 60 cases in each group. Patients of control group received western medicine nutrition nursing. On that basis of nursing in control group, patients of observation group were treated with individualized TCM nutrition nursing plan combined with TCM constitutional type. We compared the extinction time of ascites between two groups and the improvement of TCM constitutional type and serum albumin. Results Two weeks after intervention, a total of 8 patients changed to gentleness type with 33.33% for the improvement rate in observation group and 16.67% for the improvement rate in control group with a significant difference （ x^ 2=4.444, P 〈 0.05）. The extinction time of ascites of observation group and control group was （9.88 ± 2.94） d and （11.04 ±3.00） d respectively with a significant difference （t=2.139, P 〈 0.05）. The serum albumin of observation group was （35.65 ±3.21）g/L significantly higher than that of control group （t=3.841, P 〈 0.05）. Conclusions The TCM nutrition nursing plan based on TCM constitutional type can improve constitutional type, promote ascites to fade away and provide nutritional support for patients. It is worth to be popularized and applied.