健脾化浊汤对维持性血液透析患者营养状况及生活质量的影响

Effect of Jianpi Huazhuo Tang on Nutritional Status and Quality of Life in Patients with Maintenance Hemodialysis

目的:观察健脾化浊汤对维持性血液透析患者营养状况和生活质量的影响。方法:选取维持性血液透析患者156例,按随机数字表法分为对照组76例和观察组80例。对照组进行维持性血液透析,根据病情每周2~4次;给予优质蛋白、低磷饮食,治疗高血压、心功能不全、贫血,维持水电解质及酸碱平衡。观察组在对照组基础上给予健脾化浊汤口服。治疗前后,对2组患者进行改良综合营养评估量表(MQSGA)、肾脏疾病生活质量量表(KDQOL-SFTM)和中医证候评分;测量治疗前后体质量指数(BMI)、上臂肌围(MAMC)、上臂围(MAC)和肱三头肌皮褶厚度(TSF);检测治疗前后血清总蛋白(TP)、血清白蛋白(Alb)、血红蛋白(Hb)、红细胞计数(RBC)。结果:治疗后,2组MQSGA评分和中医症状评分均较治疗前降低,KDQOL-SFTM评分较治疗前升高;且观察组MQSGA评分和中医症状评分低于对照组,KDQOL-SFTM评分高于对照组;差异均有统计学意义(P<0.05)。治疗后,2组TP、Alb、Hb和RBC水平均较治疗前升高;且观察组TP、Alb、Hb和RBC水平均高于对照组;差异均有统计学意义(P<0.05)。治疗后,观察组BMI、MAMC、MAC和TSF水平均较治疗前升高,且观察组BMI、MAMC、MAC和TSF水平均高于对照组,差异均有统计学意义(P<0.05)。结论:在常规西医治疗基础上给予健脾化浊汤可减轻维持性血液透析患者营养不良症状,改善血生化指标和人体测量学指标,改善患者营养状况,从而提高患者生活质量。

Objective:To observe the effect of Jianpi Huazhuo tang on nutritional status and quality of life in patients with maintenance hemodialysis.Methods:A total of 156 cases of patients with maintenance hemodialysis were divided into the control group and the observation group according to the random number table method,76 and 80 cases in each group respectively.The control group was given maintenance hemodialysis two to four times a week according to the condition,and comprehensive symptomatic treatment including high-quality protein,low phosphorus diet,correction of hypertension,cardiac insufficiency and anemia,and maintenance of both water-electrolyte and acid-base disturbance.The observation group was additionally given oral administration of Jianpi Huazhuo tang based on the treatment of the control group.Before and after treatment,the scores of Modified Quantitative Subjective Global Assessment(MQSGA),Kidney Disease Quality of Life-Short Form(KDQOL-SFTM)and Chinese medicine syndromes were evaluated;body mass index(BMI),mid-arm muscle circumference(MAMC),midupper arm circumference(MAC)and triceps skinfold(TSF)thickness were measured;serum total protein(TP),serum albumin(Alb),hemoglobin(Hb)and red blood cell count(RBC)were detected.Results:After treatment,the scores of MQSGA and Chinese medicine syndromes in the two groups were decreased when compared with those before treatment,and the scores of KDQOL-SFTMwere increased;the scores of MQSGA and Chinese medicine syndromes in the observation group were lower than those in the control group,and the score of KDQOL-SFTMwas higher;differences being significant(P<0.05).After treatment,the levels of TP,Alb,Hb and RBC in the two groups were increased when compared with those before treatment;the above levels in the observation group were all higher than those in the control group;differences being significant(P<0.05).After treatment,the levels of BMI,MAMC,MAC and TSF in the observation group were increased when compared with those before treatment;the above levels in the observation group were all higher than those in the control group;differences being significant(P<0.05).Conclusion:Based on routine western medicine treatment,Jianpi Huazhuo tang can reduce symptoms of malnutrition in patients with maintenance hemodialysis,improve the indexes of blood biochemistry and anthropometry and the nutritional status,thus improving the quality of life of patients.