调理脾胃灸法改善脾肾阳虚证血透患者排便情况的理论和实践探讨

Discussion on the theory and practice of regulating spleen and stomach moxibustion for improving defecation in hemodialysis patients with spleen and kidney yang deficiency syndrome

维持性血液透析患者常因肠道功能失调而出现便秘或泄泻,中医认为其基本病机为脾气亏虚、肾阳虚衰。近年来血透工作者逐渐重视中医外治法在血透领域发挥的作用,灸疗显示出一定的优势,调理脾胃灸法在既往研究中已被证实可改善维持性血透患者营养状况、虚弱症状及生存质量。然笔者在为血透患者施行灸疗的过程中发现调理脾胃灸法亦可改善脾肾阳虚证患者排便情况。文章通过探讨脾肾阳虚证血透患者并发便秘或泄泻的病因病机,论述调理脾胃灸法特点及其近年来在血透领域的研究和应用,试探索调理脾胃灸法改善脾肾阳虚证血透患者排便情况的理论依据,为调理脾胃灸法在血透领域的临床和科研思路扩展上提供参考,以期使其发挥更大的作用。

Patients with maintenance hemodialysis often have constipation or diarrhea due to intestinal dysfunction.Traditional Chinese medicine(TCM) believes that the basic pathogenesis is spleen qi deficiency and kidney yang deficiency.In recent years, hemodialysis workers gradually pay attention to the role of TCM external therapy in the field of hemodialysis.Moxibustion shows certain advantages. Moxibustion for regulating the spleen and stomach has been proved to improve the nutritional status, weak symptoms, and quality of life of patients with maintenance hemodialysis. However, in the process of moxibustion for hemodialysis patients, the author found that the method of regulating spleen and stomach moxibustion can also improve the defecation of patients with spleen kidney yang deficiency syndrome. This paper discusses the etiology and pathogenesis of constipation or diarrhea in hemodialysis patients with spleen and kidney yang deficiency syndrome, discusses the characteristics of spleen stomach moxibustion and its research and application in the field of hemodialysis in recent years, and tries to explore the theoretical basis of regulating spleen and stomach moxibustion to improve the defecation of hemodialysis patients with spleen and kidney yang deficiency syndrome, so as to provide reference for clinical and scientific research ideas of regulating spleen and stomach moxibustion in hemodialysis field it plays a bigger role.