艾灸对维持性血液透析患者营养状态的影响

Effect of Moxibustion on Nutritional Status of Maintenance Hemodialysis Patients

目的:观察艾灸对维持性血液透析(MHD)患者营养状态的影响。方法:选择2019年04月—12月在河北省中医院血液透析室行规律血液透析、符合纳排标准的患者60例。采用随机数字表法分为治疗组与对照组,每组各30例。两组均根据指南指导摄入适量蛋白质、能量,行规律血液透析等基础治疗。治疗组于此基础上加用艾灸,取穴为足三里、三阴交、关元,干预时间为12周,观察记录两组人体测量学指标:身体质量指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂围(MAC),SGA评分及中医证候评分等,分析艾灸对MHD患者营养状态的改善情况。结果:治疗组中医证候疗效明显高于对照组(P<0.05),且中医证候积分较治疗前明显降低,差异具有统计学意义(P<0.05)。治疗组SGA评分较治疗前明显升高(P<0.05),且优于对照组(P<0.05)。治疗组治疗前后的BMI、TSF差异有统计学意义(P<0.05)。结论:艾灸可以降低MHD患者的中医证候积分,改善其虚证证候;同时艾灸可提高患者SGA评分、BMI、TSF,改善其营养状态。因此艾灸可作为临床治疗MHD患者营养不良状态的有效手段。

Objective:To observe the effect of moxibustion on nutritional status of maintenance hemodialysis(MHD)patients.Methods:From April to December,2019,60 patients who underwent regular hemodialysis in the hemodialysis room of Hebei Provincial Hospital of Traditional Chinese Medicine were selected,and they met the standard of nano-drainage.They were randomly divided into treatment group and control group,with 30 cases in each group.Both groups received proper protein and energy according to the guidelines,and received basic treatment such as regular hemodialysis.On the basis of this,the treatment group was treated with moxibustion,taking points Zusanli,Sanyinjiao and Guanyuan for 12 weeks.The anthropometric indexes of two groups were recorded:body mass index(BMI),triceps skinfold thickness(TSF),upper arm circumference(MAC),SGA score and TCM syndrome score,etc.,and the improvement of nutritional status of MHD patients by moxibustion was analyzed.Results:The curative effect of TCM syndrome in the treatment group was significantly higher than that in the control group(P<0.05),and the score of TCM syndrome was significantly lower than that before treatment(P<0.05).The SGA score of the treatment group was significantly higher than that before treatment(P<0.05),and it was better than that of the control group(P<0.05).There were significant differences in BMI and TSF in the treatment group before and after treatment(P<0.05).Conclusion:Moxibustion can reduce the TCM syndrome score of MHD patients and improve their deficiency syndrome.At the same time,moxibustion can improve patients SGA score,BMI and TSF,and improve their nutritional status.Therefore,moxibustion can be used as an effective means to treat malnutrition of MHD patients clinically.