益肾安神法对阴阳两虚型维持血液透析伴焦虑状态患者的疗效及生活质量的影响

Effect of Yishen Anshen Method(益肾安神法)on the Efficacy and Quality of Life of Patients with Yin-Yang Deficiency Maintenance Hemodialysis with Anxiety

目的:探究益肾安神法对阴阳两虚型维持血液透析(MHD)伴焦虑状态患者的疗效及生活质量的影响。方法:纳入60例阴阳两虚型MHD伴焦虑状态患者,采用随机数字表法分为治疗组、对照组各30例。两组患者均予以MHD及纠正并发症的常规治疗,对照组服用阿普唑仑,试验组在对照组的基础上采用益肾安神法(安神合剂联合滋肾还少膏),连续治疗8周。采用中医证候积分、中医疾病的症状指标评分及汉密尔顿焦虑量表(HAMA)评估患者中医症状及焦虑状态改善情况,同时评估患者治疗8周后临床疗效。采用肾脏疾病生存质量简表(KDQOL-SFTM)评估患者生活质量,并观察两种治疗方案的安全性[电解质指标及药物不良反应]。结果:治疗后两组患者中医郁证症状量分及中医证候积分均降低(P<0.05),且治疗组患者中医郁证症状量分及中医证候积分均低于对照组(P<0.05);两组患者HAMA评分均降低(P<0.05),且治疗组患者HAMA评分低于对照组(P<0.05);治疗组治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30)(P<0.05);两组患者治疗后简明健康状况调查量表(SF-36)评分、肾脏病和透析相关的生存质量(KDTA)评分及KDQOL-SFTM评分均升高(P<0.05),且治疗组患者SF-36评分、KDTA评分及KDQOL-SFTM评分均高于对照组(P<0.05);两组患者治疗后钾(K^(+))、磷(P^(+))水平均降低(P<0.05),且治疗组患者P^(+)、K^(+)水平低于对照组(P<0.05);治疗组、对照组药物不良反应率分别为20.00%(6/30)、26.67%(8/30),两组比较,差异无统计学意义(P>0.05)。结论:益肾安神法能够提高阴阳两虚型MHD伴焦虑状态患者的临床疗效,改善其中医症状及焦虑状态,提高其生活质量,改善其电解质水平,且未增加不良反应,安全性较高。

Objective:To explore the effects of Yishen Anshen method on the efficacy and quality of life of patients with yin-yang deficiency maintenance hemodialysis(MHD)with anxiety state.Methods:A total of 60 patients with yin-yang deficiency type MHD with anxiety state were selected and divided into treatment group and control group,with 30 cases in each,using the random number table method.Both groups were given conventional treatment for MHD and correction of complications,the control group was given alprazolam,and the treatment group was given Yishen Anshen method[Anshen mixture(安神合剂)combined with Zishen Huanshao ointment(滋肾还少膏)]on the basis of the control group,continuous treatment for 8 weeks.TCM symptom score,TCM disease symptom index score and Hamilton Anxiety Scale(HAMA)were used to evaluate the improvement of TCM symptoms and anxiety state of the patients,and the clinical efficacy of the patients after 8 weeks of treatment was evaluated.Kidney Disease Quality of Life(KDQOL-SFTM)was used to assess patients'quality of life.The safety[electrolyte indexes and adverse drug reactions]of the two treatment regimens were also observed.Results:After treatment,the scores of TCM depression symptoms and TCM syndromes in the two groups were decreased(P<0.05),and the scores of TCM depression symptoms and TCM syndromes in the treatment group were lower than those in the control group(P<0.05).The HAMA scores of the two groups were decreased(P<0.05),and the HAMA score of the treatment group was lower than that of the control group(P<0.05).The total effective rate of the treatment group was 93.33%(28/30),which was higher than 73.33%(22/30)of the control group(P<0.05).After treatment,the SF-36 score,KDTA score and KDQOL-SFTM score in two groups were increased(P<0.05),and the SF-36 score,KDTA score and KDQOL-SFTM score in the treatment group were higher than those in the control group(P<0.05).After treatment,the levels of potassium(K^(+))and phosphorus(P^(+))in two groups were decreased(P<0.05),and the levels of P^(+)and K^(+)in the treatment group were lower than those in the control group(P<0.05).The adverse drug reaction rates of the treatment group and the control group were 20.00%(6/30)and 26.67%(8/30),respectively,and there was no significant difference between the two groups(P>0.05).Conclusion:Yishen Anshen method can improve the clinical efficacy of yin-yang deficiency MHD patients with anxiety,improve the symptoms of traditional Chinese medicine and anxiety state,improve the quality of life of patients,improve electrolyte level and do not increase the occurrence of adverse reactions,and has high safety.