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艾灸疗法治疗尿毒症胃肠功能障碍患者的效果观察

王一峰 杨美霞 蔡红珠 刘琨 余春丽 费秀丽 姚卫国

王一峰, 杨美霞, 蔡红珠, 刘琨, 余春丽, 费秀丽, 姚卫国. 艾灸疗法治疗尿毒症胃肠功能障碍患者的效果观察[J]. 中华全科医学, 2024, 22(1): 89-92. doi: 10.16766/j.cnki.issn.1674-4152.003338
引用本文: 王一峰, 杨美霞, 蔡红珠, 刘琨, 余春丽, 费秀丽, 姚卫国. 艾灸疗法治疗尿毒症胃肠功能障碍患者的效果观察[J]. 中华全科医学, 2024, 22(1): 89-92. doi: 10.16766/j.cnki.issn.1674-4152.003338
WANG Yifeng, YANG Meixia, CAI Hongzhu, LIU Kun, YU Chunli, FEI Xiuli, YAO Weiguo. Effect of moxibustion therapy on gastrointestinal dysfunction in patients with uremia[J]. Chinese Journal of General Practice, 2024, 22(1): 89-92. doi: 10.16766/j.cnki.issn.1674-4152.003338
Citation: WANG Yifeng, YANG Meixia, CAI Hongzhu, LIU Kun, YU Chunli, FEI Xiuli, YAO Weiguo. Effect of moxibustion therapy on gastrointestinal dysfunction in patients with uremia[J]. Chinese Journal of General Practice, 2024, 22(1): 89-92. doi: 10.16766/j.cnki.issn.1674-4152.003338

艾灸疗法治疗尿毒症胃肠功能障碍患者的效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003338
基金项目: 

上海市卫生健康委员会科研资助项目 202040217

上海市名老中医学术经验研究工作室建设项目 SHGZS-202237

上海市金山区第七周期医学重点专科建设项目 JSZK2023H04

上海市“十四五”中医特色专科建设项目 ZYTSZK2-13

详细信息
    通讯作者:

    姚卫国,E-mail:saynever2004@163.com

  • 中图分类号: R692.5  R245.81

Effect of moxibustion therapy on gastrointestinal dysfunction in patients with uremia

  • 摘要:   目的  观察艾灸疗法对尿毒症腹膜透析胃肠功能障碍患者的炎症因子水平、中医症候积分的影响及临床疗效。  方法  选取2021年5月—2022年1月在上海中医药大学附属普陀医院及上海市第六人民医院金山分院肾内科治疗的尿毒症胃肠功能障碍患者72例,采用随机数字表法将患者分为艾灸组(36例)与对照组(36例),对照组接受基础治疗(持续规律腹膜透析, 降血压,控制血糖,营养摄入及抑酸护胃、促胃肠动力等对症处理),艾灸组在对照组基础上辅以艾灸足三里、三阴交穴。收集治疗前后1周患者的安全性指标、血清炎症因子(CRP、TNF-α、IL-6)及中医症候疗效结果。  结果  观察期间脱落3例(2例转血液透析治疗,1例退出),实际完成69例(对照组35例,艾灸组34例)。艾灸组治疗尿毒症胃肠功能障碍总有效率明显高于对照组(P<0.05)。艾灸组和对照组患者血清CRP、TNF-α、IL-6水平均较治疗前降低,且艾灸组均低于对照组(P<0.01)。艾灸组中医症候治疗总有效率为88.24%(30/34),明显高于对照组的65.71%(23/35,χ2=4.911,P=0.027)。  结论  艾灸疗法能显著降低尿毒症腹膜透析胃肠功能障碍患者炎症因子IL-6、TNF-α、CRP水平,提高临床治疗有效率,安全性良好。

     

  • 表  1  2组尿毒症腹膜透析伴胃肠功能障碍患者一般资料比较

    Table  1.   Comparison of general data between the two groups of uremic peritoneal dialysis patients with gastrointestinal dysfunction

    项目 艾灸组(n=34) 对照组(n=35) 统计量 P
    年龄(x±s, 岁) 61.47±8.83 59.09±12.68 0.902a 0.370
    性别[例(%)] 0.354b 0.552
      男性 17(50.0) 20(57.3)
      女性 17(50.0) 15(42.7)
    原发病诊断[例(%)]
      慢性肾炎 15(44.1) 18(51.4) 0.369b 0.543
      糖尿病肾病 9(26.5) 10(28.6) 0.038b 0.845
      高血压肾病 7(20.6) 5(14.3) 0.477b 0.490
      其他 3(8.8) 2(5.7) 0.001b 0.974
    透析时间(x±s, 月) 66.89±20.23 61.50±19.74 1.120a 0.267
    尿素氮(x±s, mmol/L) 17.65±4.67 19.08±5.05 1.220a 0.227
    肌酐(x±s, μmol/L) 1 001.60±288.24 1 063.70±298.03 0.879a 0.382
    血清β2微球蛋白(x±s, mg/L) 42.18±9.90 43.15±7.60 0.457a 0.649
    血红蛋白(x±s, g/L) 112.85±13.09 116.49±12.13 1.199a 0.235
    血白蛋白(x±s, g/L) 33.80±4.63 33.95±5.61 0.121a 0.904
    谷丙转氨酶(x±s, U/L) 10.97±3.77 9.66±5.12 1.207a 0.232
    谷草转氨酶(x±s, U/L) 11.71±4.68 10.93±4.06 0.740a 0.462
    血清钙(x±s, mmol/L) 2.29±0.24 2.28±0.22 0.181a 0.857
    血清磷(x±s, mmol/L) 2.00±0.70 1.83±0.69 1.016a 0.313
    甲状旁腺素(x±s, pg/mL) 262.15±54.81 272.02±58.79 0.721a 0.474
    血钾(x±s, mmol/L) 5.01±0.89 4.74±0.75 1.364a 0.177
    血钠(x±s, mmol/L) 138.18±3.05 137.91±3.38 0.348a 0.729
    透析充分性(x±s, Kt/V) 1.77±0.12 1.73±0.19 1.042a 0.301
    注:at值,b为χ2值。
    下载: 导出CSV

    表  2  2组尿毒症腹膜透析伴胃肠功能障碍患者胃肠道症状疗效比较[例(%)]

    Table  2.   Comparison of the gastrointestinal symptoms efficacy in two groups of uremic peritoneal dialysis patients with gastrointestinal dysfunction[cases (%)]

    组别 例数 显效 有效 无效 总有效
    艾灸组 34 11(32.35) 18(52.94) 5(14.71) 29(85.29)
    对照组 35 6(17.14) 16(45.72) 13(37.14) 22(62.86)
    注:2组疗效比较,Z=2.183,P=0.029。
    下载: 导出CSV

    表  3  2组尿毒症腹膜透析伴胃肠功能障碍患者中医症候总有效率比较[例(%)]

    Table  3.   Evaluation of Traditional Chinese Medicine Symptom efficacy between the two groups of uremic peritonealdialysis patients with gastrointestinal dysfunction[cases (%)]

    组别 例数 痊愈 显效 有效 无效 总有效
    艾灸组 34 4(11.76) 11(32.35) 15(44.12) 4(11.76) 30(88.24)
    对照组 35 0 7(20.00) 16(45.71) 12(34.29) 23(65.71)
    注:2组总有效率比较,χ2=4.911,P=0.027。
    下载: 导出CSV

    表  4  2组尿毒症腹膜透析伴胃肠功能障碍患者血清CRP、TNF-α、IL-6水平比较[M(P25, P75)]

    Table  4.   Comparison of Serum CRP, TNF-α and IL-6 levels between the two groups of uremic peritoneal dialysis patients with gastrointestinal dysfunction[M(P25, P75)]

    组别 例数 CRP(mg/L) TNF-α(pg/mL) IL-6(mg/L)
    治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
    艾灸组 34 23.79(19.75, 46.92) 2.98(1.80, 8.75)a 10.14(9.82, 20.78) 2.63(1.76, 6.37)a 22.34(16.79, 46.28) 7.56(6.72, 10.37)a
    对照组 35 23.94(16.97, 42.34) 12.40(9.17, 20.03)a 10.51(8.76, 28.43) 4.97(2.94, 10.78)a 26.34(14.76, 41.92) 19.50(13.74, 28.96)a
    Z 0.072 12.352 0.240 5.184 1.820 15.331
    P 0.943 <0.001 0.811 <0.001 0.073 <0.001
    注:与同组治疗前比较,aP<0.05。
    下载: 导出CSV
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  • 收稿日期:  2023-03-18
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