基于“治痿独取阳明”理论的中医综合疗法治疗腹膜透析并发不安腿综合征临床观察
Clinical Effect of Integrated Traditional Chinese Medicine Therapy Based on the Theory of “Treating Flaccidity by Selecting the Yangming Meridian Alone” in Treatment of Restless Legs Syndrome During Peritoneal Dialysis
  
DOI:
中文关键词:  腹膜透析  不安腿综合征  治痿独取阳明  参苓白术散
英文关键词:Peritoneal dialysis  Restless legs syndrome  Treating flaccidity by selecting the Yangming meridian alone  Shenling Baizhu Powder
基金项目:第四批全国中医临床优秀人才研修项目(国中医药办人教发〔2017〕124号)
作者单位
吕 勇,宋蓓蓓,金 华 安徽中医药大学第一附属医院肾内科安徽 合肥 230031 
摘要点击次数: 1126
全文下载次数: 1406
中文摘要:
      目的 观察应用“治痿独取阳明”理论治疗腹膜透析伴发不安腿综合征(restless legs syndrome,RLS)的临床疗效。方法 将50例持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)伴发RLS的终末期肾病患者随机分为对照组和观察组,每组25例(对照组3例和治疗组2例退出观察)。所有患者均予CAPD及常规对症治疗。对照组患者口服盐酸普拉克索片;观察组患者口服加味参苓白术散,并联合夜间穴位温灸和中药敷贴治疗,疗程8周。应用国际RLS评定量表和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)分别评估两组患者的不安腿症状和睡眠质量的改善状况,每2周评估1次。同时观察两组患者治疗前后血清白蛋白(albumin, ALB)、血红蛋白(hemoglobin,Hb),血清铁、磷、钙、超敏C反应蛋白(high sensitive C-reactive protein, hs-CRP)、碱性磷酸酶(alkaline phosphatase, AKP)和甲状旁腺素(parathyroid hormone, PTH)水平以及血尿素清除指数(blood urea clear index, KT/V)。结果 两组患者治疗后RLS评分和PSQI评分均较治疗前明显降低(P<0.05);治疗第6周末和第8周末,观察组RLS评分和PSQI评分明显低于对照组(P<0.05);观察组RLS评分和PSQI评分随疗程延长而进行性下降。与治疗前比较,对照组患者治疗后Hb,血清ALB、铁、磷、钙、AKP、PTH、hs-CRP和总KT/V均无明显变化(P>0.05),而观察组患者治疗后Hb、血清ALB显著上升(P<0.05),hs-CRP显著下降(P<0.05),且观察组治疗后hs-CRP下降程度明显大于对照组(P<0.05)。结论 基于“治痿独取阳明”理论的中医综合疗法(加味参苓白术散内服联合穴位温灸和中药敷贴)可明显改善腹膜透析RLS患者的临床症状和睡眠质量。
英文摘要:
      Objective To investigate the clinical effect of the theory of "treating flaccidity by selecting the Yangming meridian alone" in the treatment of restless legs syndrome (RLS) during peritoneal dialysis. Methods A total of 50 patients with end-stage renal disease (ESRD) who underwent continuous ambulatory peritoneal dialysis (CAPD) and developed RLS were randomly divided into control group and observation group, with 25 patients in each group. Three patients in the control group and two in the observation group withdrew from the observation. All patients received CAPD and routine symptomatic treatment. The patients in the control group were given oral pramipexole hydrochloride tablets, and those in the observation group were given oral Jiawei Shenling Baizhu Powder combined with needle warming moxibustion and traditional Chinese medicine (TCM) application treatment during night; the course of treatment was 8 weeks for both groups.The International RLS Scale and Pittsburgh sleep quality index (PSQI) were used to evaluate the improvement in RLS symptoms and sleep quality once every two weeks. Serum albumin (Alb), hemoglobin (Hb), serum iron, serum phosphorus, serum calcium, high-sensitivity C-reactive protein (hs-CRP), alkaline phosphatase (AKP), parathyroid hormone (PTH), and urea clearance index (KT/V) were observed before and after treatment. Results Both groups had significant reductions in RLS score and PSQI after treatment (P<0.05). At the end of week 6 and 8 of treatment, the observation group had significantly lower RLS score and PSQI than the control group (P<0.05), and the observation group had progressive reductions in RLS score and PSQI over treatment. There were no significant changes in Hb, serum Alb, serum iron, serum phosphorus, serum calcium, AKP, PTH, hs-CRP, and overall KT/V after treatment in the control group (P>0.05), while the observation group had significant increases in Hb and serum Alb (P<0.05) and a significant reduction in hs-CRP (P<0.05) after treatment, and compared with the control group, the observation group had a significantly greater reduction in hs-CRP after treatment (P<0.05). Conclusion Integrated traditional Chinese medicine therapy based on the theory of "treating flaccidity by selecting the Yangming meridian alone" (oral Jiawei Shenling Baizhu Powder combined with needle warming moxibustion and TCM application treatment) can significantly improve clinical symptoms and sleep quality in patients with RLS during peritoneal dialysis.
查看全文  查看/发表评论  下载PDF阅读器
关闭