中医体质辨证护理改善老年透析病人疲乏及生活质量的研究

doi:10.3969/j.issn.1003-9198.2024.06.002

摘要/Abstract

摘要： 目的探讨中医体质辨证护理对老年维持性血液透析病人疲乏状态及生活质量的改善效果。方法选取2022年6—12月在东南大学附属中大医院两个院区血液净化中心行维持性血液透析并符合纳排标准的病人146例,随机分为对照组和观察组,每组73例。对照组给予常规护理,观察组在常规护理基础上,同时接受包括中医饮食调护、穴位按摩在内的中医体质辨证护理,共干预24周。采用修订版Piper疲乏量表(RPFS)、简明健康状况调查表(SF-36)评估2组病人护理干预前后疲乏及生活质量的变化情况。结果干预24周后,观察组病人RPFS量表中的认知维度、情感维度、感觉维度得分以及RPFS总分明显低于对照组(P <0.05)。干预后观察组RPFS量表感觉维度、认知维度、情感维度以及总分较干预前明显降低(P <0.05),而对照组病人干预前后疲乏程度未明显改善(P >0.05);干预后观察组SF-36中的生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能得分以及总分均明显高于对照组(P＜0.05),且观察组生理职能、总体健康、精力、社会功能得分以及SF-36总分较干预前明显升高(P＜0.05);对照组病人干预前后SF-36评分没有明显变化(P>0.05)。结论中医体质辨证护理对于改善老年维持性血液透析病人的疲乏状态以及生活质量有积极意义。

关键词: 中医体质辨证护理, 血液透析, 老年人, 疲乏, 生活质量

Abstract: Objective To explore the effects of traditional Chinese medicine constitution dialectical nursing on fatigue and quality of life in the elderly patients receiving maintenance hemodialysis. Methods A total of 146 patients who underwent maintenance hemodialysis at two blood purification centers of Zhongda Hospital Southeast University from June to December 2022 and met the inclusion and exclusion criteria were randomly divided into the control group and the observation group, with 73 patients in each group. The control group received routine nursing, while the observation group received traditional Chinese medicine constitution dialectical nursing, including traditional Chinese medicine dietary adjustment and acupoint massage, on the basis of routine nursing. The intervention lasted for 24 weeks. The revised Piper Fatigue Scale (RPFS) and the 36 item short form health survey (SF-36) were assessed and compared between the two groups before and after nursing intervention. Results After 24 weeks of intervention, the scores of cognitive dimension, emotional dimension and sensory dimension, and total score of RPFS in the observation group were significantly lower than those in the control group (P<0.05), the scores of sensory dimension, cognitive dimension, emotional dimension and total score of RPFS in the observation group were significantly lower than those before intervention (P<0.05), while the fatigue level in the control group was not significantly improved after intervention (P>0.05). The physiological function, overall health, energy, social function, emotional function, and total score of SF-36 in the observation group were significantly higher than those in the control group and those before intervention (P<0.05), while there was no significant change in SF-36 score in the control group after intervention (P>0.05). Conclusions Dialectical nursing of traditional Chinese medicine constitution has positive significance in improving the fatigue state and quality of life of the elderly patients undergoing maintenance hemodialysis.

Key words: traditional Chinese medicine constitution dialectical nursing, hemodialysis, aged, fatigue, quality of life

中图分类号:

R473

胡阳阳, 王越, 谢庆磊. 中医体质辨证护理改善老年透析病人疲乏及生活质量的研究[J]. 实用老年医学, 2024, 38(6): 545-548.

HU Yangyang, WANG Yue, XIE Qinglei. Effects of traditional Chinese medicine constitution dialectical nursing on fatigue and quality of life in elderly patients receiving dialysis[J]. Practical Geriatrics, 2024, 38(6): 545-548.

参考文献

[1] 翁佳敏,王梦婧,黄碧红,等. 老年维持性血液透析患者症状困扰的纵向研究[J]. 老年医学与保健,2023,29(2):294-298.
[2] COLLINS A, FOLEY R, CHAVERS B, et al.US Renal Data System 2013 Annual Data Report[J]. Am J Kidney Dis, 2014, 63 (1 Suppl): A7.
[3] 姚晨思.维持性血液透析患者疲乏的中医证候分布特点及影响因素研究[D].北京:中国中医科学院,2020.
[4] 郭军军,刘敏华,何超成,等.穴位按摩治疗血液透析患者疲乏和睡眠障碍的临床研究[J].世界科学技术:中医药现代化,2020,22(7):2499-2503.
[5] 曲畅,郭海玲,魏宇,等.维持性血液透析后疲乏管理最佳证据总结[J].护理学报,2021,28(5):43-48.
[6] 王琦.中医体质学[M].北京:人民卫生出版社,2005:62-63.
[7] 邓世翩,容景瑜,何丽意,等.中医体质辨识结合情志护理对肿瘤化疗患者衰弱和癌因性疲乏的影响[J].医学理论与实践,2021,34(10):1783-1785.
[8] 朱燕波,王琦,折笠秀树.中医体质量表的信度和效度评价[J].中国行为医学科学,2007,16(7):651-654.
[9] 张海林,路潜,文翠菊,等.血液透析患者疲乏状况及其心理社会影响因素分析[J].中国护理管理,2011,11(7):69-71.
[10] WHITEHEAD L. The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures[J]. J Pain Symptom Manage, 2009, 37(1):107-128.
[11] 袁怀红,张颖君.女性维持性血液透析患者的疲乏状况及影响因素分析[J].中国血液净化,2018,17(10):717-719.
[12] 马原,吴银银,窦俊凯,等.维持性血液透析患者营养状况及生活质量研究[J].沈阳医学院学报,2023,25(2):159-163.
[13] 郭青,贺碧英,赵荻,等.推拿疗法对维持性血液透析病人疲乏状况的影响[J].护理研究,2016,30(3C):1129-1131.
[14] 高云,李亚洁,陈媛,等.老年维持性血液透析患者症状困扰与希望的相关性研究[J].护理学报,2012,19(10):17-20.
[15] 廖淑媚,朱丽芳,周珍俐,等.中医饮食调护对维持性血液透析患者营养状况及生活质量的研究分析[J].中国医药科学,2020,10(5):40-42.
[16] 刘清国,胡玲.经络腧穴学[M].北京:中国中医药出版社,2012:86-128.