| 摘要: |
| 目的：探讨足三里穴位注射维生素B1与B12对维持性血液透析（maintenance hemodialysis， MHD）患者生活质量的影响。方法：将60例MHD患者按照随机数字表法分为治疗组与对照组，每组各30例。对照组接受常规血液透析治疗，治疗组在常规治疗基础上加用足三里穴位注射维生素B1与B12各2 mL，每周2～3次，持续60 d。采用肾脏疾病生活质量简表（kidney disease quality of life short form， KDQOL-SFTM 1.3）评估患者生活质量，检测相关生化指标［包括血红蛋白（hemoglobin，Hb）、血清白蛋白（serum albumin，Alb）、血清铁蛋白（serum ferritin，SF）、血肌酐（serum creatinine，Scr）、尿素氮（blood urea nitrogen，BUN）、血钙（calcium，Ca）、血磷（phosphorus，P）、C 反应蛋白（C-reactive protein，CRP）、白细胞介素-6（interleukin-6，IL-6）、甲状旁腺激素（intact parathyroid hormone，iPTH）］， 评估生活质量临床疗效，并对KDQOL-SFTM 1.3总分与临床指标进行相关性分析。结果：生活质量总有效率治疗组为90.0%（27/30），对照组为66.7%（20/30），组间比较，差异有统计学意义（P<0.01）。治疗后，治疗组KDQOL-SFTM 1.3量表中肾脏与透析相关生存质量（kidney disease-targeted areas，KDTA）及一般健康相关生活质量（short form-36 health survey，SF-36）总分及各维度评分均较治疗前提高（P<0.05），且高于对照组（P<0.05）；治疗组Hb、Alb、SF较治疗前显著上升（P<0.01），CRP、IL-6较治疗前显著下降（P<0.01），且治疗组Alb、SF上升幅度及IL-6下降幅度均大于对照组（P<0.05）。相关性分析显示，生活质量总分与营养指标呈正相关，与炎症指标呈负相关。结论：足三里穴位注射维生素B1与B12可有效改善MHD患者的生活质量，缓解临床症状，增强社会功能，并对改善患者营养状况、减轻微炎症状态具有积极作用。 |
| 关键词: 维持性血液透析 穴位注射 维生素B1 维生素B12 KDQOL-SFTM 1.3量表 生活质量 |
| DOI： |
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| Clinical effect of acupoint injection at Zusanli on quality of life in patients undergoing maintenance hemodialysis |
| LIU Wen,FU Shufang,CHEN Menglin,XIE Hongming,HU Donghe,LI Haitao |
| (Yueyang Hospital of Traditional Chinese Medicine Affiliated to Hunan University of Chinese Medicine, Yueyang 414000, Hunan, China) |
| Abstract: |
| Objective： To investigate the effect of acupoint injection of vitamins B1 and B12 at Zusanli on the quality of life of patients undergoing maintenance hemodialysis （MHD）. Methods： A total of 60 patients undergoing MHD were divided into treatment group and control group using a random number table, with 30 patients in each group. The patients in the control group received conventional hemodialysis, while those in the treatment group received acupoint injection of 2 mL vitamin B1 and 2 mL vitamin B12 at Zusanli, 2-3 times per week for 60 consecutive days, in addition to the conventional treatment. The Kidney Disease Quality of Life-Short Form （KDQOL-SFTM 1.3） was used to assess the quality of life of patients, and related biochemical parameters were measured, including hemoglobin （Hb）, serum albumin （Alb）, serum ferritin （SF）, serum creatinine （Scr）, blood urea nitrogen （BUN）, calcium （Ca）, phosphorus （P）, C-reactive protein （CRP）, interleukin-6 （IL-6）, and intact parathyroid hormone （iPTH）. The clinical outcome in terms of quality of life was assessed, and the correlation between total KDQOL-SFTM 1.3 score and clinical indicators was analyzed. Results： There was a significant difference in overall response rate between the treatment group and the control group ［90.0% （27/30） vs 66.7% （20/30）, P < 0.01］. After treatment, the treatment group had significant increases in the total scores of kidney disease-targeted areas and 36-item short-form health survey and the scores of each dimension of the two scales （P < 0.05）, with significantly higher scores than the control group （P < 0.05）. After treatment, the treatment group had significant increases in Hb, Alb, and SF （P < 0.01） and significant reductions in CRP and IL-6 （P < 0.01）, and the treatment group had significantly greater changes in Alb, SF, and IL-6 than the control group （P < 0.05）. The correlation analysis showed that the total quality of life score was positively correlated with nutritional indices and was negatively correlated with inflammatory indicators. Conclusion： For patients undergoing MHD, acupoint injection of vitamins B1 and B12 at Zusanli can effectively improve quality of life, alleviate clinical symptoms, enhance social function, and exert a positive effect on improving nutritional status and alleviating the microinflammatory state. |
| Key words: maintenance hemodialysis acupoint injection vitamin B1 vitamin B12 KDQOL-SFTM 1.3 quality of life |
