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| Study on the changes of nutritional state of ESRD patients before and after hemodialysis based on different types of deficiency syndrome |
| Hits 1437 Download times 1137 Received:April 29, 2019 |
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| DOI
10.11656/j.issn.1672-1519.2019.09.07 |
| Key Words
end-stage renal disease;TCM deficiency syndrome classification;nutritional status;hemodialysis |
| Author Name | Affiliation | E-mail | | ZHOU Shengyuan | Department of Nephrology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China | | | LIU Yue | Department of Cardiology, Tianjin People's Hospital, Tianjin 300191, China | liuyue0422@163.com | | HOU Changqing | Department of Nephrology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China | | | YANG Bo | Department of Nephrology, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China | | | YANG Hongtao | Department of Nephrology, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China | |
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| Abstract
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| [Objective] To investigate the changes of nutritional status in patients with end-stage renal disease with different deficiency syndrome types before and after dialysis,in order to adjust different nutrition programs while treating diseases.[Methods] A total of 201 ESRD patients who underwent hemodialysis and were willing to cooperate were selected from October 2012 to October 2016 at the First and Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. The 201 cases of patients were divided into different study groups according to the diagnosis of chronic renal failure,syndrome differentiation and efficacy evaluation:diagnostic criteria of TCM symptoms:The deficiency syndromes were divided into spleen-kidney qi deficiency syndrome,spleen-kidney yang deficiency syndrome,liver-kidney yin deficiency syndrome,yin-yang deficiency syndrome,qi-yin deficiency syndrome. At the same time,urea nitrogen and creatinine were measured,creatinine clearance rate and body mass index were calculated. The changes of nutritional status with different types of deficiency syndrome was analyzed before and after dialysis.[Results] After dialysis,the levels of K+,P3-,Mg2+,TC,TG and LDL-C were decreased,and the levels of Na+,Cl-,Ca2+,TP,ALB,Hb,RBC and HDL-C were increased. Potassium ions decreased significantly in liver and kidney yin deficiency,yin and yang deficiency and qi and yin deficiency groups. Sodium ions in the deficiency of spleen and kidney yang and yin and yang deficiency group were significantly higher than before. Calcium ions were significantly higher than those before dialysis in each group. Phosphorus ion was significantly lower in yin and yang deficiency group. Magnesium ions decreased significantly in liver-kidney yin deficiency group,yin and yang deficiency group and qi yin deficiency group. TC decreased significantly in patients with deficiency of spleen and kidney yang and deficiency of qi and yin. LDL-C decreased significantly in liver-kidney yin deficiency,yin and yang deficiency and qi and yin deficiency groups.[Conclusion] Hemodialysis can improve malnutrition in patients with ESRD,however,the degree of improvement is different among the patients with different deficiency syndrome. We can give more meticulous management to the nutritional index of different syndrome types. We may adjust the nutrition of patients and some Chinese and western medicine with similar effect at the same time of syndrome differentiation and treatment,in order to give full play to the advantages of integrating traditional Chinese and Western medicine. |
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