摘要
目的探讨基于中医"固本开渠"理论实施辨证施膳对肝硬化腹水患者中医证候积分的影响。方法选择2019年3月至2020年1月收治入上海中医药大学附属曙光医院的84例肝硬化腹水患者,采取2×3析因设计方法,以是否进行辨证施膳与药膳类别作为处理因素,根据研究对象的辨证分型不同,采取随机区组方法进行入组,每组14例。3个非辨证施膳组采用肝硬化腹水常规护理;3个辨证施膳组在常规护理的基础上,基于中医"固本开渠"理论辨证选择相应的药膳:脾肾阳虚证选择参芪瘦肉汤,肝肾阴虚证选择枸杞麦冬排骨汤,气滞血瘀证选择当归三七排骨汤,采用肝病中医证候积分量表、肝硬化腹水疗效评定进行效果评价。结果纳入有效病例80例。入院第1天、第14天和出院2周3个时间点肝病中医证候积分:脾肾阳虚证辨证施膳组(a1b1)分别为(46.38±8.56)、(34.20±8.42)、(31.40±4.22)分,肝肾阴虚证辨证施膳组(a1b2)分别为(41.50±8.71)、(31.35±8.63)、(31.12±4.94)分,气滞血瘀证辨证施膳组(a1b3)分别为(45.92±7.86)、(35.17±7.57)、(30.83±7.32)分,脾肾阳虚证非辨证施膳组(a2b1)分别为(46.29±8.38)、(39.79±7.65)、(36.64±6.83)分,肝肾阴虚证非辨证施膳组(a2b2)分别为(40.50±8.12)、(38.10±8.93)、(35.38±8.24)分,气滞血瘀证非辨证施膳组(a2b3)分别为(45.62±7.99)、(41.83±7.31)、(38.83±7.96)分;3个时间点肝病中医证候积分经广义估计方程统计发现有统计学意义(χ2值为63.998,P<0.05),且各组的组间比较有统计学意义(χ2值为20.993,P<0.05);入院第14天和出院2周,辨证施膳3组患者与非辨证施膳3组患者肝病中医证候积分的组间比较有统计学意义(F值为3.244、3.489,均P<0.05)。结论基于中医"固本开渠"理论,辨证施膳组可有效降低肝硬化腹水患者中医证候积分,改善症状,增强疗效,值得临床推广应用。
Objective To explore the effect of dialectical diet on traditional Chinese medicine(TCM)syndrome score of cirrhotic ascites patients based on"Gu Ben Kai Qu"theory.Methods From March 2019 to January 2020,84 patients with liver cirrhosis and ascites admitted to Shuguang Hospital Affiliated to Shanghai University of TCM were randomly divided into two groups according to the different dialectical types of the subjects,14 cases in each group.Three non-syndrome differentiation diet groups were given routine nursing care of liver cirrhosis ascites.On the basis of routine nursing,the corresponding medicinal diet was selected according to syndrome differentiation based on"Gu Ben Kai Qu"theory.Patients with spleen and kidney yang deficiency syndrome selected Shenqi lean meat decoction.Patients with Yin deficiency of liver and kidney selected Wolfberry and ophiopogon spareribs decoction.Patients with qi stagnation and blood stasis syndrome selected Danggui Sanqi spareribs decoction.The TCM syndrome score scale for liver disease and the curative effect evaluation of cirrhosis ascites were used to evaluate the effect.Results Eighty effective cases were included.On the first day of admission,the 14th day and the second week after discharge,the TCM syndrome scores of liver disease were as follows:the group(a1b1)with the spleen and kidney yang deficiency syndrome was 46.38±8.56,34.20±8.42,31.40±4.22,respectively.The group(a1b2)with the liver kidney yin deficiency syndrome was 41.50±8.71,31.35±8.63,31.12±4.94.The group(a1b3)with the qi stagnation and blood stasis syndrome was 45.92±7.86,35.17±7.57,30.83±7.32,respectively.The non-syndrome differentiation diet group(a2b1)with the spleen and kidney yang deficiency syndrome was 46.29±8.38,39.79±7.65,36.64±6.83,respectively.The non-syndrome differentiation diet group(a2b2)with the liver and kidney yin deficiency syndrome was 40.50±8.12,38.10±8.93,35.38±8.24,respectively.The non-syndrome differentiation diet group(a2b3)with the qi stagnation and blood stasis syndrome was
作者
胡丽
唐晓雯
刘丽艳
沈丹阳
张雅丽
谭红阳
Hu Li;Tang Xiaowen;Liu Liyan;Shen Danyang;Zhang Yali;Tan Hongyang(Hepatology Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Nursing Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Pharmacy Department,Shanghai Pudong New Area Mental Health Center,Shanghai 200124,China)
出处
《中国实用护理杂志》
2021年第29期2287-2295,共9页
Chinese Journal of Practical Nursing
基金
上海市卫生计生系统面上项目(201640392)。
关键词
扶正固本
开渠利水
肝硬化腹水
辨证施膳
中医证候积分
影响
Fu Zheng Gu Ben
Kai Qu Li Shui
Ascites due to cirrhosis
Dialectical meal
Traditional Chinese medicine syndrome score
Influence
