【摘要】：目的觀察耳穴壓丸法對(duì)維持性血液透析(MHD)患者焦慮狀態(tài)的影響,并同時(shí)探討患者干預(yù)前后焦慮評(píng)分變化與尿素清除指數(shù)(Kt/V)、血紅蛋白(Hb)、血清白蛋白(Alb)、鈣磷乘積(Ca×P)等指標(biāo)的相關(guān)性。方法選擇2016年3~10月在東直門醫(yī)院透析室進(jìn)行MHD的患者共44例,隨機(jī)分為兩組,采用交叉試驗(yàn)設(shè)計(jì),分為兩個(gè)治療階段,每個(gè)階段時(shí)間為6周,治療組(22例)在常規(guī)血液透析治療基礎(chǔ)上予以耳穴壓丸法干預(yù),對(duì)照組(22例)予常規(guī)血液透析治療,第一階段結(jié)束后經(jīng)過(guò)4周洗脫期,兩組進(jìn)行交叉,開(kāi)始第二階段治療。并于治療前、第一階段治療后、洗脫期末及第二階段治療后對(duì)兩組患者進(jìn)行漢密爾頓焦慮量表(HAMA)評(píng)分,以評(píng)分減分率作為療效評(píng)價(jià)標(biāo)準(zhǔn),并同時(shí)觀察患者治療前后的Kt/V、Hb、Alb、Ca×P等指標(biāo),分析是否與HAMA評(píng)分變化具有相關(guān)性。結(jié)果治療組治療后的HAMA評(píng)分與治療前比較明顯減少,差異有統(tǒng)計(jì)學(xué)意義(t=0.575,P0.01),對(duì)照組治療前后HAMA評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.770,P0.05);兩組患者治療前后的HAMA評(píng)分與Kt/V相關(guān)性無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),與Hb、Alb成負(fù)相關(guān),即Hb、Alb數(shù)值升高,HAMA評(píng)分減少,相關(guān)性均有統(tǒng)計(jì)學(xué)意義(P0.05),與Ca×P成正相關(guān),即Ca×P數(shù)值升高,HAMA評(píng)分增多,相關(guān)性有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組的總有效率為88.6%。結(jié)論耳穴壓丸法能在一定程度上改善MHD患者焦慮狀態(tài),且HAMA評(píng)分變化與Hb、Alb及Ca×P數(shù)值存在相關(guān)性。
[Abstract]:Objective to observe the effect of auricular acupoint pressing pill on anxiety in patients with maintenance hemodialysis (MHD), and to explore the correlation between anxiety score and urea clearance index (Kt/V), serum albumin (Ca 脳 P) product of hemoglobin (Hb), albumin (Ca 脳 P) before and after intervention. Methods A total of 44 patients undergoing MHD in dialysis room of Dongzhimen Hospital from March to October 2016 were randomly divided into two groups. The treatment group (22 cases) were treated with auricular acupoint pressing pills on the basis of routine hemodialysis treatment, while the control group (22 cases) were treated with routine hemodialysis. After 4 weeks of elution at the end of the first stage, the two groups were intersected to begin the second stage of treatment. Before and after the first stage of treatment, the patients in the two groups were evaluated with Hamilton anxiety scale (HAMA) at the end of elution period and after the second stage of treatment. The score reduction rate was taken as the criterion for evaluating the curative effect, and the Kt/V,Hb,Alb,Ca 脳 P indexes before and after treatment were also observed. Analysis of whether there is a correlation between the HAMA score changes. Results the HAMA score of the treatment group was significantly decreased after treatment. There was no significant difference in HAMA score between the two groups before and after treatment (P 0.05), but there was no significant correlation between HAMA score and Kt/V before and after treatment (P0.05), but there was a negative correlation between HAMA score and Hb,Alb, that is, the increase of Hb,Alb value decreased Hama score. The correlation was statistically significant (P0.05). There was a positive correlation with Ca 脳 P, that is, the Ca 脳 P increased and Hama score increased, and the correlation was statistically significant (P0.05). The total effective rate of the treatment group was 88. 6%. Conclusion the auricular acupoint pressing pill method can improve the anxiety state of MHD patients to some extent, and the change of HAMA score is correlated with Hb,Alb and Ca 脳 P values.
【作者單位】： 北京中醫(yī)藥大學(xué)東直門醫(yī)院透析室;
【基金】：北京中醫(yī)藥大學(xué)校級(jí)自主選題項(xiàng)目(2013-ZYLC-003)
【分類號(hào)】：R692.5

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