目的 研究维持性血液透析(MHD)患者中医证候与生存质量的关系.方法 选择本院血液透析中心的MHD患者102例,采用问卷调查方式,利用慢性肾脏病专用量表KDQOL-SFTM1.3的使用和计数方法评分评价患者肾脏病与透析相关生存质量(KDTA)和一般健康相关生存质量(SF-36).结果 正虚证型中肝肾阴虚、阴阳两虚的KDTA总评分较高,气阴两虚、脾肾阳虚评分较低;在认知功能、自我健康评价、躯体职能差异有统计学意义(均P〈0.05).邪实证中有血瘀证者KDTA总评分低于无血瘀证者,对症状、肾脏病对日常生活的影响、睡眠及躯体疼痛方面差异有统计学意义(均P〈0.05);有风动证者KDTA总评分低于无风动证者,对症状影响因素评分差异有统计学意义(P〈0.05).以标实为主者KDTA总评分及大部分影响因素得分明显低于以本虚为主者,差异有统计学意义(均P〈0.05).结论 中医证候与生存质量有一定关系,MHD患者血瘀证及标本虚实的研究可以借鉴生存质量的研究方法.
Objective To study the relationship between Chinese medical syndrome and living quality of maintenance hemodialysis (MHD) patients. Methods One hundred and two MHD patients in hemodialysis center of Guang'anmen Hospital were collected, adopting the way of questionnaire investigation and using the method of marking a manual for use and scoring in KDQOL-SFTM 1.3 which was disease-specific questionnaire of chronic kidney disease in order to evaluate living quality related to the patientst kidney disease and dialysis (KDTA) and the patientst general health (SF-36). Results Among deficiency of healthy energy syndromes (正虚证型), the syndrome of liver-kidney yin deficiency (肝肾阴虚) and yin-yang deficiency (阴阳两虚) got higher scores, while the qi-yin deficiency syndrome (气阴两虚) and spleen-kidney yang deficiency (脾肾阳虚) got lower scores in overall scores on KDTA. In the general estimates, the cognitive function, self-health and physiological role had statistical significant differences (all P〈0.05). Among sthenia of evil syndromes (邪实证), the patients with blood-stasis syndrome (血瘀证) got lower score than those without it in the KDTA score. In the aspect of symptoms, renal disease which had impact on daily life, sleep and body pain had statistical significant differences (all P〈0.05). In KDTA score, the patients classified to wind-act syndrome (风动证) got lower scores than those without such syndrome. The difference in scoring of symptom influencing factor had statistical significance (P〈0.05). The living quality of patients mainly classified into incidental-excess syndrome (标实证) was clearly poorer than those chiefly classified into fundamentaldeficiency syndrome (本虚证), and the difference had statistical significance (all P〈0.05). Conclusion A relationship exists between Chinese medical syndrome and living quality of a MHD patient. We can draw lessons from the method in living quality sco