体质辨证饮食护理对胆石症手术患者中医证候与复发率的影响
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摘要
目的:探究体质辨证饮食护理对胆石症手术患者中医证候积分、营养状况及复发率的影响。方法:将96例胆石症手术患者随机分为观察组与对照组。对照组采用常规饮食护理,观察组采用体质辨证饮食护理,对比两组患者中医证候积分、营养状况、生命质量及结石复发率。结果:观察组中医证候积分较对照组低(P<0.05);观察组血红蛋白(Hb)、血清白蛋白(ALB)、血清前白蛋白(PA)及外周血淋巴细胞总数(TLC)较对照组低(P<0.05);两组患者护理后核心症状、躯体症状、心理症状、社会条目及特异疾病、总分均明显高于护理前,且观察组各评分较对照组高(P<0.05);护理后2周、3个月复发率比较,差异无统计学意义(P>0.05),而护理后6个月及1年观察组复发率明显低于对照组(P<0.05)。结论:体质辨证饮食护理有利于降低胆石症手术患者中医证候积分,改善营养状况,提高生命质量,并降低结石复发率。
Objective: To explore the effects of diet nursing guided by TCM constitution theory on TCM syndrome score, nutritional status, and recurrence rate of patients undergoing cholelithiasis surgery. Methods: A total of 96 patients with cholelithiasis underwent cholelithiasis surgery were randomoly divided into observation group and control group. The control group was given routine diet nursing while the observation group was given diet nursing guided by TCM constitution theory. The scores of TCM syndromes, nutritional status, quality of life, nursing satisfaction, and recurrence rate of stones were compared between the two groups. Results: The observation group showed lower TCM syndrome score than control group(P<0.05); the hemoglobin(Hb), serum albumin(ALB), serum prealbumin(PA), and total lymphocyte count(TLC) in the observation group were lower than those in the control group(P<0.05); the core symptoms, physical symptoms, psychological symptoms, social items and special diseases, and total scores of the two groups after nursing were significantly higher than those before nursing, and the observation group showed higher scores than control group(P<0.05); there was no significant difference in recurrence rate between the two groups, 2 weeks and 3 months after nursing(P>0.05), but the observation group showed lower recurrence rate than the control group, 6 months and 1 year after nursing(P <0.05). Conclusion: The diet nursing guided by TCM constitution theory is helpful to reduce TCM syndrome scores, improve nutritional status, improve quality of life, and reduce the recurrence rate of gallstones in patients undergoing cholelithiasis surgery.
Objective: To explore the effects of diet nursing guided by TCM constitution theory on TCM syndrome score, nutritional status, and recurrence rate of patients undergoing cholelithiasis surgery. Methods: A total of 96 patients with cholelithiasis underwent cholelithiasis surgery were randomoly divided into observation group and control group. The control group was given routine diet nursing while the observation group was given diet nursing guided by TCM constitution theory. The scores of TCM syndromes, nutritional status, quality of life, nursing satisfaction, and recurrence rate of stones were compared between the two groups. Results: The observation group showed lower TCM syndrome score than control group(P<0.05); the hemoglobin(Hb), serum albumin(ALB), serum prealbumin(PA), and total lymphocyte count(TLC) in the observation group were lower than those in the control group(P<0.05); the core symptoms, physical symptoms, psychological symptoms, social items and special diseases, and total scores of the two groups after nursing were significantly higher than those before nursing, and the observation group showed higher scores than control group(P<0.05); there was no significant difference in recurrence rate between the two groups, 2 weeks and 3 months after nursing(P>0.05), but the observation group showed lower recurrence rate than the control group, 6 months and 1 year after nursing(P <0.05). Conclusion: The diet nursing guided by TCM constitution theory is helpful to reduce TCM syndrome scores, improve nutritional status, improve quality of life, and reduce the recurrence rate of gallstones in patients undergoing cholelithiasis surgery.
引文
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[2]赵今.综合护理对胆石症手术患者手术依从性、术后睡眠质量的影响[J].中国医药导刊,2016,18(7):732-733.
[3]陈禹,李玲孺,石劢,等.基于中医体质的营养学研究方法探讨[J].中华中医药学刊,2016,34(3):554-556.
[4]王慧如,于宁,刘哲,等.《黄帝内经》体质学说与现代中医体质学说比较[J].中华中医药杂志,2017,32(4):1458-1461.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[6]中华中医药学会.中医体质分类与判定(ZYYXH/T157-2009)[J].世界中西医结合杂志,2009,4(4):303-304.
[7] Eypasch E, Williams J I, Wooddauphinee S, et al.Gastrointestinal Quality of Life Index:development,validation and application of a new instrument.[J]. British Journal of Surgery,2010,82(2):216-222.
[8]潘群.中医综合护理干预对非手术胆石症患者效果观察[J].四川中医,2016,34(8):220-222.
[9]黄家元,林碧英.中西医结合护理方案对胆结石手术患者情绪及生活质量影响的观察[J].中医药导报,2015,21(11):106-109.
[10]屈玉华,陈凤鸣,黎胜春.根据中医体质学对功能性便秘者行中医食疗效果研究[J].四川中医,2016,34(5):144-145.
[11]王苑,许洪伟.我国胆石症危险因素的Meta分析[J].中华肝胆外科杂志,2016,22(6):386-390.
[12]冯群英,邵铭.邵铭教授治疗胆石症经验[J].吉林中医药,2018,38(6):638-640.
[13]郭清华,刘玉,颜延凤,等.对“胆移热于脑,则辛颏鼻渊”的认识[J].国际中医中药杂志,2017,39(2):163-164.
[14]徐立军,程友花,曾勇.肝胆结石患者中医体质类型分析[J].中国医药导报,2013,10(22):118-120.
[15]伊西磊,郭吕.120例胆石症患者中医体质辨证调查与分析[J].现代中西医结合杂志,2013,22(4):382-383.