中医慢病管理对腹膜透析相关性腹膜炎发生率的影响

    Effect of chronic disease management of traditional Chinese medicine on the incidence of peritoneal dialysis-related peritonitis

    • 摘要: 目的 探讨中医慢病管理模式对腹膜透析相关性腹膜炎发生率的影响。方法 选取广东省中医院就诊的117例腹膜透析患者,按照随机数字表法随机分为对照组59例和观察组58例。对照组患者按照本院既往随访模式给予常规管理,观察组采用中医慢病管理模式给予管理,在中医慢病管理理念的指导下,我们中心采用了5A干预法具体内容是评估(Assess)、建议(Advise)、知情同意(Agree)、帮助(Assist)、安排(Arrange),随访12个月,比较2组患者腹膜透析相关性腹膜炎发生情况、发生原因、C-反应蛋白水平和营养状况。结果 对照组患者在一年的治疗中共发生14例次感染,腹膜炎发生率为0.24次/患者年,观察组患者共发生5例次感染,腹膜炎发生率为0.09次/患者年,相比有统计学差异(P<0.05)。比较2组腹膜类发生原因,差异无统计学意义(P>0.05)。2组患者治疗后C-反应蛋白、总蛋白、白蛋白、血红蛋白均较治疗前改善,观察组改善更显著(P<0.05)。结论 中医慢病管理模式可以降低腹膜透析相关性腹膜炎的发生率,改善患者的炎症指标及营养状况,改善患者的整体健康状况。

       

      Abstract: Objective To explore the influence of chronic disease management model on the incidence of peritoneal dialysis-related peritonitis.Methods 117 patients with peritoneal dialysis in Guangdong Province Traditional Chinese Medical Hospital, in accordance with the random number table, were divided into 59 cases in the control group and 58 in the experimental group. The control group was given routine management according to our previous follow-up mode. The observation group was administered by TCM chronic disease management mode. Under the guidance of the chronic disease management of TCM, 5A interventions (assess, advise, agree, assist, and arrange) were adopted in our center. After 12 months of follow-up, the occurrence of peritoneal dialysis-related peritonitis, causes of peritonitis, C-reactive protein (CRP) and nutritional status were compared between the two groups.Results In the control group, there were 14 cases of infection in one year, and the incidence of peritonitis was 0.24 times/year. There were 5 cases of infection in the experimental group, and the incidence of peritonitis was 0.09 times/year. There was a significant difference between the two groups(P<0.05). There were no statistical differences between the two groups in four aspects of the common causes of peritonitis, such as intestinal infection(caused by diet irregularities), fluid exchange operation, other infection and other reasons(P>0.05). After treatment, the C-reactive protein(CRP), total protein(TP), albumin(Alb) and hemoglobin(Hb) were improved after treatment in the two groups, but the improvement in the experimental group was more significant(P<0.05).Conclusions The chronic disease management of TCM can reduce the incidence of peritoneal dialysis-related peritonitis, improve the inflammatory indexes and nutritional status of the patients, and improve the overall health of the patients.

       

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