| 鲍浩月,陈凯,钱莉莉,等.针刺对维持性血液透析病人钙磷代谢、微炎症状态以及并发症的影响[J].安徽医药,2026,30(4):762-766. |
| 针刺对维持性血液透析病人钙磷代谢、微炎症状态以及并发症的影响 |
| Effect of acupuncture on calcium and phosphorus metabolism, micro inflammatory status, complications and sleep in maintenance hemodialysis patients |
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| DOI：10.3969/j.issn.1009-6469.2026.04.024 |
| 中文关键词: 针刺疗法 维持性血液透析 钙代谢障碍 磷代谢障碍 瘙痒症 白细胞介素 -6 肿瘤坏死因子 α C反应蛋白 睡眠质量 |
| 英文关键词: Acupuncture therapy Maintenance hemodialysis Calcium metabolism disorders Phosphorus metabolism disor-ders Pruritus Interleukin-6 Tumor necrosis factor-alpha C-reactive protein Sleep quality |
| 基金项目:开封市科技发展项目( 1903071)；中原学者工作站资助项目( 224400510016) |
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| 中文摘要: |
| 目的探讨针刺对维持性血液透析(MHD)病人钙磷代谢、微炎症状态、并发症以及睡眠的改善作用。方法选取 2020年 9月至 2021年 9月开封市人民医院内收治的 84例行 MHD的终末期肾病病人采用随机数字表法分组开展随机对照试验。对照组 42例病人和观察组 42例病人均给予常规西医治疗，另观察组 42例病人给予常规西医联合针刺治疗。观察治疗前、 3个疗程后、 6个疗程后钙磷代谢(钙和磷)和炎症介质水平［白细胞介素 -6(IL-6)、肿瘤坏死因子 α(TNF-α)和超敏 C反应蛋白( hs-CRP)］变化和治疗期间并发症发生情况，并采用匹兹堡睡眠质量指数( PSQI)量表评估不同时间点睡眠质量。结果 3个疗程后和 6个疗程后两组血清钙水平均高于治疗前(P<0.05)6个疗程后均高于 3个疗程后(P<0.05)； 3个疗程后和 6个疗程后两组血清磷、 IL-6、TNF-α、hs-CRP水平均低于治疗前( P<0.05)，6个，疗程后均低于 3个疗程后( P<0.05)；观察组 3个疗程后和 6个疗程后血清钙水平高于对照组［( 2.65±0.48)mmol/L比( 2.37±0.45)mmol/L、(3.01±0.50)mmol/L比( 2.68±0.47)mmol/L，P<0.05］，血清磷、 IL-6、TNF-α、hs-CRP水平均低于对照组［( 1.23±0.25)mmol/L比( 1.46±0.28)mmol/L、(134.95±27.48)ng/L比( 167.44±53.51) ng/L、(26.44±5.18)ng/L比( 35.86±9.04)ng/L、(7.26±1.54)mg/L比( 8.95±1.92)mg/L，(1.01±0.20)mmol/L比( 1.25±0.21)mmol/L、(102.25±22.06)ng/L比( 126.89±25.37)ng/L、(20.10±4.03)ng/L比( 27.28±5.10)ng/L、(5.01±0.97)mg/L比( 7.06±1.19)mg/L，P<0.05］；观察组皮肤瘙痒、低血压发生率低于对照组( P<0.05)； 3个疗程后和 6个疗程后两组 PSQI分数及睡眠障碍率均低于治疗(P<0.05)6个疗程后两组 PSQI分数均低于 3个疗程后( P<0.05)且观察组 3个疗程后和 6个疗程后 PSQI分数及睡眠障碍率 |
| 英文摘要: |
| Objective To explore the improvement effect of acupuncture on calcium and phosphorus metabolism, micro inflammatorystatus, complications and sleep quality in maintenance hemodialysis (MHD) patients.Methods Eighty-four MHD patients with end-stage renal disease treated in Kaifeng People's Hospital from September 2020 to September 2021 were randomly divided into two groups using a random number table method for clinical controlled trials. 42 patients in the control group were treated with convention-al Western medicine, while 42 patients in the observation group were treated with conventional Western medicine combined with acu-puncture treatment. The changes of calcium and phosphorus metabolism (calcium and phosphorus) and inflammatory media levels [in-terleukin-6 (IL-6), tumour necrosis factor α (TNF-α) and high-sensitive C-reactive protein (hs-CRP)] before treatment, after 3 courses oftreatment and after treatment, and the occurrence of complications during treatment were observed. The Pittsburgh sleep quality index(PSQI) scores was used to evaluate sleep quality.Results The serum calcium levels in the two groups after 3 courses of treatment and after treatment were higher than those before treatment (P < 0.05), which after treatment were higher than those after 3 courses of treat-ment (P < 0.05). The serum phosphorus, IL-6, TNF-α and hs-CRP levels in the two groups after 3 courses of treatment and after treat-ment were lower than those before treatment (P < 0.05), which after treatment were lower than those after 3 courses of treatment (P < 0.05). The serum calcium levels in the observation group after 3 courses of treatment and after treatment were higher than those in thecontrol group [(2.65 ± 0.48) mmol/L vs. (2.37 ± 0.45) mmol/L, (3.01 ± 0.50) mmol/L vs. (2.68 ± 0.47) mmol/L, P < 0.05], and the serum phosphorus, IL-6, TNF-α, and hs-CRP levels were lower than those in the control group [(1.23 ± 0.25) mmol/L vs. (1.46 ± 0.28) mmol/L, (134.95 ± 27.48) ng/L vs. (167.44 ± 53.51) ng/L, (26.44 ± 5.18) ng/L vs. (35.86 ± 9.04) ng/L, (7.26 ± 1.54) mg/L vs. (8.95 ± 1.92) mg/L; (1.01 ± 0.20) mmol/L vs. (1.25 ± 0.21) mmol/L, (102.25 ± 22.06) ng/L vs. (126.89 ± 25.37) ng/L, (20.10 ± 4.03) ng/L vs. (27.28 ± 5.10) ng/L, (5.01 ± 0.97) mg/L vs. (7.06 ± 1.19) mg/L, P < 0.05]. The incidence of skin itching and hypotension in the observation group was lower than that in the control group (P < 0.05). After 3 courses of treatment and after treatment, the PSQI scores and sleep disorderrates in both groups were lower than those before treatment (P < 0.05), and the PSQI scores of both groups after treatment were lower than those after 3 courses of treatment (P < 0.05), and the PSQI scores and sleep disorder rates of in the observation group after 3 cours-es of treatment and after treatment were lower than those in the control group (P < 0.05).Conclusion Combining acupuncture withconventional Western medicine treatment for MHD patients can improve calcium and phosphorus metabolism and micro inflammatorystatus, reduce the occurrence of skin itching and hypotension, and improve sleep quality. |
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