| Objective: General information and laboratory parameters were collected from both groups of maintenance haemodialysis patients with constipation and non-constipated patients to derive the relevant factors affecting constipation.Information on bowel movements and the degree of constipation in constipated patients was analysed.The overall distribution of TCM constitution between the two groups was compared and analysed and differences in constitution were derived.To analyse the distribution of body composition between age,gender,primary illness and degree of constipation in the constipation group and to provide a basis for the prevention and treatment of constipation by TCM.Materials and methods:The study was retrospective and included patients who underwent haemodialysis treatment at the Haemodialysis Centre of the Affiliated Hospital of Liaoning University of Chinese Medicine from December 2021 to February 2023,and were divided into a constipation group and a non-constipation group according to whether they were constipated or not.General data collection was completed,including medical record number,age,gender,age on dialysis,total number of dialysis sessions,dry weight,primary illness,amount of ultrafiltration per haemodialysis session,and medication use in both groups.Information on bowel movements was collected using the Bristol stool chart to describe stool characteristics,the PAC-QOL Chinese version(Patient-Assessment of Constipation Quality Of Life)to assess constipation status,and the degree of constipation in conjunction with the Chinese guidelines for the diagnosis and treatment of chronic constipation.The degree of constipation was assessed using the PAC-QOL Chinese version(Patient-Assessment of Constipation Quality Of Life),and the degree of constipation was graded according to the Chinese guidelines for the management of chronic constipation.Experimental indicators were collected,including Hemoglobin(HGB),Albumin(ALB),Serum creatinine(Scr),Blood urea nitrogen(BUN),Calcium(Ca),Phosphorus(P)Potassium(K),parathyroid hormone(PTH),etc.The data were statistically analysed by SPSS 22.0.Result:1.A total of 102 cases of MHD patients were investigated in this study.The incidence of constipation was 54.9% in 56 cases,including 28 cases of mild constipation(50%),17 cases of moderate constipation(30.4%)and 11 cases of severe constipation(19.6%).The stools were mainly dry and hard in 34 cases(60.7%)and nutty in 22 cases(39.3%).The main features of defecation were straining to pass stools in 19 cases(34.3%),hard and dry stools in 12 cases(22.5%),reduced frequency of defecation in 9 cases(16.7%)and the need for manual assistance in 6 cases(11.8%).2.In the present study,the age distribution of MHD constipated patients was mainly older than 60 years,the amount of ultrafiltration per haemodialysis was mostly≥5% of body weight,the age of dialysis was mostly≥24 months,and diabetic nephropathy was the most common primary disease.There were no significant differences in gender,number of dialysis sessions,dry weight,medications taken and dietary vegetables compared to the non-constipated group(p >0.05).3.There was a significant difference in serum calcium levels and serum potassium levels between the MHD constipated group and the non-constipated group(p<0.05).Serum calcium levels were higher in the constipated group than in the non-constipated group,and serum potassium levels were lower than in the non-constipated group.There was no statistically significant difference in haemoglobin,albumin,blood creatinine,blood urea nitrogen,blood uric acid,serum phosphorus ion and parathyroid hormone between the two groups respectively(P>0.05).4.In this study,multi-factor logistic regression analysis revealed that age,amount of ultrafiltration per haemodialysis,and diabetic nephropathy were positively associated with the occurrence of constipation,and the results were statistically significant(P<0.05).5.In this study,the frequency of TCM constitution of patients in the constipation group was in the following order: Yin deficiency(25.0%)> Qi deficiency(17.9%)> Yang deficiency(17.9%)> Blood stasis(14.3%)> Phlegm dampness(12.5%)> Damp heat(12.5%).On comparative testing,there was a statistically significant difference between patients in the constipation group and those in the non-constipation group in terms of yin deficiency quality,suggesting that yin deficiency quality may be a susceptible constitution for patients to develop constipation(P<0.05).6.In terms of age distribution of constipation patients,Qi deficiency was predominant at 46-60 years of age and Yin deficiency at >60 years of age.In terms of the distribution of primary illnesses,diabetic nephropathy with Yin deficiency quality was most common,hypertensive nephropathy with Blood stasis quality was most common,and chronic glomerulonephritis with Yin deficiency quality was most common(P<0.05).In terms of gender distribution,there was no statistical difference between males and females.In terms of the degree of constipation,there were differences between the constipation groups(P<0.05),with Yin deficiency predominating in mild constipation,Qi deficiency in moderate constipation and Yang deficiency in severe constipation.Conclusion:1.The incidence of constipation in MHD patients with CKD-5D was 54.9%,which was higher than that in the general population.2.This study found that the occurrence of constipation in MHD patients was influenced by age,diabetic nephropathy,the amount of ultrafiltration per haemodialysis,and that serum potassium ions were lower and calcium ions were higher in the constipated group compared to the non-constipated group.3.The main traditional chinese medicine constitution types in patients with MHD constipation are Yin deficiency,Qi deficiency and Yang deficiency4.The distribution of body masses varies according to age stage,primary illness,and degree of constipation. |
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