| BackgroundPeritoneal dialysis is use of peritoneal as semi permeable membrane, remove toxins as well as Correct water, electrolyte, acid-base balance disturbance by Diffusion and convection principle. Peritoneal dialysis is the most effective method of the treatment as end-stage renal disease, beacause it can carry out in the family easily, operate simply, effect on hemodynamics for the patients little, apply to the elderly and the cardiovascular. In the process of peritoneal dialysis gastrointestinal disorders are the most common compl icat ions, however, its pathogeny and mechanism is not completely clear. Modern medical mainly adopts the antiemetic, protecting gastric prokinetic, symptomatic treatment at present.ObjectivesThe thesis aims at observing and summing up the spleen-kidney-yang syndrom Patient’s gastrointestinal disorders caused by peritoneal dialysis (PD), curing with ginger moxibustiong therapy, probing the impact of the ginger moxibustiong therapy treatment on PD patients. Methods1.60Patients who carried on PD in the kidney internal medicine peritoneum of the first hospital of Wuhan by2010.3-2011.12was chosen. The dialectical dividing type of Chinese medicine, the spleen-kidney Yang-deficiency patients were randomly divided into control group (30cases) and therapy group (30cases), The treatment time was composed ten days.2. Tow groups for the high-quality protein diet and fully dialyse and treat, combine and control blood pressure, control blood glucose, correct anaemia, enrich the calcium and supplement vitamins to deal with to the ill according to the condition.3.control groupBe metoclopramide pin10mg, intramuscular injection, once daily; Domperidone Tablets10mg, oral, three times a day.4.Therapy groupAcu-point:Zhongwan (CV12), Shenque (RN8)Cutting fresh ginger into pieses of3mm because the heat cannot penetrate if it is too thick while it hurts easily if it is too thin.Punch the ginger piese into several pin holes from the center and put it on the acu-point Shenque(RN8), Zhongwan (CV12),and then put the burning moxa in certain size on ginger. Some patient feel burning pain because of the stimulation of fresh ginger immediately after they have moxibustion. Lift the ginger then and put it back right after the pain disappears.The doctor should check from time to time to prevent the patient from blebbing by insensitivity against heat. The Moxibusition is taken3zhuang each acu-point.5.Observe the physical symptom of2group before and after treatment,compared its overall curative effect and general course of treatment.6.After the day before treatment, and the end of treatment, observes the2group of PD patients’biochemical index:Urea Clearance (KT/V)、 Residual renal urea clearance、 Creatinine Clearance (Ccr)、 Residual renal creatinine Clearance、 Peritoneal Equilibration Test(PET)、 Peritoneal dialysate volume、 Urinary volume、 Serum Creatinine (Scr)、 Carbon dioxide combining power (CO2CP)、 Albumin (ALB)、 Hemoglobin (Hb)、 Potass ium (K+).Result1. Comparing nausea and vomiting between the two groups before and after treatment, the effective rate of control group was76.9%, and the other group was50.0%, there is obvious significant difference by statistical analysis (P<0.05); Comparing flatulence between the two groups before and after treatment, the effective rate of control group was68.9%, and the other group was86.7%, there is obvious significant difference by statistical analysis (P<0.05); Comparing reduction diet and defecate between the two groups before and after treatment, The effective rate of treatment group was respectively79.2%,68.4%, and the other group was respectively79.2%,68.4%, there is no significant difference by statistical analysis (P>0.05)2. By statistical analysis, the control group treated with gastrointestinal disorders of the total effective rate was72.1%, total effective rate in the treatment group was75.9%. There was no significant difference by comparison (P>0.05).3. By statistical analysis, the total course of the control group was8.6±1.9days, and the total course of the therapy group was5.9±2.1days. There was significant difference by comparison (P<0.05).4. The comparison of relevant biochemical indexes in the therapy group there were no significant differences in Urea Clearance (1.99±0.39、1.96±0.44)、 Residual renal urea clearance (0.65±0.33,0.70±0.29)、 Creatinine Clearance (66.95±8.03、67.02±7.99) Residual renal creatinine Clearance (23.78±7.63、23.19±8.50)(P>0.05).The comparison of relevant biochemical indexes in the control group before and after treatment, there were no significant differences in Urea Clearance (2.13±0.24、2.02±0.33)、 Residual renal urea clearance(0.66±0.35、0.69±0.31)、Creatinine clearance (67.81±8.52、66.71±8.85)、Residual renal creatinine clearance (23.78±7.63、23.19±8.50)(P>0.05)5.Comparing indexes of2groups before and after treatment, there were no significant differences in Dialysate/Plasma ratio of creatinine (D/Pcr) in the treatment group (0.612±0.059、0.593±0.064) and control group (0.627±0.057、0.660±0.053).(P>0.05).6. Comparing indexes of2groups before and after treatment, there were no significant differences in Peritoneal dialysate volume (Vd) in the treatment group (155±128、150±123) and control group (153±130、149±119) and Urinary volume (Vu) in the treatment group (752±298、739±305) and control group (758±292、740±301)(P>0.05)7.Comparing indexes of2groups before and after treatment, there were no significant differences in Scr in the treatment group (672.4±166.6、650.4±190.3) and control group (674.3±173.9、646.3±189.4)、CO2CP in the treatment group (22.9±1.8、22.8±2.1) and control group (24.3±1.32、23.4±1.22)、ALB in the treatment group (36.6±3.6、37.1±2.3) and control group (35.7±2.9、36.4±3.1)、 K+in the treatment group (4.0±0.99、3.7±1.33) and control group (3.9±1.1、4.1±0.91), Hb in the treatment group (84.5±11.4、79.4±12.6) and control group (83.3±10.8、80.5±14.3)(P>0.05)ConclusionMetoclopramide combined with domperidone and Ginger separated moxibustion can effectively improve the spleen kidney yang deficiency type PD patients show symptoms of nausea and vomiting, but Ginger separated moxibustion noninvasive, painless treatment method is simple, quick, worthy of clinical application. |
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