| Objective:The cognitive function of Maintenance peritoneal dialysis(MPD)patients in our hospital were evaluated.Record TCM syndromes of patients in clinical report form,invite TCM doctors to carry out dialectical classification;The subjects of Mild cognitive impairment(MCI)were randomly divided into two groups to explore the clinical effect of comprehensive intervention of traditional Chinese medicine(TCM)on MCI of pd patients.Method:1.The Chinese version of Montreal Cognitive Assessment Scale(Mo CA)was used to screen the Cognitive function of MPD patients.All patients were from the peritoneal dialysis center and inpatients of wuhan hospital of integrated traditional Chinese and western medicine from September 2016 to September 2018.2.The medical record of TCM syndromes of patients with MCI on maintenance peritoneal dialysis was formulated.the patients with MCI were divided into five types of syndromes,including deficiency and reality,according to the degree of main syndromes and syndromes.Meanwhile,the doctors with TCM professional qualifications were invited to carefully carry out the four diagnostic combinations to distinguish the patients' syndromes.3.Record by scoring method before and after treatment in patients with disease,mainly including seven core symptoms(when words do not know fore and aft,as when he turned to forget,the consideration is poor,slow,and then forgotten,memories,not thinking not to get together,the body clumsy)and the eight surrounding symptoms(fatigue,insomnia,irritability,dizziness,fear cold,cold extremities,chest condition,dim complexion,lumbar debility)4.Patients diagnosed with cognitive dysfunction were randomly divided into two groups.On the basis of general treatment,the control group was treated with lifestyle guidance(health education,reasonable diet,etc.),psychological intervention and social support.The observation group was treated with Chinese medicine foot bath and acupoint massage on the basis of the control group for 3 months.Result:1.A total of 304 MPD patients in our hospital completed the cognitive function screening,106 of which were diagnosed as MCI,104 of which met the inclusion criteria.The 104 patients were randomly divided into observation group and control group with 52 cases each.2.After 3 months of treatment,Mo CA scores in both groups were higher than before(P<0.05).The difference in cognitive field of visual space and executive function in delayed recall was statistically significant in the observation group before and after treatment(P<0.05).Compared with the control group,the observation group had higher scores in overall cognitive function,visual space and execution,delayed recall and other cognitive domains after treatment,and the difference was statistically significant(P<0.05).3.Core observation group after treatment symptoms separate core symptom integral and total integral were obviously decreased(P< 0.05),the control group in addition to turn to forget limbs awkward aspect,there was no statistically significant difference before and after treatment,other symptoms were improved from the previous group(P<0.05)after treatment is compared between observation group in the core symptoms always turn to forget limbs awkward aspect symptoms integral was lower than those of control group(P <0.05).4.Observation group surrounding symptoms are obviously improved after treatment,around eight symptoms integral are compared with the previous decreased(P<0.05),the control group only insomnia symptom score before and after treatment difference was statistically significant(P<0.05),the observation group after treatment around eight symptoms than the control group decreased(P<0.05),two groups of peripheral symptoms curative effect compared with the total effective rate was significant difference(P<0.05).Conclusion:1.MCI in MPD patients generally involves multiple cognitive domains,among which delayed recall,reduced visual space and execution score have the highest incidence,and reduced directional function score has the least occurrence.2.The most common syndrome of MPD patients with MCI is phlegm turbidity obstruction syndrome,followed by kidney deficiency and pith loss,heart and spleen deficiency,qi stagnation and blood stasis,heart and liver Yin deficiency.3.Cognitive intervention(including lifestyle guidance,psychological adjustment,social support,etc.)with the medicated bath foot and acupoint massage on the cognitive function of patients with MPD and TCM syndrome has significant curative effect,than the single use of non-pharmaceutical interventions for cognitive effects,and medicated bath foot and acupoint massage in the core of traditional Chinese medicine on the patients with peripheral symptoms improved significantly effect,can improve the patients quality of life... |
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