Observation On The Effect Of Diet Based On Syndrome Differentiation And Self-management On The Malnutrition Of Liver And Kidney Liver Cirrhosis Patients

Objectives:To observe the effect of diet based on syndrome differentiation and self-management on malnutrition in patients with hepatitis B cirrhosis caused by deficiency of liver and kidney,and to explore a simple,effective and suitable home nutrition intervention program with traditional Chinese medicine characteristics,so as to provide a scientific basis for home nutrition intervention in patients with hepatitis B cirrhosis.Methods:A randomized controlled study was conducted to select 64 patients with liver and kidney deficiency hepatitis B cirrhosis malnutrition who were admitted to the liver disease outpatient department or inpatient department of Guangdong Hospital of Traditional Chinese Medicine from April 2018 to May 2019.The patients were divided into control group and observation group according to the order of the patients’ treatment according to simple randomized grouping method,with 32 patients in each group.The control group was given conventional TCM and Western medicine treatment and health education,and the observation group was given individualized TCM syndrome differentiation diet combined with self-management guidance on the basis of the control group,a course of treatment every 4 weeks,a total of 3 courses of treatment.Patients in both groups were observed and followed up for 12 weeks.To evaluate whether there were differences in nutrition-related biochemical indicators(including serum albumin,prealbumin and total cholesterol),Subjective global assessment(SGA),TCM symptom score and The Mos 36-item short form health survey(SF-36)between the two groups after intervention.Results:1.Baseline situationA total of 64 cases were included in this study,including 32 cases in the observation group and 32 cases in the control group.During the follow-up observation,2 patients in the observation group withdrew from the study because they could not adhere to the dietary requirements,and 2 patients in the control group withdrew from the study because of job changes,with a shedding rate of 6.25%.No patients had adverse events during the study.Finally,30 effective cases in each group were included in the statistical data set.There were no significant differences between the two groups in age distribution,gender distribution,marital status,education,Body Mass Index(BMI),Child-Pugh grading score for cirrhosis,course of cirrhosis and related therapeutic drugs(P>0.05).2.Efficacy evaluation(1)Comparison of nutrition-related biochemical indexes between the two groupsAfter 12 weeks of intervention,serum albumin and prealbumin levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference in total cholesterol level between the two groups(P>0.05).(2)Comparison of Subjective Total Nutrition Assessment(SGA)between the two groupsAfter 12 weeks of intervention,the subjective comprehensive nutritional assessment results of patients in both groups were as follows:observation group(19 cases of SGA-A,11 cases of SGA-B,0 cases of SGA-C);There were 3 cases of SGA-A,24 cases of SGA-B and 3 cases of SGA-C in the control group.The nutritional status of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).(3)Comparison of TCM symptom scores between the two groupsAfter 12 weeks of intervention,the total score of liver and kidney Yin deficiency in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).(4)Comparison of quality of life(SF-36)between the two groupsIntervention after 12 weeks,observation group of patients in physical functioning(PF),role limitation because of physical problem(RP),bodily Pain(BP),general health(GH)and vitality(VT),social function(SF),role limitation caused by emotional problem(RE)and mental health(MH)eight dimension score and physical component summary(PCS),mental component summary(MCS)total score were higher than the control group,The difference was statistically significant(P<0.05).Conclusions:The traditional Chinese medicine characteristic nutrition intervention method combining syndrome differentiation and self-management can effectively improve the nutritional status of liver and kidney Yin deficiency type hepatitis B cirrhosis patients,reduce the clinical symptoms of patients,and improve the quality of life of patients.This method is suitable for the rehabilitation of liver and kidney deficiency hepatitis B cirrhosis patients at home and is worthy of further clinical application.