穴位温灸对持续性不卧床腹膜透析脾肾阳虚证患者营养状况和腹膜透析充分性的影响

目的 观察穴位温灸对持续性不卧床腹膜透析（continuous ambulatory peritoneal dialysis，CAPD）脾肾阳虚证慢性肾衰竭患者营养状况和腹膜透析充分性的影响。方法 将50例行CAPD脾肾阳虚证慢性肾衰竭患者随机分为对照组与治疗组，每组25例。治疗组和对照组各有1例退出观察，对照组完成24例，治疗组完成24例。两组患者均给予CAPD及肾衰竭常规治疗。治疗组患者应用温灸疗法，每天1次，每次30 min，疗程为8周。观察两组患者治疗前后中医证候疗效、中医证候积分、血白蛋白（albumin，ALB）、前白蛋白（prealbumin，PA）、改良定量主观整体评估（modified quantitative subjective global assessment，MQSGA）评分、总尿素清除指数（blood urea clear index，KT/V）和每周总肌酐清除率（total creatinine clearance，TCcr）。结果 两组脾肾阳虚证疗效比较，差异有统计学意义（P<0.05），治疗组明显优于对照组。与治疗前比较，治疗组治疗后畏寒肢冷、倦怠乏力、食少纳呆、腰膝酸软、脘腹胀满、大便溏泄、MQSGA评分均显著降低（P<0.05），治疗后ALB、PA、KT/V和每周TCcr显著上升（P＜0.05）；对照组治疗后上述指标均无显著变化（P>0.05）。结论 温灸中脘、神阙和关元穴能改善CAPD脾肾阳虚证慢性肾衰竭患者临床症状和营养状况，提高患者腹膜透析充分性。

Effect of Needle Warming Moxibustion at Acupoints on Nutritional Status and Dialysis Adequacy in Patients with Syndrome of Spleen-Kidney Yang Deficiency Undergoing Continuous Ambulatory Peritoneal Dialysis

Objective To investigate the effect of needle warming moxibustion at acupoints on nutritional status and dialysis adequacy in chronic renal failure patients with syndrome of spleen-kidney Yang deficiency undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods A total of 50 chronic renal failure patients with syndrome of spleen-kidney Yang deficiency who underwent CAPD were randomly divided into treatment group and control group, with 25 patients in each group. One patient in the treatment group and one in the control group withdrew from the treatment, and 24 patients in the treatment group and 24 in the control group completed the treatment. Both groups were given CAPD and conventional treatment of renal failure; in addition, the patients in the treatment group were given needle warming moxibustion once a day for 30 minutes each time, and the course of treatment was 8 weeks. The two groups were observed in terms of the outcome of traditional Chinese medicine (TCM) syndrome, TCM syndrome score, albumin (Alb), prealbumin (PA), modified quantitative subjective global assessment (MQSGA) score, blood urea clear index (KT/V), and total creatinine clearance rate (TCcr) before and after treatment. Results There was a significant difference in the outcome of syndrome of spleen-kidney Yang deficiency between the two groups (P<0.05), and the treatment group had a significantly better outcome than the control group. After treatment, the treatment group had significant reductions in MQSGA score and the scores of fear of cold and cold limbs, fatigue and weakness, poor appetite, soreness and weakness of the waist and knees, abdominal fullness and distention, and loose stool (P<0.05) and significant increases in Alb, PA, KT/V, and weekly TCcr (P<0.05), while the control group had no significant changes in these indices (P>0.05). Conclusion Needle warming moxibustion at Zhongwan, Shenque, and Guanyuan acupoints can improve clinical symptoms, nutritional status, and dialysis adequacy in patients with syndrome of spleen-kidney Yang deficiency undergoing CAPD.