关键词: 肾病, 生活质量, 透析, 中医治疗, 数据收集

Abstract: Background　Patients with chronic kidney disease（CKD） stage 5D often suffer from different levels of functional disability，which causes physical and mental stresses，seriously impairing the prognosis and quality of life（QOL）．Most of treatments for such patients focus on improving their QOL and promoting clinical rehabilitation，by which they can return to normal daily activities.TCM treatment has great potential for improving the QOL of dialysis patients.Objective　To investigate the impact of TCM treatment on the QOL of patients with CKD stage 5D.Methods　Participants with CKD stage 5D were recruited from Department of Nephrology，Affiliated Hospital of Nanjing University of Chinese Medicine from January 2017 to January 2018 in accordance with the inclusion and exclusion criteria of the study.General data were collected，such as dialysis mode，essential information（gender，age，marital status，education level，employment status，primary disease，dialysis duration，comorbidity），laboratory inspection indicators，TCM treatment in the past half year，and types of TCM treatment（herbal decoction，Chinese patent medicine Baoshen Tablets，lavipeditum with herbs，acupoint plaster therapy，auriculotherapy with ear seeds，or moxibustion）．KDQOL-SFTM 1.3 was used in a survey to assess the QOL of patients.Results　Of the 140 participants，132 responded to the survey effectively，achieving a response rate of 94.29%.Among the 132 respondents，80 underwent hemodialysis（HD） and 52 underwent peritoneal dialysis（PD）；86（65.15%） received TCM treatment within six months，including 40 with HD and 46 with PD；60 received Chinese patent medicine，20 received Chinese herbal decoction，15 received lavipeditum with herbs，17 received auriculotherapy with ear seeds，15 received acupoint plaster therapy，and 9 received moxibustion.At least 2 types of TCM treatments were simultaneously administered to 12 HD patients，and 20 PD patients.The percentage of taking Baoshen Tablets was highest in HD patients，followed by that of receiving acupoint plaster therapy.The percentage of taking Baoshen Tablets was also highest in PD patients，followed by that of receiving herbal decoction.HD patients had lower KDTA dimension score than PD patients （P<0.05）．In KDTA dimension，HD patients had lower average item scores in terms of dialysis staff encouragement，and patient satisfaction compared with PD patients （P<0.05）．The KDTA dimension score achieved by those younger than 45 years was higher than that achieved by those aged 60-75，or aged greater than 75 years（P<0.05）．The KDTA dimension score achieved by those without comorbidity was higher than that achieved by those with 1，2 or 3 comorbidities（P<0.05）．Those with TCM treatment had higher KDTA dimension score than those without（P<0.05）．In KDTA dimension，those with TCM treatment had higher average item scores in terms of symptom/problems，effects of kidney disease on daily life，cognitive function，sexual function，sleep，support and encouragement of dialysis staff than those without（P<0.05）．HD patients had lower SF-36 dimension score than PD patients（P<0.05）．In SF-36 dimension，HD patients had lower item scores in terms of physical functioning（P<0.05）．The SF-36 dimension score achieved by those younger than 45 years was higher than that achieved by those aged 60-75，or aged greater than 75 years（P<0.05）．Those with primary education had lower SF-36 dimension score than those with secondary or tertiary education（P<0.05）．The SF-36 dimension score achieved by those without comorbidity was higher than that achieved by those with 1，2 or 3 comorbidities（P<0.05）．Those with TCM treatment had higher SF-36 dimension score than those without（P<0.05）．In SF-36 dimension，those with TCM treatment had higher item scores in terms of physical functioning，pain，general health perceptions，emotional well-being，role limitations caused by emotional health problems，and social functioning than those without（P<0.05）．Conclusion　Dialysis mode，age，education level，and comorbidity were associated with the QOL of patients with CKD stage 5D.TCM treatment has a positive effect on the improvement of the QOL of such patients.

Key words: Nephrosis, Quality of life, Dialysis, Therapeutics, Data collection