Based On BCM To Study The Relationship Between MHP Quality Of Life And Nutritional Status, Water Storage Status And TCM Syndromes

Obj ective:We use body composition monitor(BCM)combined with laboratory tests,TCM syndrome classification and quality of life(QOL)assessment to study the relationship between QOL and nutritional status,water storage status and TCM syndromes in maintenance hemodialysis patient(MHP).The determination of this study is to provide a theoretical basis for comprehensive treatment of MHP,and improve the QOL of them.Methods:The study include 85 MHP treated in the blood purification room of Oriental Hospital of BUCM from August 1,2017 to March 1,2019,The basic information,physical and chemical examination results and BCM test results of the patients were collected.The TCM symptoms and QOL of the patients were quantitatively processed by using the TCM syndrome classification scale and KDQOL-SFTM 1.3.The original data were entered Excel,and analyzed by cross-sectional study with SPSS 20.0 statistical software and Excel.Results:?The mean scores of KDTA and SF-36 were(66.67±9.61)and(66.30±17.04)of the 85 MHP.There were 42 cases in high KDTA group and 43 cases in low KDTA group.There were 46 cases in high SF-36 group and 39 cases in low SF-36 group.?The QOL in male was significantly higher than that in female(P?0.01).There was no significant correlation between primary disease,age,dialysis age and QOL(P>0.05).?LTI and QOL are positively correlated.Under the state of hyperlipidemia,the level of TG in the high QOL group was significantly lower than that in the low QOL group(P<0.05).There were no significant differences in Hb,RBC,HCT,CHO,LDL,HDL,ALB,nPCR levels and QOL(P>0.5).?The difference between clinical DW and theoretical DW(?DW)was<-lkg.sp KT/V level was in the normal range.In this state,there was no statistical difference between sp KT/V and QOL(P>0.05).?TBW%(xi)and LTI(x2)could form a statistically significant binary regression equation with KDTA(y1)and SF-36(y2):y1=73.345-28.585x1+0.568x2;y2=68.073-36.893xi+1.286x2.?The average score of KDTA in spleen-kidney qi deficiency syndrome was the highest(69.75±8.08 points),followed by liver-kidney yin deficiency syndrome(69.08±12.47 points),qi-yin deficiency syndrome(68.47±9.84 points).Yin-yang deficiency syndrome had the lowest KDTA score(61.95±5.69 points),followed by dampness-turbidity syndrome(64.12±7.02 points)and spleen-kidney yang deficiency syndrome(64.94±10.26 points).The SF-36 scores of each syndrome type also showed the same trend.The proportion of KDTA high group in each syndrome type was the lowest in yin-yang deficiency syndrome,followed by dampness-turbidity syndrome.The spleen-kidney qi deficiency syndrome was the highest.The difference was statistically significant(P<0.05).There was no statistical difference in the proportion of SF-36 high group with different syndrome types(P>0.05).?The order of different TCM syndromes(deficiency syndrome)according to the order of dialysis age from low to high is as follows:spleen-kidney qi deficiency syndrome(44.90±39.09 months),qi-yin deficiency syndrome(58,88±44.00),liver-kidney yin deficiency syndrome(66.07±47.56),spleen-kidney yang deficiency syndrome(1.95 ± 55.70),yin-yang deficiency syndrome(98.45±58.38).?The TBW%of different TCM syndromes was highest in dampness-turbidity syndrome(0.54±0.11),and lowest in the 3 yin deficiency syndrome types:liver-kidney yin deficiency syndrome(0.50±0.07),qi-yin deficiency syndrome(0.50±0.09),yin-yang deficiency syndrome(0.50±0.08).The ECW%of different TCM syndromes was highest in dampness-turbidity syndrome.And ICW%was highest in the 3 yin deficiency syndrome.There is no statistical difference between the syndrome types.Conclusions:?The nutritional status of MHP was positively correlated with QOL,and LTI could be used as an important indicator.?The water storage capacity of MHP was negatively correlated with QOL,and TBW%before dialysis could be used as an important indicator.?In terms of QOL,the dialysis adequacy is not the higher the better.The most favorable TBW%interval for adequate dialysis is[0.48,0.88].?The indicators obtained by BCM can be used to quickly and quantitatively assess the QOL of MHP.?The dampness-turbidity syndrome and yin deficiency syndrome in TCM may be related to the total water storage status of body.?Alignment of TCM syndromes from high to low QOL:spleen-kidney qi deficiency syndrome>liver-kidney yin deficiency syndrome>qi-yin deficiency syndrome>spleen-kidney yang deficiency syndrome>dampness-turbidity syndrome>yin-yang deficiency syndrome.?The evolution rule of MHP TCM syndrome type is:spleen-kidney qi deficiency syndrome ? qi-yin deficiency syndrome ? liver-kidney yin deficiency syndrome? spleen-kidney yang deficiency syndrome ?yin-yang deficiency syndrome.