| Research Background:Peritonitis have a poor prognosis and a higher mortality rate.At present,there are relatively few studies on PDAP with repeated episodes at home and abroad.In addition,the characteristics of peritonitis are different in different regions and even in different dialysis centers in the same region.The purpose of this study is to explore the risk factors of recurrence of peritonitis in this center through a retrospective study of patients with peritonitis in a single center for a period of time,and analyze the distribution of medical syndromes in the center.So as to provide an effective basis for the treatment and prevention of peritonitis associated with peritoneal dialysis in our center and the idea of integrated traditional Chinese and Western medicine.And improve the prognosis of patients with abdominal dialysis and improve the quality of life Research purposes:Analysis of the risk factors of PDAP recurrence and the distribution of TCM syndromes in the Abdominal Dialysis Center of the Nephrology Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Research methods:In this study,a retrospective case-control study method was used to select patients who received regular peritoneal dialysis treatment in our peritoneal dialysis center and were hospitalized in our hospital for PDAP from May 2018 to December 2019.Observe the recurrence of the patient’s peritonitis within 1 year after this peritonitis.Patients with more than one occurrence of PDAP within one year were classified as relapse group,and patients with one occurrence of PDAP within one year were classified as single-shot group.The differences in general information,peritoneal dialysis-related data,laboratory examinations,compliance,and information of four Chinese medicine clinics were compared between the two groups.Research result:1.The compliance index level of patients in the single-onset group was significantly higher than that in the recurrence group,and the difference was statistically significant(P<0.05).In the logistics regression analysis model,the results show that low compliance is a risk factor for recurrence of peritonitis associated with peritoneal dialysis.2.The RBC,Hb,Alb of the single-shot group were significantly higher than those of the relapsed group,and the difference was statistically significant(P<0.05).Other laboratory tests,such as calcium and phosphorus metabolism indicators: Ga,P,calcium and phosphorus product,i PTH;coagulation indicators: D2 polymer,APTT;peritoneal dialysis fluid routine:peritoneal dialysis fluid total cells,peritoneal dialysis fluid white blood cells,percentage of multinucleated cells;Dialysis adequacy indicators: Kt/v,BUN,UA,K,CO2CP;other nutritional indicators: such as TP,TC,TG,HDL-C,LDL-C,there was no statistical difference between the two groups.In the logistics regression analysis model,the results did not show that RBC,Hb,and Alb are risk factors for PDAP.3.The proportion of patients with abdominal distension in the single-onset group was higher than that in the recurrence group(P<0.05),and the difference was statistically significant.Turbidity of the peritoneal dialysis fluid was the most common in the single-onset group and the recurrence group,and the difference was not statistically significant(P>0.05).There was no significant difference in other peritoneal dialysis related data,such as other clinical manifestations,dialysate pathogenic bacteria,inducement of PDAP,and peritoneal transport methods(P>0.05).4.In the PDAP patients in the recurrence group,24 cases(64.86%)of spleen and kidney qi deficiency were the main deficiency syndrome.Followed by 6 cases(16.21%)with deficiency of both qi and yin,4 cases with deficiency of spleen and kidney yang(10.08%),2cases with deficiency of liver and kidney yin(5.41%),and 1 case with deficiency of yin and yang(2.71%).The standard evidence is mainly 15 cases(40.54%)of damp-heat syndrome.Followed by damp turbidity syndrome in 14 cases(37.84%),blood stasis syndrome in 4 cases(10.81%),water-gas syndrome 3(8.11%),wind-movement syndrome in 1 case(2.7%);There were 33 cases(67.35%)with deficiency of spleen and kidney qi.Followed by 13 cases of Qi and Yin deficiency(26.53%),2 cases of Yin and Yang deficiency(4.08%),1 case of Spleen and Kidney Yang deficiency(2.04%),and 0(0%)of Liver and Kidney Yin deficiency.20cases(40.82%)of damp turbidity syndrome were the main standard evidence,followed by 14cases(28.57%)of damp-heat syndrome,12 cases(24.45%)of blood stasis syndrome,and 2(4.08%)of wind-movement syndrome.5.In this study,31 kinds of pathogenic bacteria were cultured,mainly including 16 cases of Staphylococcus epidermidis,7 cases of Escherichia coli,6 cases of Streptococcus miritus,and 6 cases of Oral Streptococcus.The main causes of the two groups were informal disinfection or improper contact,gastrointestinal dysfunction,and respiratory tract infection.The percentages of irregular disinfection or improper contact in the single-shot group and recurrent group were 46.94% and 54.05%,respectively;the percentages of gastrointestinal dysfunction were 32.66% and 32.43%;the percentages of respiratory tract infection were16.33% and 5.41%.Comparing the composition of the two groups of inducements,the difference was not statistically significant(P>0.05).In conclusion:1.Low compliance is a risk factor for PDAP recurrence in our peritoneal dialysis center.Enhancing the publicity and education of patients’ health awareness and improving patient compliance can reduce the recurrence of patients with peritonitis.2.Low RBC,low Hb,and low Alb may be risk factors for the recurrence of peritonitis associated with peritoneal dialysis in this peritoneal dialysis center.Pay attention to the detection of relevant indicators of peritoneal dialysis patients and correct anemia and hypoproteinemia in a timely manner,which is of great significance for reducing the recurrence of peritonitis.3.PDAP patients with peritonitis in the single-onset group have stronger subjective feelings than abdominal distension in the recurrence group are less likely to relapse.4.The distribution law of TCM syndromes in patients with recurring peritonitis is as follows: It is always the main deficiency syndrome,which is mainly due to spleen and kidney qi deficiency,followed by qi and yin deficiency,spleen and kidney yang deficiency,and liver and kidney yin deficiency.,Yin and Yang deficiency syndrome.The main evidence is damp-heat syndrome,followed by damp-turbidity syndrome,blood stasis syndrome,water-qi syndrome,and wind-movement syndrome.5.The main causes of PDAP in our hospital are,in order,gastrointestinal dysfunction and respiratory tract infection.Informal disinfection or improper contact. |
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