A Clinical Study On The Improvement Of Anxiety State In Maintenance Hemodialysis Patients With Auricular Point Pressing Pills Based On Syndrome Differentiation

Objective1.Through a cross-sectional survey on the anxiety state of maintenance hemodialysis patients,the distribution characteristics of TCM syndromes were understood,so as to provide a syndrome differentiation basis for TCM clinical intervention.2.A prospective randomized controlled clinical study was conducted to explore the improvement effect of auricular acupoint pressing pill method based on syndrome differentiation on the anxiety state of maintenance hemodialysis patients,and to provide reference for its clinical application.Methods1.Investigation on the distribution characteristics of TCM syndromes of anxiety state in maintenance hemodialysis patientsUsing cross-sectional survey method,this study choose Chinese Academy of Sciences wangjing hospital of traditional Chinese medicine,combined Chinese and western medicine hospital,changping district two hospital blood purification center in patients undergoing maintenance hemodialysis treatment as investigation object,and collect the patient’s general information,anxiety level,TCM four diagnostic information,analysis of maintenance hemodialysis patients with anxiety status of TCM syndrome characteristics.2.Clinical study on improving anxiety state of maintenance hemodialysis patients by auricular acupoint pressing pill with syndrome differentiationIn this randomized controlled clinical study,60 patients who met the inclusion criteria in the Blood Purification Center of Wangjing Hospital,China Academy of Chinese Medical Sciences were randomly divided into treatment group and control group with 30 patients in each group by random number table method.The control group received conventional hemodialysis treatment,and the treatment group was additionally treated with auricular acupoint pressure pill method based on syndrome differentiation in the control group.The observation was carried out for 4 weeks.Before and after treatment,GAD-7 scale was used to evaluate patients’ anxiety state,and TCM symptom grading quantitative evaluation scale was used to evaluate patients’ TCM syndrome scores.Results1.Investigation on distribution characteristics of TCM syndromes in anxiety state of maintenance hemodialysis patients1.1 Anxiety state and anxiety degree distribution of maintenance hemodialysis patientsIn this study,a total of 203 valid questionnaires were collected,with GAD-7 score≥5.113 hemodialysis patients with anxiety status accounted for 55.66%.The patients with mild,moderate and severe anxiety accounted for 43.35%,10.34%and 1.97%,respectively.1.2 Distribution characteristics of TCM syndromes of anxiety state in maintenance hemodialysis patientsAmong 113 patients with maintenance hemodialysis anxiety,the syndrome of stagnation of kidney deficiency and liver,stagnation of liver qi,damp-heat of liver and gallbladder,depression and anxiety,stagnation of liver stagnation and spleen deficiency,and stagnation of blood circulation accounted for 39.82%,21.24%,12.39%,9.73%,8.85%and 7.96%,respectively.2.Clinical study on improving anxiety state of maintenance hemodialysis patients by auricular acupoint pressing pill with syndrome differentiation2.1 General informationThere were no significant differences in gender,age,dialysis age and dialysis frequency between the two groups(P>0.05).2.2 Comparison of GAD-7 scoresThere was no significant difference in GAD-7 score between the two groups before treatment(P>0.05).After treatment,the score of the treatment group(4(3,6))was significantly lower than that of the control group(7(4,9)),P<0.05.The difference of GAD-7 scores in treatment group(3(2,4))was significantly higher than that in control group(1(0,1))before and after treatment,P<0.05.GAD-7 scores in the treatment group were significantly different before and after treatment(P<0.05).There was no significant difference in GAD-7 scores in the control group(P>0.05).2.3 Comparison of TCM syndrome scoresBefore treatment,there was no significant difference in TCM syndrome scores between the two groups(P>0 0.05).After treatment,there was no significant difference in TCM syndrome scores between the two groups(P>0 0.05).The difference of TCM syndrome scores before and after treatment was significantly higher in the treatment group(10.63±5.945)than in the control group(2.22±5.957),P<0.05.The TCM syndrome scores of treatment group were significantly different before and after treatment(P<0.05).There was no significant difference before and after treatment in the control group(P>0.05).2.4 Efficacy evaluationEfficacy of anxiety state:the effective rate of treatment group(86.67%)was significantly higher than that of control group(29.63%),P<0.05.Efficacy of TCM syndromes:the effective rate of treatment group(36.67%)was significantly higher than that of control group(7.41%),P<0.05.Conclusions1.In the maintenance hemodialysis patients,55.66%of the patients were accompanied by a mild or more anxious state.The most common TCM syndromes were kidney deficiency and liver stagnation and liver qi stagnation in patients with maintenance hemodialysis anxiety.2.Prospective,randomized controlled clinical trials have shown that ear acupoint pressing pill based on syndrome differentiation can improve the anxiety state of maintenance hemodialysis patients,and can improve the TCM syndrome scores of kidney deficiency and liver stagnation syndrome and liver qi stagnation syndrome in maintenance hemodialysis patients.