Abstract:

Objective　To explore the effect of traditional Chinese medicine characteristic nursing combined with continuous health guidance for patients with early diabetic nephropathy (DKD) and deficiency of both qi and yin. Methods　This was a prospective study. From January 2020 to February 2022, 108 patients with early DKD and deficiency of both qi and yin were selected from Zhoukou Traditional Chinese Medicine Hospital. They were divided into a control group and an observation group according to the admission order, with 54 cases in each group. There were 29 males and 25 females in the control group; they were 41-68 (52.36±4.36) years old. There were 31 males and 23 females in the observation group; they were 42-68 (52.44±4.17) years old. The control group were routinely cared; in addition, the observation group took traditional Chinese medicine characteristic nursing and continuous health guidance. The levels of 24 h urine protein, fasting blood glucose (FPG), and creatinine (Scr), health knowledge, scores of Self-rating Anxiety Scale (SAS), Comprehensive Quality of Life Questionary-74 (GQOL-74), and Self-rating Depression Scale (SDS), and satisfaction were compared between the two groups. t and χ² tests were applied. Results　After the intervention, the FPG level in the observation group was lower than that in the control group [(5.31±0.92) mmol/L vs. (5.87±0.83) mmol/L], with a statistical difference (t=3.321, P=0.001). After the intervention, the Scr and 24 h urine protein levels in the observation group were lower than those in the control group [(83.59±6.77) µ mol/L vs. (96.81±6.73) µ mol/L and (1.64±0.13) g vs. (1.85±0.11) g], with statistical differences (t=10.177 and 9.062, both P<0.001). After the intervention, the mastery of health knowledge in the observation group was higher than that in the control group [94.44% (51/54) vs. 77.78% (42/54)], with a statistical difference (χ²=6.27, P<0.05). After the intervention, the scores of SAS and SDS in the observation group were lower than those in the control group [(36.81±4.55) vs. (43.15±5.28) and (33.85±4.28) vs. (42.97±5.26)], with statistical differences (t=6.684 and 9.883, both P<0.001). After the intervention, the GQOL-74 score in the observation group was higher than that in the control group [(82.67±4.98) vs. (72.69±6.18)], with a statistical difference (t=9.240, P<0.001). The satisfaction of the observation group was higher than that of the control group [98.15% (53/54) vs. 81.48% (44/54)], with a statistical difference (χ²=8.20, P<0.05). Conclusion　Traditional Chinese medicine characteristic nursing combined with continuous health guidance for patients with early DKD and deficiency of both qi and yin can improve their disease indicators, knowledge mastery, mental health, quality of life, and satisfaction.

Key words:

Diabetic nephropathy, Early stage, Qi and yin deficiency, Traditional Chinese medicine, Nursing

摘要：

目的　探究中医特色护理联合延续性健康指导在早期糖尿病肾脏病（DKD）气阴两虚证患者中的应用效果。方法　本研究为前瞻性研究，选取2020年1月至2022年2月就诊于周口市中医院的早期DKD气阴两虚证患者108例，以入院顺序不同分为对照组和观察组，各54例。对照组男29例，女25例，年龄41～68（52.36±4.36）岁，给予常规护理。观察组男31例，女23例，年龄42～68（52.44±4.17）岁，在对照组基础上，联合中医特色护理+延续性健康指导。对比两组病情指标［24 h尿蛋白、空腹血糖（FPG）、肌酐（Scr）］、健康知识掌握情况、焦虑自评量表（SAS）、生活质量综合评定问卷-74（GQOL-74）、抑郁自评量表（SDS）评分及满意度。统计学方法采用t检验、χ²检验。结果　干预后观察组FPG水平低于对照组［（5.31±0.92）mmol/L比（5.87±0.83）mmol/L］，差异有统计学意义（t=3.32，P<0.05）；干预后，观察组Scr、24 h尿蛋白水平均低于对照组［（83.59±6.77）µmol/L比（96.81±6.73）µmol/L、（1.64±0.13）g比（1.85±0.11）g］，差异均有统计学意义（t=10.18、9.06，均P<0.05）；干预后，观察组健康知识掌握度为94.44%（51/54），高于对照组［77.78%（42/54）］，差异有统计学意义（χ²=6.27，P<0.05）；干预后，观察组SAS、SDS评分均低于对照组［（36.81±4.55）分比（43.15±5.28）分、（33.85±4.28）分比（42.97±5.26）分］，GQOL-74评分高于对照组［（82.67±4.98）分比（72.69±6.18）分］，差异均有统计学意义（t=6.68、9.88、9.24，均P<0.05）；观察组满意度为98.15%（53/54），高于对照组［81.48%（44/54）］，差异有统计学意义（χ²=8.20，P<0.05）。结论　中医特色护理联合延续性健康指导可改善早期DKD气阴两虚证患者病情指标，增强患者健康知识掌握度，提高心理健康水平，改善生活质量，提高满意度。

关键词:

糖尿病肾脏病, 早期, 气阴两虚证, 中医, 护理