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1.
Chinese Journal of Nephrology ; (12): 703-710, 2020.
Article in Chinese | WPRIM | ID: wpr-871004

ABSTRACT

Objective:To explore the effect of the interaction between estimated glomerular filtration rate (eGFR) and serum uric acid (SUA) on all-cause and cardiovascular mortality in patients on peritoneal dialysis (PD).Methods:Patients who performed PD catheterization at the PD center of the First Affiliated Hospital of Sun Yat-sen University and had initiated PD therapy for over 3 months from January 2006 to December 2016 were enrolled and followed up until December 2018. Demographic data, baseline clinical and laboratory examination results of the patients were collected. Kaplan-Meier survival curve and Cox regression analysis were used to explore the correlation between SUA and all-cause mortality, cardiovascular mortality in different eGFR groups of PD patients.Results:A total of 2 124 PD patients were enrolled with age of (47.0±15.2) years, among whom 1 269 patients were male and 536 patients had diabetes. The SUA level was (429±96) μmol/L and the median level of eGFR was 6.69(5.17, 8.61) ml·min -1·(1.73 m 2) -1. After a median follow-up time of 42 months, 554 patients died, among whom 275 patients were cardiovascular death. The Cox regression analysis revealed that there was a significant interaction between eGFR and SUA on all-cause mortality ( P=0.043). The Kaplan-Meier curve showed that the tertile 1 (SUA<384 μmol/L) and tertile 3 (SUA>460 μmol/L) group had significantly higher all-cause mortality ( P=0.009) than the reference group of tertile 2 (SUA 384-460 μmol/L) in the higher eGFR group [eGFR>6.69 ml·min -1·(1.73 m 2) -1]but not in the lower eGFR. After adjusting for relevant demographic data, complications, biochemical results and other variables, in patients with higher eGFR, the risk of all-cause mortality increased by 0.2% ( HR=1.002, 95% CI 1.000-1.003, P=0.019) for every 1 μmol/L increase in SUA. In addition, compared with the tertile 2 reference group, the tertile 3 group was independently correlated with higher risk of all-cause mortality ( HR=1.670, 95% CI 1.242-2.245, P=0.001). Conclusions:The eGFR and SUA level significantly interacts with all-cause mortality, and the higher SUA level in higher eGFR group is an independent risk factor for all-cause mortality in PD patients.

2.
Chinese Journal of Nephrology ; (12): 588-594, 2020.
Article in Chinese | WPRIM | ID: wpr-870994

ABSTRACT

Objective:To explore the effect of continuous quality improvement (CQI) on reducing the incidence of peritoneal dialysis (PD)-related peritonitis in patients within the first year of PD initiation.Methods:The patients who received catheter placement from January 2006 to December 2016 in our hospital were enrolled in this study. All patients were divided into four groups: pre-CQI group patients who initiated PD treatment from 2006 to 2007 (before CQI phase, group A), CQI Ⅰphrase patients who initiated PD treatment from 2008 to 2010 (group B), CQI Ⅱ phrase patients who initiated PD treatment from 2011 to 2013 (group C), and CQI Ⅲ phrase patients who initiated PD treatment from 2014 to 2016 (group D). The method of plan, do, check and act (PDCA) was conducted to decrease the incidence of PDRP. All the patients were followed up for 12 months or until they withdrew from PD in this period. Poisson analysis was used to compare the incidence of PDRP among the groups.Results:There were 2 383 PD patients recruited in this study, including 346 cases in group A, 850 cases in group B, 688 cases in group C and 499 cases in group D, with an age of (47.1±15.8) years, among whom 59.1% of the patients were male, and 21.4% with diabetes. The follow-up time was (10.9±2.8) months. Compared with group A, the incidence of PDRP was lower than that in group C (0.156 episodes/patient year vs 0.234 episodes/patient year, P=0.020); the incidence of gram positive PDRP decreased (0.052, 0.049, 0.054 episodes/patient year vs 0.104 episodes/patient year, all P<0.05) in group B, C, D; the incidence of gram negative PDRP increased in group B, then decreased in group C and group D (all P>0.05). Cox regression analysis indicated that CQI was independently associated with the incidence of gram positive PDRP ( HR=0.526, 95% CI 0.349-0.792, P=0.002). Conclusion:CQI can effectively reduce the incidence of gram positive PDRP in patients within the first year of PD initiation.

3.
Chinese Journal of Nephrology ; (12): 417-423, 2020.
Article in Chinese | WPRIM | ID: wpr-870975

ABSTRACT

Objective:To explore the prevalence and risk factors of exit-site infection (ESI) in elderly peritoneal dialysis (PD) patients.Methods:The status of exit-site was evaluated in elderly PD patients (≥60 years) who had catheter insertion in our center between January 1, 2009 and December 31, 2013, with follow-up for 1 year or withdrawing from peritoneal dialysis in this period. The patients were divided into ESI and non-ESI group. The data was collected including demographics, clinical features, and nursing care methods of the exit-site.Results:A total of 247 patients were recruited in this study, aged (68.6±6.2) years, among whom there were 132 male (53.4%) and 119 diabetes (48.2%). Median follow-up time was 12.0 months. Thirty-two patients had 34 episodes of ESI with a rate of 82.5 patient-months per episode (0.15 episodes per year). Coagulase-negative Staphylococcus was the main pathogen, accounting for 35.3% of the ESI. No bacterial growth was found in 8.8%. The exit-site nursing care status included that poor compliance of exit-site care 23.5%, poor catheter immobilization 62.3%, history of catheter-pulling injury 9.7%, mechanical stress on exit-site 5.3%, improper frequency of nursing care 29.6%, mupirocin usage 13.8%, patients taking exit-site care 26.7%, exit-site caregiver instability 16.6%. There were no differences in demographic (such as age, gender, primary disease, etc) and laboratory data (hemoglobin, serum albumin, blood potassium, etc) between the ESI and non-ESI groups. Poor compliance with exit-site care ( HR=2.352, 95% CI 1.008-5.488, P=0.048), poor catheter immobilization ( HR=3.074, 95% CI 1.046-9.035, P=0.041) and exit-site caregiver instability ( HR=2.423, 95% CI 1.004-5.845, P=0.049) were significantly correlated with increased risk of ESI. Conclusions:The prevalence of ESI in elderly PD patients was 0.15 episodes per year. Educating PD patients to improve the compliance with exit-site care, maintain catheter immobilization and do exit-site care by a stable and trained caregiver may reduce ESI events in elderly PD patients.

4.
Chinese Journal of Nephrology ; (12): 337-344, 2020.
Article in Chinese | WPRIM | ID: wpr-870969

ABSTRACT

Objective:To explore the correlation between serum 25-hydroxyvitamin D3 [25(OH)D3] level and peritoneal dialysis (PD) associated peritonitis, and provide a new idea for the prevention and treatment of peritonitis.Methods:In this single-center retrospective cohort study, patients who were≥18 years old and were treated with regular PD≥3 months in PD center from January 1, 2014 to September 30, 2018 were recruited, except those who had a history of malignant tumors or systemic infectious diseases, transferred from permanent hemodialysis (HD) or failed kidney transplantation. Baseline data including demographic characteristics as well as clinical and biochemical data were collected. All the patients were followed up until death, transfer to HD, kidney transplantation, transfer to other centers or the end of our study (December 31, 2018), and were divided into low tertile [serum 25(OH)D3 ≤12μg/L], middle tertile[12 μg/L<serum 25(OH)D3≤17 μg/L] and high tertile[serum 25(OH)D3 >17 μg/L] according to the baseline serum 25(OH)D3 level. Multivariate adjusted Poisson model was used to evaluate the association between serum 25(OH)D3 level and PD related peritonitis.Results:A total of 642 patients were enrolled in our study, of whom 341 were male (53.12%) , and the age was (47.58±14.10) years old. The serum 25(OH)D3 level was (13.83±6.41) μg/L. As for the primary disease, 67.19% were chronic glomerulonephritis. During a median 42(19, 59) months follow-up period, 232 peritonitis occurred in 139 patients. After adjusting for confounders, including gender, age, albumin, body mass index(BMI), calcium-phosphorus product, intact parathyroid hormone (iPTH), diabetes, charlson index and drug use, multivariate Poisson regression analysis showed that the risk of peritonitis in the middle tertile and the low tertile was 92% (95% CI 0.62-1.38, P= 0.690) and 1.74 times (95% CI 1.19-2.54, P=0.004) of the high tertile respectively. The difference between the low tertile and the high tertile was statistically significant. Conclusions:The level of serum 25(OH)D3 is closely related to the occurrence of PD associated peritonitis. Low level serum 25(OH)D3 is an independent risk factor for peritonitis in PD patients.

5.
Chinese Journal of Nephrology ; (12): 321-328, 2019.
Article in Chinese | WPRIM | ID: wpr-745976

ABSTRACT

Objective To explore the clinical characteristics and risk factors of catheterrelated infection in continuous renal replacement therapy (CRRT) patients.Methods The demographic and clinical data of CRRT patients who inserted with double-lumen non-cuffed dialysis catheter at the First Affiliated Hospital of Sun Yat-sen University from January 1,2016 to December 31,2016 were collected.According to the presence or absence of catheter-related infections,they were divided into infected group and uninfected group.Statistics and analysis of the incidence and pathogenic characteristics of catheter-related infections;Comparison of clinical features of infected and uninfected groups;A multivariate Cox proportional hazard model was used to analyze risk factors for catheter-related infections.Results A total of 364 patients with CRRT (437 cases of central venous catheterization) were enrolled in the study.Catheter-related bloodstream infection (CRBSI) and catheterrelated colonization (CRCOL) rates were 3.565 and 2.228 events per 1000 catheter-days.These catheters were associated with higher proportion of inserted in ICU (P=0.007),immunosuppression (P=0.002),receive catecholamine inotropes therapy (P=0.001) and shock (P=0.030).The infection catheters also had shorter indwelling time (P=0.032) and lower level of blood hemoglobin (P=0.017),serum creatinine (P=0.004),blood brain natriuretic peptide (P=0.005) pericatheter use.The most common pathogens were Gram-negative bacteria,especially Acinetobacter baumannii,which caused 37.5% CRBSI and 20.0% CRCOL.Multivariate Cox regression model showed female (P=0.029,HR=2.151),diabetes (P=0.016,HR=2.807),receive catecholamine inotropes therapy (P=0.012,HR=2.655),immunosuppression (P=0.037,HR=2.203) were independent risk factors associated with catheterrelated infection.Conclusions The incidence of CRBSI and CRCOL is 3.565 and 2.228 events per 1000 catheter-days CRRT patients in our hospital.The most common pathogen of catherter-related infection is Gram-negative bacteria.Female,diabetes,received catecholamine inotropic drugs,and immunosuppression were independent risk factors associated with catheter-related infection.

6.
Chinese Journal of Nephrology ; (12): 801-808, 2018.
Article in Chinese | WPRIM | ID: wpr-711164

ABSTRACT

Objective To investigate the association of low serum total bilirubin (TBIL) levelwith all?cause mortality and cardiovascular mortality in peritoneal dialysis patients. Methods As a single ? center, retrospective, cohort study, all the patients who underwent peritoneal dialysis catheterization in the Department of Nephrology, the First Affiliated Hospital of Sun Yat?sen University and started peritoneal dialysis for more than 3 months from January 1, 2006 to December 31, 2010 were included. Demographics, baseline clinical and laboratory test results were collected. All patients were followed up until December 31, 2012. Patients were divided into 4 groups according to their baseline serum TBIL levels (interquartile range). Kaplan?Meier method was used to compare the survival rate of each group. Cox regression model was used to analyze the association of TBIL with all?cause mortality and cardiovascular mortality. Logistic regression was used to analyze the influencing factors of low TBIL level. Results A total of 880 peritoneal dialysis patients with baseline TBIL data were enrolled in this study, with age of (48.0 ± 15.4) years old, among whom 59.0% were male. Median TBIL was 4.5 μmol/L and interquartile range was 3.4?5.8 μmol/L. The comparison between TBIL quartile groups showed that the difference in proportion of diabetics, Charlson comorbidity index, hemoglobin, serum albumin, serum calcium, intact parathyroid hormone, urea nitrogen, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was statistically significant (all P<0.05), while the difference in body mass index (BMI), estimated glomerular filtration rate, serum creatinine, urea nitrogen, uric acid and phosphorus was not statistically significant. After a median follow?up of 31 months, 194 patients died, 104 of which were cardiovascular deaths. Kaplan?Meier curves showed higher all?cause mortality in patients with TBIL≤3.4 μmol/L (Q1 group) (P=0.032) and there was no statistical difference in the cardiovascular mortality among different groups. After adjusting for biochemical indicators such as demographics, comorbidities, and liver function, taking baseline TBIL Q2 level (3.4<TBIL≤4.5 μmol/L) as a reference, the hazard ratio for all?cause death in patients with TBIL≤3.4 μmol/L was 1.702 (95%CI 1.093-2.650, P=0.019), and the hazard ratio for cardiovascular death was 1.760 (95%CI 0.960-3.227, P=0.068). Multiple logistic regression analysis results showed that diabetes (OR=1.065, 95%CI 1.010-1.122, P=0.019) and high BMI (OR=1.838, 95%CI 1.056-3.197, P=0.031) were risk factors for baseline serum TBIL≤3.4 μmol/L. However, high hemoglobin (OR=0.990, 95%CI 0.982-0.998, P=0.011), high serum albumin (OR=0.950, 95%CI 0.916-0.985, P=0.006) and high ALT (OR=0.998, 95%CI 0.976-0.999, P=0.036) were the protective factors for patients with baseline serum TBIL≤3.4 μmol/L. Conclusion Baseline serum TBIL≤3.4 μmol/L in peritoneal dialysis patients is independently associated with all?cause mortality, and is not significantly associated with cardiovascular mortality; and baseline serum TBIL≤3.4 μmol/L occurred is associated with diabetes, high body mass index, low levels of hemoglobin, serum albumin and ALT.

7.
Chinese Journal of Nephrology ; (12): 721-726, 2018.
Article in Chinese | WPRIM | ID: wpr-711155

ABSTRACT

Objectives To investigate the prevalence and its risk factors of restless legs syndrome (RLS) in maintenance peritoneal dialysis (PD) patients.Methods Patients who performed PD in the First Affiliated Hospital of Sun Yat-sen University were recruited by convenience sampling.International Restless Legs Syndrome Study Group diagnostic criteria and International Restless Leg Syndrome rating scale were used to diagnose and evaluate the RLS and its severity.Co-morbidities level,baseline demographic,clinical and biochemical data were collected to analyze the clinical characteristics of patients with RLS.Multivariate logistic regression analysis was used to assess the risk factors for RLS.Results A total of 421 PD patients were enrolled in this study.Their age was (46.3±12.8) years old,44.2% were female and 17.3% with diabetes.The median vintage of PD was 46.8(28.0,73.5) months.The prevalence of RLS was 14.0%,most of whom were affected with moderate or severe RLS.Logistic regression analysis showed that younger age,long-term dialysis duration,higher serum calcium and phosphorus were the risk factors associated with RLS in PD patients after adjustment for confounders (all P < 0.05).Conclusions Prevalence of RLS in PD patients is 14.0%.Younger age,long-term dialysis duration,higher serum calcium and phosphorus were the risk factors associated with

8.
Chinese Journal of Nephrology ; (12): 481-487, 2018.
Article in Chinese | WPRIM | ID: wpr-711129

ABSTRACT

Objective To investigate the clinico-pathological features and renal outcomes of primary IgA nephropathy (IgAN) with glomerular IgM deposition.Methods Primary IgAN diagnosed with biopsy from January 2006 to December 2011 were recruited.Patients were divided into groups according to IgM deposition (Group A) and without IgM deposition (Group B).In addition,Group A was subdivided into two groups based on the position of IgM deposits as the mesangium (Group A1) and both mesangium and capillary wall (Group A2).Renal outcomes were defined as end stage renal disease (ESRD) and/or the doubling of baseline serum creatinine.Clinico-pathological features were retrospectively compared.Kaplan-Meier was conducted for renal outcomes,and Cox regression model was used to analyze the prognostic value of IgM deposition and the position of IgM deposition in the progression of nephropathy in IgAN patients.Results 939 patients were enrolled with 422 (44.9%) having IgM deposition (Group A).Of the 422 patients,382 patients were divided as Group A 1,whereas 40 patients were noted as Group A2.Compared to Group B,hemoglobin,serum protein,albumin and serum IgG levels in group A were significantly lower,and the cholesterol and serum IgM levels were significantly higher (all P < 0.05).There was no significant difference in serum creatinine,estimated glomerular filtration rate (eGFR),urinary protein,blood pressure and uric acid between group A and B.In terms of pathological manifestations,patients in Group A exhibited more severe histological lesions including glomerular sclerosis,S1,M1 and interstitial inflammatory cell infiltration (all P<0.05).Immunofluorescence showed that the proportion of IgG,C1q and Fg deposition in group A was significantly higher than that in group B (all P < 0.05).By Kaplan-Meier,cumulative renal survival rate has no significant difference between Group A and B (Log-rank test x2=0.019,P=0.891).Univariate and muhivariable Cox regression analysis showed that IgM deposition had no significant effect on the renal progression in IgAN patients.Subgroup analysis showed that patients in Group A2 exhibited higher urine protein,creatinine and blood pressure,and lower eGFR and serum albumin,also had worse histological lesions including M1,E1 and T1-2 of Oxford classification (all P<0.05),Immunofluorescencc showed that the proportion of IgG,C1q and Fg deposition in group A2 was significantly higher than that in group A1 (all P < 0.05).By Kaplan-Meier,renal survival rates calculated from outcomes were lower in Group A2 (Log-rank test x2=1 8.207,P < 0.001).In addition,IgM deposited both in the mesangium and capillary wall was a risk factor for renal progression of IgAN patients with IgM deposition by a univariate Cox hazards regression mode and multivariable-adjusted Cox models (HR=3.621,95%CI 1.924-6.814,P< 0.001;HR=2.309,95%CI 1.176-4.533,P=0.015respectively).Conclusions The IgAN patients with IgM deposition relatively had more severe clinicopathological changes,especially those with IgM deposited both in the mesangium and capillary wall.In this study,IgM deposition was not found to be an independent risk factor for the prognosis of kidney in IgAN patients.However,IgM deposited both in the mesangium and capillary wall was an independent risk factor for renal prognosis in IgAN patients with IgM deposition.

9.
Chinese Journal of Nephrology ; (12): 401-409, 2017.
Article in Chinese | WPRIM | ID: wpr-618011

ABSTRACT

Objective To develop a nomogram for the use of predicting renal outcomes of Chinese lupus nephritis (LN) patients.Methods From January 1,2005 to October 1,2015,513 patients with biopsy-proven LN in the First Affiliated Hospital of Sun Yat-Sen University were enrolled into this study.Renal outcomes were defined as end-stage renal disease or doubling of serum creatinine.Demographic characteristics,laboratory data,and pathologic data were recorded and included for analysis.Nomograms were designed using multivariate Cox proportional hazards regression to predict the non-outcome renal survival in 5 and 8 year according to the Akaike information criterion (AIC) and continuous reclassification net improvement (cNRI).Predictive accuracy and discriminative ability of the models were determined by concordance index (C-index) and calibration curve.Results During a median follow up of 48 (24,71) months,44 patients (8.58%) reached the endpoint.1-year,5-year and 8-year non-outcome renal survival were 97.57%,92.89%,79.89% respectively.According to multivariate Cox regression,four nomograms including index for baseline renal function,pathologic severity,and response to treatment were designed.The best model,within which included eGFR was lower than 30 ml · min-1 · (1.73 m2)-1(HR=4.44,95% CI 2.16-9.13,P < 0.01),percentage of global glomerulosclerosis was higher (HR=12.28,95%CI 3.58-42.13,P < 0.01) and partial remission occurred after 6-month induction treatment (HR=9.16,95% CI 4.71-17.82,P < 0.01) demonstrated good discrimination to predict 5-year and 8-year non-outcome renal survival [C-index,0.80(95%CI 0.81-0.91),0.76(95%CI 0.68-0.85),respectively].The nomogram based on above model also performed good calibration.Conclusion The nomogram based on patients' baseline eGFR,percentage of global glomerulosclerosis,and treatment reaction after 6-month induction therapy can accurately predict 5-year and 8-year non-outcome renal survival in Chinese lupus nephritis patients.

10.
Chinese Journal of Nephrology ; (12): 881-886, 2017.
Article in Chinese | WPRIM | ID: wpr-711071

ABSTRACT

Objective To explore the clinicopathological features and renal outcomes of primary IgA nephropathy (IgAN) patients with chronic tonsillitis.Methods Patients with biopsyproven primary IgAN admitted to The First Affiliated Hospital,Sun Yat-sen University from January 2006 to December 2011 were enrolled.The clinicopathological features and renal outcomes of patients with and without chronic tonsillitis were retrospectively compared.The primary outcome was progression to end stage renal diseases and/or doubling of serum creatinine.Results A total of 981 primary IgAN patients were enrolled and 98 patients (9.99%) had a history of chronic tonsillitis.Compared with patients without chronic tonsillitis,IgAN patients with chronic tonsillitis exhibited significantly higher prevalence of acute episodes of tonsillitis as a predisposition (P < 0.001),higher serum IgA levels (P=0.012),and higher prevalence of macrohematuria (P=0.006).No significant difference in renal pathological features was observed in patients with and without chronic tonsillitis.Moreover,the renal outcomes were similar as regards IgAN patients with and without chronic tonsillitis.Conclusion IgAN patients with chronic tonsillitis had higher prevalence of acute episodes of tonsillitis and macrohematuria as well as higher serum IgA levels.However,IgAN patients with and without chronic tonsillitis showed no significant difference in renal pathological features and renal outcomes.

11.
Chinese Journal of Nephrology ; (12): 401-407, 2015.
Article in Chinese | WPRIM | ID: wpr-469106

ABSTRACT

Objective To investigate the clinical and pathological characteristics of IgA nephropathy (IgAN) with macrohematuria (MH).Method 1512 consecutive patients with biopsyproven IgAN diagnosed from January 2006 to December 2011 were enrolled,and divided into MH group and control group respectively,according to whether there existed episodes of MH before renal biopsy.The clinical and pathological characteristics were compared between two groups.Patients in MH group were then divided into three groups according to the interval from the last episode of MH to renal biopsy to clarify the concomitant clinicopathological changes associated with occurrence of MH.Results The rate of MH in history was 22.1%.MH group patients had significantly lower serum creatinine,slighter proteinuria,lower prevalence of hypertension and heavier microhematuria than control group (all P < 0.001).The prebiopsy durations were similar in two groups (P=0.627).In MH group,chronic pathological indicators,including global/segmental sclerosis,tubule atrophy/interstitial fibrosis were all slighter (all P< 0.001),whereas activity indicators,including necrosis lesions,crescents and mesangial proliferation were all more severe compared with control group (all P < 0.05).Those who underwent renal biopsy within 30 days of the last episode of MH had more severe proteinuria and microhematuria,higher prevalence of necrosis lesions,more severe crescents formation,and endothelial proliferation (all P < 0.05).Conclusions IgAN patients with MH in history have relatively milder clinical and chronic pathological manifestations,however more active pathological changes especially in those who suffer episode of MH recently.

12.
Article in Chinese | WPRIM | ID: wpr-483961

ABSTRACT

This study was aimed to explore the relationship between atrophic lung disease and modern medicine diseases through the study of experiences of modern famous doctors of traditional Chinese medicine (TCM) in the treatment of atrophic lung disease. Literatures which met the inclusion criteria were retrieved from the existing Lung Disease Database of Modern Famous Doctors of Chinese Medicineand Lung Disease Database of Journals for the establishment ofLiterature Research Database of Experience of Modern Famous Doctors of Chinese Medicine in Treating Atrophic Lung Disease. The SPSS 19.0 software was used in the statistical analysis. The results showed that atrophic lung disease can be interstitial lung disease, atelectasis, pneumonia, primary bronchogenic carcinoma, bronchiectasis, tuberculosis, chronic bronchitis and pneumothorax in modern medicine. Among them, interstitial lung disease was the most common one. It was concluded that atrophic lung disease can be the outcome of many types of lung diseases. The relationship between atrophic lung disease and modern medicine diseases should require further studies by experts to confirm.

13.
Article in Chinese | WPRIM | ID: wpr-461696

ABSTRACT

This study was aimed to analyze effects on quality of life (QOL) for stable chronic obstructive pulmonary disease (COPD) by Shu-Fei Paste (SFP) with different sticking time, in order to determine the optimal sticking time. A multicenter, randomized, controlled clinical trial was designed. A total of 164 stable COPD cases were randomly divided into Group A and Group B. There were 82 cases in Group A (sticking time for 6-8 h), and 82 cases in Group B (sticking time for 8-12 h). The paste was given 10 days before the summer “dog days”, on the 1st, 10th, and 20th day during the summer “dog days”, and 10 days after the summer “dog days”. At the end of the study, 18 cases were fallen off or removed. The 146 cases (71 cases in Group A and 75 cases in Group B), which met the require-ments of the study, were analyzed. The results showed that both groups can improve QOL in patients with stable COPD after treatment. However, there were no statistical differences. There were no statistical differences between the sticking time for 6-8 h and sticking time for 8-12 h. However, the sticking time for 6-8 h with low incidence of severe bullous and better safety. Therefore, the best choice of sticking time was 6-8 h. It was concluded that there was no statistical differences on the treatment between the sticking time for 6-8 h and 8-12 h. However, the sticking time for 8-12 h had high rate of severe bullous and low safety. The best sticking time of SFP was 6-8 h.

14.
Article in Chinese | WPRIM | ID: wpr-457681

ABSTRACT

This study was aimed to analyze the therapeutic effect of Shu-lung post with different stimula-tion intensities on chronic obstructive pulmonary disease (COPD), in order to determine the best stimulus intensity. A multicenter, randomized, controlled clinical trial was designed to take COPD patients at stable stage as study sub-jects. Patients were randomly divided into two groups, which were the foaming group and non-foaming group. The application was given 10 days before the summer dog days, on the 1st, 10th and 20th day within the dog days, and 10 days after the dog days. The results showed that a total of 164 cases were enrolled in the study, with 18 drop-out cases, and 146 cases fitted in the program. There was statistical difference on acute exacerbation frequency after treatment between the foaming group and non-foaming group (P < 0.05). There were statistical differences on clinical symptoms and signs of total score (P< 0.01) during the 8-month follow-up. It was concluded that Shu-lung post with different stimulation intensities were positively correlation with clinical efficacy.

15.
Article in Chinese | WPRIM | ID: wpr-454813

ABSTRACT

This article was aimed to explain the distribution of syndrome and study the change of pathogenesis in patients of acute exacerbation of chronic obstructive pulmonary disease risk-window (AECOPD-RW) based on clini-cal investigation. The data of the traditional Chinese medicine (TCM) syndrome of patients diagnosed as AECOPD into AECOPD-RW were collected from 8 hospitals. The database was established. Data was analyzed with SPSS 13.0 software. The results showed that among 15 basic syndromes, the syndrome of lung-qi deficiency was with the high-est frequency, which was followed by the syndrome of kidney-qi deficiency and syndrome of phlegm-dampness. A-mong 14 combined syndromes, the syndrome of lung-kidney qi deficiency and the syndrome of phlegm-dampness ac-cumulated in the lung were with the highest frequency. The common syndromes of AECOPD-RW were the syndrome of lung-kidney qi deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syn-drome of lung-kidney qi deficiency, the syndrome of lung-spleen qi deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syndrome of lung-spleen qi deficiency, the syndrome of lung-kidney qi-yin deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syndrome of lung-kidney qi-yin deficiency, the syndrome of lung-kidney qi deficiency combined with the syndrome of phlegm-stasis accumulated in the lung, and the syndrome of lung-kidney qi-yin deficiency combined with the syndrome of phlegm-stasis accumulated in the lung. It was concluded that the main common syndromes of AECOPD-RW was the mixture of deficiency and excess. There was relatively less pure deficiency and excess syndrome.

16.
Article in Chinese | WPRIM | ID: wpr-441648

ABSTRACT

This paper was aimed to establish the curative effect evaluation indexes scientifically , which is the key technical step for the study of traditional Chinese medicine ( TCM ) effect evaluation methods under the mode of disease-syndrome combination. However, there is still a lack of generally accepted methods. In this paper , several key technical steps in the research process for establishing the curative effect evaluation indexes were put forward , namely , the framework of scientific and reasonable formation on the evaluation indexes is the premise; target selection of evaluation indexes is the core link; the evaluation and verification of evaluation in-dexes are key points , which provide the methodology reference for similar research in this field .

17.
Article in Chinese | WPRIM | ID: wpr-441619

ABSTRACT

Based on the traditional Chinese medicine ( TCM ) theory of correspondence between man and the universe and supporting yang in spring and summer, acupoint sticking therapy has a good clinical effect in respiratory diseases treatment in summer . Its mechanism may be involved in regulating immune function , in-hibiting inflammatory response , scavenging oxygen free radicals and inhibiting protease-antiprotease imbalance , which need to be further studied and identified .

18.
Article in Chinese | WPRIM | ID: wpr-441601

ABSTRACT

This study was aimed to review of the selection and use of the therapeutic effect assessment indexes of randomized controlled trials ( RCTs ) on traditional Chinese medicine ( TCM ) syndrome differentiation and treatment of chronic obstructive pulmonary disease ( COPD ) based on clinical efficacy . Published studies were searched in the CBM , CNKI , VIP , Wanfang database , Cochrane Library , PubMed and Embase to identity all RCTS on TCM treatment of COPD . Two researchers selected studies and extracted data independently using a designed extraction form . The Cochrane collaboration software RevMan 5 . 1 was used for meta-analysis . The re-sults showed that a total of 40 RCTs were included . Meta-analyses showed that TCM syndrome differentiation and treatment of COPD can improve the pulmonary function and life quality , improve the clinical effect and TCM syndrome effect , reduce the number of acute exacerbation of COPD and improve clinical symptoms . Some therapeutic effect assessment indexes , such as pulmonary function , life quality , clinical comprehensive effect , the number of acute exacerbation of COPD, clinical symptoms and signs, syndrome effect and the integral of syndrome were used more frequent . Other indexes such as 6-min walk distance , BODE Index and health eco-nomic evaluation were used less frequently . It was concluded that TCM syndrome differentiation and treatment of COPD had certain therapeutic efficacy. A large number of strictly-designed, multicenter, high-quality RCTs are required because of the low quality of the included studies. The selection of therapeutic effect assessment indexes is still not standardized . The therapeutic effect assessment indexes should be selected based on differ-ent purposes of clinical studies with the clinical characteristics of TCM .

19.
Article in English | WPRIM | ID: wpr-450037

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Pulmonary rehabilitation (PR) is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China.

20.
Chinese Journal of Nephrology ; (12): 933-936, 2012.
Article in Chinese | WPRIM | ID: wpr-429308

ABSTRACT

Objective To study the prevalence and associated factors of secondary hyperparathyroidism (SHPT) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods A cross-section study was performed.A total of 639 eligible participants undergoing CAPD treatment more than three months in our peritoneal dialysis center from July 2011 to January 2012 were recruited in the study.All the patients were divided into SHPT group and non-SHPT group according to the intact parathyroid hormone (iPTH) level,and the associated factors of SHPT were investigated through Logistic regression analysis.Results The prevalence of SHPT was 46.95% (300/639).Logistic regression analysis demonstrated that lower hemoglobin,hypocalcemia,hyperphosphatemia,higher alkaline phosphatase,higher Scr,higher nPCR and low calcium dialysate were independent influencing factors of SHPT.Conclusions The prevalence of SHPT is quite high in CAPD patients.Abnormal calcium-phosphorus metabolism,renal anemia,high protein diet and low calium dialysate may affect the SHPT.

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