Li Li, Wang Jin, Li Yanlin
the Fourth Clinical Medical College of Guangzhou University of CM, Guangzhou 510006, Guangdong Province, China.
Zhongshan Hospital of Guangzhou University of CM, Zhongshan 528400, Guangdong Province.
Zhongguo Zhen Jiu. 2017 Sep 12;37(9):938-43. doi: 10.13703/j.0255-2930.2017.09.007.
To observe the effects of auricular plaster therapy on quality of life in uremia patients after parathyroidectomy plus autograft (PTX+AT).
A total of 34 uremia patients complicated with secondary hyperparathyroidism (SHPT) who received PTX+AT were randomly divided into an observation group and a control group, 17 cases in each one. The patients in the control group were treated with calcium supplementation after surgery, 1 to 2 mg/kg an hour; one day after surgery, the patients were treated with oral administration of calcium carbonate before meals, 1.5 g, three times per day, and calcitriol (0.5 to 4 μg/d) was added if necessary. None-heparin hemodialysis was performed for one week after surgery. Besides calcium supplementation, patients in the observation group were treated with auricular plaster therapy at Shenmen (TF), Jiaogan (AH), Neifenmi (CO) and Shen (CO). The laboratory indexes, including immunoreactive parathyroid hormone (iPTH), calcium, phosphorus, and SF-36 questionnaire, including 8 dimensions of physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotional (RE) and emotional well-being (EB), were observed before surgery and 1 week, 2 weeks, 4 weeks and 8 weeks after surgery in the two groups.
The iPTH in the two groups was significantly decreased 1 week, 2 weeks, 4 weeks and 8 weeks after surgery, and the serum calcium and phosphorus were also improved to a certain degree (all <0.05); however, the differences of iPTH, calcium and phosphorus between the two groups were not significant at each time point after surgery (all >0.05).The PF, RP, BP, GH, VT, SF, RE and EB of SF-36 in the two groups before surgery were lower than the normal score; after surgery, each dimension of SF-36 were improved to some extent in the two groups (all <0.05). Eight weeks after surgery, the improvement of PF, RP, BP, GH and EB in the observation group was superior to that in the control group (all <0.05); however, in terms of VT, SF and RE, no significant difference was observed between the two groups (all >0.05).
The auricular plaster therapy can improve the physical and mental health, relieve pain and improve quality of life in patients with uremia after PTX+AT, which is superior to calcium carbonate alone.
观察耳穴贴压疗法对甲状旁腺切除加自体移植（PTX+AT）术后尿毒症患者生活质量的影响。
将34例接受PTX+AT治疗的尿毒症合并继发性甲状旁腺功能亢进（SHPT）患者随机分为观察组和对照组，每组17例。对照组术后补钙治疗，每小时12mg/kg；术后1天，患者于饭前口服碳酸钙1.5g，每日3次，必要时加用骨化三醇（0.54μg/d）。术后进行1周无肝素血液透析。观察组除补钙外，采用耳穴贴压疗法，穴位取神门（TF）、交感（AH）、内分泌（CO）、肾（CO）。观察两组患者手术前及术后1周、2周、4周、8周的实验室指标，包括免疫反应性甲状旁腺激素（iPTH）、钙、磷，以及SF-36问卷，该问卷包括身体功能（PF）、身体角色（RP）、身体疼痛（BP）、总体健康（GH）、活力（VT）、社会功能（SF）、情感角色（RE）和心理健康（EB）8个维度。
两组患者术后1周、2周、4周、8周时iPTH均显著降低，血清钙和磷也有一定程度改善（均P<0.05）；但术后各时间点两组间iPTH、钙和磷的差异均无统计学意义（均P>0.05）。两组患者手术前SF-36的PF、RP、BP、GH、VT、SF、RE和EB均低于正常评分；术后两组SF-36各维度均有不同程度改善（均P<0.05）。术后8周，观察组PF、RP、BP、GH和EB的改善情况优于对照组（均P<0.05）；但在VT、SF和RE方面，两组间差异无统计学意义（均P>0.05）。
耳穴贴压疗法可改善PTX+AT术后尿毒症患者的身心健康，缓解疼痛，提高生活质量，优于单纯碳酸钙治疗。
