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终末期肾病和中风的长期综合个性化医疗护理:一份符合CARE标准的病例报告。

Long-term integrative personalized medicine care in end-stage renal disease and stroke: A CARE-compliant case report.

作者信息

Kang Chae-Yeon, Lim Ju-Yeon, Lee Eui-Ju, Lee Yu-Na, Choi Won-Hee, Yu Hyeon-Ji

机构信息

College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Department of Sasang Constitutional Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2025 Aug 1;104(31):e43541. doi: 10.1097/MD.0000000000043541.

DOI:10.1097/MD.0000000000043541
PMID:40760640
Abstract

RATIONALE

End-stage renal disease (ESRD) is characterized by severely impaired renal function that necessitates dialysis or kidney transplantation for patient survival. Integrative Personalized Medicine Care (IPMC), which integrates conventional therapies with Traditional Korean Medicine, has been applied as a complementary approach to address ESRD and its associated complications through a holistic and individualized care model. To our knowledge, this is among the first documented cases evaluating the long-term safety and efficacy of IPMC in a patient with ESRD complicated by intracerebral hemorrhage (ICH).

PATIENT CONCERNS

An 80-year-old male patient undergoing dialysis for ESRD since 2021 experienced a left ICH in September 2022. Poststroke, he presented with clinical challenges including uncontrolled hypertension, nutritional imbalance, and persistent constipation.

DIAGNOSES

The patient was diagnosed with ESRD requiring regular dialysis and later suffered from a left ICH, which further complicated his clinical condition.

INTERVENTIONS

The patient received IPMC at Kyung Hee University Hospital, integrating conventional treatments with individualized herbal medicine and acupuncture. Herbal prescriptions were continuously adjusted in response to clinical status, laboratory markers, and interactions with concurrent medications.

OUTCOMES

Renal function parameters stabilized during the treatment period, and clinical control of comorbidities improved. Nutritional status improved, blood pressure was effectively managed, and symptoms of constipation were resolved. Subjective enhancements in quality of life were also reported. Importantly, no hepatic or renal toxicity was observed despite the long-term administration of herbal medicines, indicating favorable safety under medical supervision.

LESSONS

This case demonstrates the clinical feasibility and safety of IPMC in managing ESRD patients with concurrent complications such as ICH. Long-term integration of Traditional Korean Medicine and conventional therapies may provide adjunctive clinical benefits without compromising safety. IPMC may serve as a viable supportive strategy for addressing multifactorial challenges in ESRD management. Further large-scale cohort studies are warranted to strengthen the evidence base for this integrative treatment model.

摘要

理论依据

终末期肾病(ESRD)的特征是肾功能严重受损,患者必须进行透析或肾脏移植才能存活。综合个性化医疗护理(IPMC)将传统疗法与韩医相结合,已作为一种补充方法,通过整体和个性化的护理模式来解决ESRD及其相关并发症。据我们所知,这是首批记录评估IPMC对一名合并脑出血(ICH)的ESRD患者的长期安全性和有效性的病例之一。

患者情况

一名80岁男性患者自2021年起因ESRD接受透析治疗,2022年9月发生左侧ICH。中风后,他面临着包括高血压控制不佳、营养失衡和持续便秘等临床挑战。

诊断

该患者被诊断为需要定期透析的ESRD,后来又患上左侧ICH,这使他的临床病情更加复杂。

干预措施

该患者在庆熙大学医院接受了IPMC,将传统治疗与个性化草药和针灸相结合。根据临床状况、实验室指标以及与同时使用药物的相互作用,不断调整草药处方。

结果

治疗期间肾功能参数稳定,合并症的临床控制得到改善。营养状况改善,血压得到有效控制,便秘症状得到缓解。患者还报告了生活质量的主观改善。重要的是,尽管长期服用草药,但未观察到肝毒性或肾毒性,表明在医学监督下安全性良好。

经验教训

该病例证明了IPMC在管理合并ICH等并发症的ESRD患者方面的临床可行性和安全性。韩医与传统疗法的长期结合可能在不影响安全性的情况下提供辅助临床益处。IPMC可能是应对ESRD管理中多因素挑战的可行支持策略。有必要进一步开展大规模队列研究,以加强这种综合治疗模式的证据基础。

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本文引用的文献

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The Roadmap toward Personalized Medicine: Challenges and Opportunities.个性化医疗之路:挑战与机遇
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KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.KDIGO 2024慢性肾脏病评估与管理临床实践指南
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Meta-analysis of traditional Chinese medicine on chronic kidney disease.中医治疗慢性肾脏病的Meta分析
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How to use the Bristol Stool Chart in childhood constipation.如何在儿童便秘中使用布里斯托大便分类法。
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Acupuncture as a post-stroke treatment option: A narrative review of clinical guideline recommendations.针刺作为一种中风后治疗选择:临床指南推荐的叙述性综述。
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