血液透析患者的五行体质分布特点及其便秘的治疗体会
Distribution Characteristics of the Five Elements Constitution of Hemodialysis Patients and Their Experience in Treating Constipation

目的：探讨血液透析患者的五行体质分布特点；以补肾祛毒汤为蓝本方，通过辨质加减治疗血液透析患者便秘的体会。方法：选取2022年11月~2024年4月福建省第二人民医院规律血液透析患者218例，进行五行体质辨识；探讨五行体质特点及其与便秘的相关性，并对便秘患者88例，随机分组。西药对照组以乳果糖，15 ml，口服，bid；中药对照组以补肾祛毒汤，50 ml，口服，bid；中药治疗组以补肾祛毒汤为蓝本方，根据优势五行体质辨质加味治疗；观察各组治疗便秘的效果。结果：血液透析患者土行人最多，占比32.5%；五色五态体质分类中排名前三位的有土1木2、木1木2、土1土2型；不同优势五行患者的便秘发生率差异没有统计学意义(P > 0.05)。中药治疗组便秘评分改善平均下降68.83%，中药对照组平均下降57.21%，西药对照组平均下降50.23%，差异有统计学意义(P < 0.05)。中药治疗组明显优于西药对照组(P < 0.05)；中药治疗组与中药对照组，中药对照组与西药对照组之间没有明显差异(P > 0.05)；结论：1) 血液透析患者五行体质差异可能与便秘等并发症的发生有一定关系，通过五行体质辨质治疗血液透析患者便秘能明显增加疗效。2) 补肾祛毒汤治疗血液透析患者便秘效果与乳果糖相当。
Objective: To explore the distribution characteristics of the five elements constitution in hemodialysis patients, and to explore the experience of treating constipation in hemodialysis patients through differentiation of constitution and modification based on the formula of Bushen Qudu Tang. Method: 218 regular hemodialysis patients from the Second People’s Hospital of Fujian Province from November 2022 to April 2024 were selected for identification of the Five Elements constitution; Explore the characteristics of the Five Elements constitution and its correlation with constipation, and randomly group 88 patients with constipation. The Western medicine control group was treated with lactulose, 15 ml, orally, bid; The traditional Chinese medicine control group was treated with Bushen Qudu Tang, 50 ml, orally, bid; the traditional Chinese medicine treatment group uses the tonifying kidney and detoxifying decoction as the blueprint formula, and treats according to the superior five element constitution by distinguishing quality and adding flavor; observe the effectiveness of each group in treating constipation. Result: Hemodialysis patients had the highest proportion of natives, accounting for 32.5%; the top three types in the five color and five state physical constitution classification are Tu 1 Mu 2, Mu 1 Mu 2, and Tu 1 Tu 2; there was no statistically significant difference in the incidence of constipation among patients with different advantages in the Five Elements (P > 0.05). The average improvement in constipation score in the traditional Chinese medicine treatment group decreased by 68.83%, the average decrease in the traditional Chinese medicine control group was 57.21%, and the average decrease in the Western medicine control group was 50.23%, with statistical significance (P < 0.05). The traditional Chinese medicine treatment group was significantly better than the Western medicine control group (P < 0.05); there was no significant difference (P > 0.05) between the Chinese