中醫對於末期腎病變透析患者之現況、挑戰、與運用

Traditional Chinese Medicine for End-Stage Renal Disease Patients on Hemodialysis: Current State, Challenges, and Applications

許詠棠(Yung-Tang Hsu) ； 柳硯文(Yan-Wen Liu) ； 李文欽(Wen-Chin Lee) ； 黃惠勇(Hwee-Yeong Ng) ； 蔡明諺(Ming-Yen Tsai)

《中西整合醫學雜誌》 23卷1期 (2021/06) Pp. 12-27

摘要

腎臟替代療法是末期腎衰竭病患延續生命的重要治療。目前在臺灣，血液透析是其中最多病人接受的治療。雖然此治療可以延續生命，但是卻要面對許多可能的不舒服與併發症，譬如透析低血壓、疼痛、透析不平衡症候群與抽筋等幾乎是病患與醫師天天需要面對的狀況。中醫藥是補充和替代醫學方法之一，已被世界衛生組織認可適用於多種疾病。如今，中醫治療末期腎病變患者的臨床應用已成為其效用和安全性的焦點。在本文中，我們將探討不同中醫干預措施如中藥、針灸、穴敷、耳穴、或藥浴，針對患者按照常見症狀做系統性的分類，來了解中西醫現行治療方式和中醫觀點。在患有末期腎病的患者中，中醫可以平衡陰陽，預防心血管意外、控制血壓、緩解疼痛；以及改善許多患者的不適症狀，如尿毒症瘙癢、體液與電解質失衡、失眠和營養不良。中醫藥作用機制與自主功能的調節，和生物活性化學物質的激活有關。事實證明，中醫能擔任末期腎病變患者的輔助腳色。但是，需要更多的研究來驗證潛在的機轉。

關鍵字

末期腎病變 ； 透析 ； 中醫觀點 ； 中醫治療 ； 研究證據

並列摘要

Traditional Chinese medicine (TCM) is one of complementary and alternative medicine methods and has been used in a variety of diseases. Nowadays, the clinical application of TCM treatment for dialysis patients with common complication has become the focus for its effectiveness and security. In this paper, we will review the therapeutic effects and TCM viewpoints of different TCM application for patients with complication related HD. In patients with end-stage renal disease (ESRD), TCM could balance the yin and yang, prevent cardiovascular events, control blood pressure, relieve pain, and improve many complications such as uremic pruritus, water-electrolyte imbalance, insomnia and malnutrition. The mechanisms are related to the regulation of autonomic function and the activation of bioactive chemicals. In conclusion, TCM is proved to be beneficial for patients with ESRD-associated complications. More research, however, is needed to verify the potential mechanisms.

並列關鍵字

End-stage renal disease ； Dialysis ； Viewpoint ； Traditional Chinese medicine ； Evidence research

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