Objective:To explore the effect of PBL model on the pain and toxin clearance in patients with chronic renal failure and diabetes with hemodialysis. Methods:118 patients with chronic renal failure and diabetes mellitus who were treated in our hospital from January 2015 to January 2017, were randomly divided into PBL group and control group, 59 cases in each group.The control group received routine nursing, and the PBL group was given PBL education. Results:The rate of severe anxiety and severity of depression in PBL group were 3.39% and 1.69%, which were significantly lower than 11.86% and 13.56% in the control group. Compared with the control group, the mood of PBL group was significantly better than that of the control group(P<0.05). After treatment, the VAS score of the study group was significantly lower than that before intervention, that ofPBL group was (2.16±1.22), and that in the control group was (4.83±1.76), the difference was significant (P<0.05). Adipokines, adiponectin, resistin and inflammatory factor (Leptin, 1L-6, TNF-a) in the two groups had no statistical difference before treatment (P>0.05), after treatment the data were improved, however it was improved slightly in the control group, PBL group has a significant effect, the difference between the two groups had a statistical significance (P<0.05). The blood sugar index showed that after treatment fasting plasma glucose (FBG), 2 h fasting blood glucose (2Hpbg), triglyceride (TG) and total cholesterol (TC) were all better than those before treatment, but the effect of PBL group was better. The difference between the two groups was statistically significant (P<0.05). In addition, the life quality of patients with PBL was significantly higher than that of the control group (P<0.05). Conclusion:PBL education mode has a certain effect on toxin clearance and blood glucose control in diabetic patients with renal failure, and can significantly reduce the pain degree of patients due to dialysis, and improve the quality of life and negative emotions of patients. |
[1] 陈建栋,陈建中.2型糖尿病患者血清同型半胱氨酸含量与糖尿病肾病关系的探讨[J].标记免疫分析与临床,2016,23(1):19-20.
[2] 范瑾.血清及尿液特定蛋白检测在糖尿病肾病早期诊断中的意义[J].检验医学与临床,2017,14(5):689-690.
[3] WADA J,MAKINO H.Inflammation and the pathogenesis of diabetic nephropathy[J].Clin Sci,2013,124(34):139-152.
[4] 赵春艳,刘亚玮.中西医结合治疗糖尿病肾病临床疗效观察[J].四川中医,2016,12(4):65-67.
[5] FARMER E A.Faculty development for problem-based learning[J]. Eur J Dent Educ,2004,8(2):59-66.
[6] 田鹏,马信龙,王涛,等.腰椎间盘突出症患者VAS评分与外周血T淋巴细胞水平相关性研究[C]//全国创伤学术会议暨2009海峡两岸创伤医学论坛.2009.
[7] KIND P.Measuring the value of quality of life in cancer:An index based on EORTC QLQC-30[J].J Clin Oncol,2005,23(16):531S.
[8] 陈茂盛,金娟,刘岳明,等.基于病理学分期的糖尿病肾病中医辨证分型研究[J].中华中医药学刊,2016,23(11):2668-2672.
[9] 陈结慧,姚文萃,祝胜郎,等.虫草制剂通过TGF-β/Snail信号通路拮抗糖尿病小鼠肾小管上皮细胞间充质转分化[J].临床军医杂志,2017,45(2):140-144.
[10] PUTTA S,LAN L,SUN G,et al.Inhibiting microRNA-192 ameliorates renal fibrosis in diabetic nephropathy[J].J Am Soc Nephrol,2012,23(3):458-69.
[11] 段晋燕,苑晓舟,李新军,等.多指标检测在糖尿病肾病监测中的临床价值[J].标记免疫分析与临床,2016,23(5):551-553.
[12] 何文,陈进芬,郑玲芳,等.以问题为导向教学法在儿科临床实习教学中的应用研究[J].检验医学与临床,2017,14(14):2163-2164.
[13] 李志恒.分析多项指标表达水平在糖尿病肾病早期诊断中的意义[J].检验医学与临床,2016,13(8):1111-1113.
[14] WOLF G.New insights into the pathophysiology of diabetic nephropathy:from haemodynamics to molecular pathology[J].Eur J Clin Invest,2015,34(12):785-796.
[15] 孙丹,王薇,李子龙.马来酸桂哌齐特联合羟苯磺酸钙治疗糖尿病肾病临床观察[J].临床军医杂志,2016,44(3):325-326.
[16] SUN Y M,SU Y,LI J,et al.Recent advances in understanding the biochemical and molecular mechanism of diabetic nephropathy[J].Biochem Biophys Res Commun,2013,433(4):359-361. |