2025 年第 7 期 第 20 卷

慢性肾脏病患者预后与中医药治疗的质性研究

A qualitative study on the prognosis and traditional Chinese medicine treatment of patients with chronic kidney disease

作者：方晓月李雪李靖

英文作者：Fang Xiaoyue Li Xue Li Jing

单位：北京中医药大学东直门医院肾病内分泌科二区，北京100700

英文单位：Second Ward Department of Nephrology Endocrinology Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 China

关键词：慢性肾脏病；疾病预后；中医药；质性研究

英文关键词：Chronickidneydisease;Diseaseprognosis;TraditionalChinesemedicine;Qualitativestudy

• 摘要：

• 目的 从“知信行”角度探索慢性肾脏病患者对于疾病预后以及中医药治疗的认知。方法 本研究采用半结构化深度访谈的定性研究方法，对2025年1—2月就诊于北京中医药大学东直门医院肾病内分泌科的21例慢性肾脏病患者进行访谈，采用Colaizzi七步法对资料进行分析、提炼，Maxqda 2022软件辅助资料整理、数据编码。结果 本研究访谈到第21例患者时呈资料饱和状态，其中男8例，女13例，年龄29～76岁，病程3～420个月。患者对疾病发展和预后认知不足，中医治疗认可度较高，认为其治疗优势突出；对疾病治疗有较高期待和信心，中医药治疗普遍接受度广，信任度高；患者自我管理具有偏差性，饮食起居有待规范。结论 患者对疾病认知和预后的模糊性、对治疗的高信心和高期待、自我管理行为的偏差性三者之间存在矛盾，需要加强健康教育，改善认知不足与高期待冲突；推广中医药治疗，发挥特色优势；构建“认知-信念-行为”协同干预模型，形成“知信行”良性循环，为慢性病管理提供中医智慧。

• Objective  To explore the cognition of chronic kidney disease patients on disease prognosis and traditional Chinese medicine treatment from the perspective of "knowledge, belief and action". Methods A total of 21 patients with chronic kidney disease who visited the Department of Nephrology Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine from January to February 2025 were interviewed by semi-structured in-depth interviews. The Colaizzi seven-step method was used to analyze and refine the data, and Maxqda 2022 software was used to assist data sorting and data coding.Results In this study, the data was saturated when the 21st patient was interviewed, including 8 males and 13 females, aged 29 to 76 years, and the course of disease was 3 to 420 months. The patients had insufficient cognition of the development and prognosis of the disease, and the recognition of traditional Chinese medicine treatment was high, and the advantages of traditional Chinese medicine treatment were prominent. They had high expectations and confidence in disease treatment, and traditional Chinese medicine treatment was widely accepted and trusted. Patients′ self-management is biased, and their diet and daily life need to be standardized. Conclusion There is a contradiction among the ambiguity of patients′ cognition of the disease and prognosis, their high confidence and high expectations in treatment, and the deviation of self-management behaviors. It is necessary to strengthen health education to improve the conflict between insufficient cognition and high expectations. Promoting the treatment of traditional Chinese medicine, giving full play to its characteristic advantages, constructing a collaborative intervention model of "cognition-belief-behavior", and forming a virtuous cycle of "knowledge, belief and action" can provide the wisdom of traditional Chinese medicine for the management of chronic diseases.