从湿热血瘀论治血液透析低血压的临床研究

Clinical Experience of Hemodialysis Related Hypotension from Damp-heat and Blood Stasis Syndrome Differentiation

血液透析低血压是维持性透析患者最常见的并发症,属于中医学"眩晕"、"厥证"、"脱证"等病的范畴。单纯的益气回阳等治疗并不能预防低血压的发生。笔者通过临床观察,体会到该类患者气阴(阴阳)两虚为本,湿热或瘀血阻遏清阳上升为标,是透析过程中阴阳大量脱失,气随津脱,加之湿热瘀血阻遏三焦清阳上升之道,清浊相干为病。因此治疗应益气养阴的同时要清热利湿化瘀,方可获得良效。

Hypotension was a common complication of hemodialysis.It was classified as ＂Xuanyun＂,＂Tuo syndrome＂ and ＂Jue syndrome＂ according to theory of traditional Chinese medicine.However,the clinical efficacy of mere replenishing Qi and Yang was not that satisfactory.We recognized that deficiency of Qi and Yin or deficiency of Yin and Yang was the basis of hemodialysis related hypotension.However,damp-heat and blood stasis that hindered the elevation of clearing Yang qi was of equal importance to the pathogenesis.Clearing heat-damp and stimulating blood circulation while replenishing Qi（Yang） and Yin at the same time could obtain good clinical efficacy.