当归补血汤联合可调钠曲线透析对尿毒症心肌病患者Q-T间期离散度的影响

Effect of Danggui Buxue Decoction Combined with Adjustable Sodium Curve Hemodialysis on Q-T Dispense in Patients with Uremic Cardiomyopathy

目的探讨当归补血汤（Danggui Buxue Decoction,DBD）联合可调钠曲线血液透析对尿毒症心肌病患者透析低血压及Q-T间期离散度（Q-T dispense,Q-Td）的影响。方法选取2014年1月-12月在河南省中医院血液净化中心维持性血液透析患者,符合尿毒症心肌病诊断标准。观察全部9例患者16周血液透析,前4周恒定钠浓度透析,中间4周可调钠曲线透析,后4周DBD联合可调钠曲线透析,观察每次透析时血压,脱水量,平均动脉压,每次透析结束时心电图检测Q-Td和校正Q-Td（Q-Tc）。结果前中后4周透析前患者血压及每次透析脱水量比较差异无明显性,但中后4周透析中患者平均动脉压明显高于前4周,有统计学差异（P〈0.05）;前4周,患者在上机后1.5小时易于发生透析低血压反应,中后4周透析中,在透析进行1.5小时后患者血压较前4周明显增加,有统计学差异（P〈0.05）;中后4周透后患者Q-Td,Q-Tc较前4周比较明显减少,有统计学差异（P〈0.05）。中后4周比较,平均动脉压,上机后1.5小时较中4周明显增加,Q-Td和Q-Tc较中4周明显减少,均具有统计学差异（P〈0.01）。结论 DBD联合可调钠曲线透析能改善尿毒症心肌病患者透析低血压,减少Q-Td和Q-Tc;联合应用效果强于单独可调钠曲线透析治疗。

Objective To investigate the effect of dangguibuxue decoction （ DBD ） combined with adjustable sodium curve dialysis on Q-T dispense in patients with uremic cardiomyopathy.Methods Selected maintenance hemodialysis patients in the blood purification center of henan province traditional Chinese medicine hospital in January 2014 to December, all the patients met the uremic cardiomyopathy diagnosis standard.All 9 patimlts were Observed for 16 weeks, the first 4 weeks at a constant concentration of sodium hemodialysis, the second 4 weeks with adjustable curve of sodium hemodialysis, the last 4 weeks DBD combined adjustable sodium curve hemodialysis.Blood pression, dewatering amount and mean arterial pressure of every hemodialysis were obsvered.Q-Td and Q-To in the end or＇every hemodialysis were recorded with electrocardiowaph.Results There was no obvious difference in blood pressure before dialysis and dewatering mnount of the first, second and last 4 weeks.But the mean arterial pressures is sibnfificanfly higher in the second and last 4 weeks compared with the first 4 weeks in dialysis （ P〈0.05 ） .In the first 4 weeks, patients were more prone m dialysis hypotension 1.5 h after dialysis, but in the second and last 4 weeks blood prcqsure1.5h after dialysis increased statistically sigmificantly in patient（ P〈0.05 ）.Q-Td, Q-Tc in the second and last 4 weeks were less than those in the first 4 weeks（ P〈 0.05 ）. The mean arterial pressure and blood pression 1.5 hours are increased statistically siglificantly in the last 4 weeks compared with the second 4 weeks （ P〈0.01 ） ; the Q-Td and Q-To is sibmificantly reduced in the last 4 weeks compared with in the second 4 weeks （ P〈0.01 ） . Conelusion DBD combined with adjustable sodium curve dialysis can improve dialysis hypotension in patients with uremic cardiomyopathy, reduce Q-Td and Q-To ; Joint application effect is better than single adjustble curve or＇sodium dialysis treatment.