运用中医辩证探究参芪颗粒对血液透析低血压患者的疗效

Effect of Shen Qi on TCM Syndromes of Patients with Hemodialysis Associated Hypotension

目的运用中医辩证论治统计与归纳血液透析相关低血压患者中医证候,探究参芪颗粒防治此类低血压患者的疗效。方法对符合入组条件的40例血液透析低血压患者运用中医四诊合参,归纳总结相关中医证候。通过自身对照,连续观察10次血液透析,设治疗组、对照组两组,对照组:透析前5次予以参麦注射液,治疗组:参麦注射液联合参芪颗粒。参芪颗粒(黄芪,党参,附子,干姜)服用方法:每剂兑入20ml温水泡服,每日两次。观察中医证型变化,统计低血压发生频数与症状发生情况。结果 40例血液透析低血压患者的中医证型为脾肾气虚28例占70%、脾肾阳虚12例占30%,兼挟标实中医证型为湿浊证4例占10%、湿热证2例占5%、血瘀证1例占2.5%。治疗组40例低血压发生9次、24例治疗有效,对照组40例低血压发生22例、11例治疗有效。结论血液透析低血压患者的中医证型以脾肾气虚最多、脾肾阳虚次之,兼挟标实中医证型以湿浊证、湿热证、血瘀证为主;参芪颗粒治疗后患者低血压的发生频率降低、中医证候趋于正常。

Objective To analyze the TCM Syndromes of patients with hemodialysis associated hypotension and to observe the clinical effect of Shen Qi on TCM Syndromes of patients with hemodialysis associated hy- potension. Methods 40 cases of patients with hemodialysis associated hypotension were chosen. TCM Syn- dromes were then analyzed after TCM treatment and clinical investigation. 40 cases were given hypotension 10 times and by Self-control were divided to two groups, control group （top 5 times） giving Shenmai injection and observe group （later 5 times） giving Shenmai injection and Shen Qi soup which containing Huang Qi, dangshen, aconite and dried ginger. Shen Qi soup was blended with 20ml warm water and given twice one day. Results TCM Syndromes of 40 cases of patients with hemodialysis associated hypotension were asfollows： 28 cased （70%） were Spleen and kidney deficiency, 12 cased （30%） were insuflqciency of both the spleen and the kidney. TCM Syndromes of mark and real coexist were as follows： 4 cased （10%） were wet material certificate, 2 cased （5%） were damp-heat syndrome, 1 cased （2.5%） were syndrome of blood stagnation. After TCM treatment, in the observe group 9 cases occur hypotension and 24 cases were therapeutically effective while in control group 22 cases occur hypotension and 11 cases were therapeutically effective. Conclusion The key Syndrome of patients with hemodialysis associated hypotension was Spleen and kidney deficiency and then was insutticiency of both the spleen and the kidney. The key Syndrome of mark and real coexist were wet material certificate, damp-heat syndrome and syndrome of blood stagnation. After treatment of Shen Qi soup, the incidence of hypotension was apparently lower and the TCM syndromes become normal.