中医药治疗尿毒症合并慢性心功能不全患者低温可调钠透析致低血压26例

Twenty-Six Cases of Hypotension Caused by Low Temperature Adjustable Sodium Dialysis of Patients with Uremia in Combination with Chronic Cardiac Insufficiency

目的:观察中医药治疗尿毒症合并慢性心功能不全患者低温可调钠透析致低血压的临床疗效。方法:选取透析中多次出现低血压的尿毒症伴慢性心功能不全患者52例,按随机数字表法分成对照组和治疗组,每组26例。对照组在血液透析过程中给予低温钠曲线透析,治疗组在对照组治疗的基础上加用黄芪注射液持续静脉滴注,并服用中药汤剂。观察两组治疗前后血压变化情况及治疗效果。结果:治疗组和对照组治疗后的收缩压分别为(98.5±7.1)mmHg和(93.7±6.2)mmHg,均较治疗前提高(P<0.05),治疗后治疗组收缩压优于对照组(P<0.05);治疗组和对照组治疗后的左室射血分数分别为(55.87±2.76)%和(53.92±3.62)%,均较治疗前提高(P<0.05),治疗组治疗后左室射血分数优于对照组(P<0.05)。结论:黄芪注射液及中药汤剂能明显降低尿毒症合并心功能不全反复发生透析过程中低血压发生率,增加左室射血分数,改善患者左心室功能。

Objective： To observe the clinical curative effect of low temperature adjustable sodium dialysis on patients with uremia in combination with chronic cardiac insufficiency. Methods： Fifty-two patients with uremia and chronic cardiac insufficiency who had frequent hypotension during dialysis were divided into the control group and the treatment group according to the random number table method,with 26 cases in each group. The control group was given low temperature sodium curve dialysis during blood dialysis,while the treatment group was given continuous infusion of Astragalus Injection on the basis of the control group and took Chinese medicine decoction. The changes of blood pressure and the treatment effect before and after the treatment were observed in the two groups. Results： After the treatment,the systolic blood pressure of the treatment group and the control group were（98. 5 ± 7. 1） mmHg and（93. 7 ± 6. 2） mmHg respectively,both were higher than that before the treatment（P 0. 05）. And the systolic blood pressure of treatment group was superior to that of the control group（P 0. 05）. After the treatment,the left ventricular ejection fraction of the treatment group and the control group were（55. 87 ± 2. 76） % and（53. 92 ± 3. 62） % respectively,both were higher than that before the treatment（P 0. 05）. And the left ventricular ejection fraction of the treatment group was superior to that of the control group（P 0. 05）. Conclusion： Astragalus Injection and traditional Chinese medicine decoction can significantly reduce the incidence of hypotension,increase left ventricular ejection fraction and improve left ventricular function in patients with uremia and chronic cardiac insufficiency during repeated dialysis.