林启展从瘀论治自体动静脉内瘘成熟不良

Professor Lin Qizhan Treating Immaturity of Autologous Arteriovenous Fistula from Perspective of Stasis

自体动静脉内瘘(arteriovenous fistula,AVF)成熟不良与瘀血有密切关系,瘀血既是病理产物,又是致病因素。故临证应从瘀论治AVF成熟不良:对于气虚血瘀证患者,须以补气为主,辅以养血活血,化瘀通络,达到气旺血行之目的,方用补阳还五汤加减;针对阳虚血瘀证患者采用温阳散寒、活血化瘀治法,方用自拟温阳活血方;针对痰浊血瘀证患者以化痰除湿、活血化瘀为治法,方用温胆汤合桃红四物汤加减;针对湿热血瘀证患者应以清热祛湿、活血化瘀法治之,方拟四妙散加味。

Immature arteriovenous fistula(AVF)is closely related to stasis,which is both a pathological product and a pathogenic factor.Therefore,the treatment of AVF immaturity should be based on blood stasis:for patients with Qi deficiency and blood stasis syndrome,it is necessary to invigorate Qi,supplemented by nourishing blood and promoting blood circulation,removing blood stasis and dredging collaterals,so as to achieve the purpose of promoting Qi and promoting blood circulation,and modified Buyang Huanwu Decoction can be used.For patients with Yang deficiency and blood stasis syndrome,the treatment method of warming Yang and dispelling Cold,promoting blood circulation and removing blood stasis should be adopted,and the prescription is self-made Wenyang Huoxue Recipe.For patients with Phlegm turbidity and blood stasis syndrome,the treatment method is to remove Phlegm and Dampness,activate blood circulation and remove blood stasis,and Wendan Decoction and Taohong Siwu Decoction can be used in combination.For patients with Damp-Heat and blood stasis syndrome,it should be treated by clearing away Heat and Dampness,promoting blood circulation and removing blood stasis,and modified Simiao Powder can be used.