麝香保心丸联合盐酸曲美他嗪用于透析低血压的临床研究

Clinical study on the combination of Shexiang Baoxin Pills and Trimetazidine Dihydrochloride for dialysis hypotension

目的探讨麝香保心丸联合盐酸曲美他嗪用于预防透析低血压的临床效果。方法选取2022年2月至2023年4月鹰潭市中医院收治的60例维持性血液透析(MHD)患者作为研究对象,采用计算机随机数字表法将患者分为对照组与观察组,每组30例。对照组采用盐酸曲美他嗪,观察组采用麝香保心丸联合盐酸曲美他嗪治疗。比较两组患者透析前后血压、心功能变化以及血管内皮功能,统计两组患者低血压发生率及不良反应。结果观察组用药后的透析中及透析后的收缩压(SBP)及平均动脉压(MAP)水平高于对照组,差异有统计学意义(P<0.05)。观察组用药后的左室射血分数(LVEF)、右房内径高于对照组,左室舒张末期内径(LVEDD)、右室流出道低于对照组,血栓素B2(TXB2)、内皮素(ET)含量高于对照组,一氧化氮(NO)水平低于对照组,差异有统计学意义(P<0.05)。观察组透析低血压发生率低于对照组,差异有统计学意义(P<0.05)。而两组患者用药时的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论麝香保心丸联合盐酸曲美他嗪的应用,使MHD患者透析期间的低血压发生率得以降低,维持透析期间稳定血压水平,值得临床应用。

Objective To investigate the clinical effect of Shexiang Baoxin Pills combined with Trimetazidine Dihydrochloride on prevention of dialysis hypotension.Methods A total of 60 patients with maintenance hemodialysis(MHD)admitted to Yingtan Hospital of Traditional Chinese Medicine from February 2022 to April 2023 were selected as the research objects,they were divided into control group and observation group by computer random number method,with 30 cases in each group.The control group was treated with Trimetazidine Dihydrochloride,and the observation group was treated with Shexiang Baoxin Pills combined with Trimetazidine Dihydrochloride.The changes of blood pressure,cardiac function and vascular endothelial function before and after dialysis were compared between the two groups,and the incidence of hypotension and adverse reactions were analyzed.Results The systolic blood pressure(SBP)and mean arterial pressure(MAP)levels in the observation group were higher than those in the control group after treatment,and the differences were statistically significant(P<0.05).After treatment,left ventricular ejection fraction(LVEF)and right atrial diameter in observation group were higher than those in control group,left ventricular end diastolic diameter(LVEDD)and right ventricular outflow tract were lower than those in control group,thrombin B2(TXB2)and endothelin(ET)contents were higher than those in control group,and nitric oxide(NO)level was lower than that in control group,the differences were statistically significant(P<0.05).The incidence of dialysis hypotension in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of Shexiang Baoxin Pills combined with Trimetazidine Hihydrochloride can reduce the incidence of hypotension and maintain stable blood pressure during dialysis in MHD patients,which is worthy of clinical application.