益气温阳活血化瘀法对慢性肾衰竭患者自体动静脉内瘘的影响

The Effect of Yiqi Wenyang Huoxue Huayu Method on Autologous Arteriovenous Fistula in Chronic Renal Failure Patients

目的:观察益气温阳活血化瘀法对慢性肾衰竭患者自体动静脉内瘘的影响。方法:选取2022年1月—2023年12月赣州市中医院收治的慢性肾功能衰竭患者60例作为研究对象,采用简单随机、单盲、相互对照的试验设计方法,将其分为两组,均为自体动静脉内瘘成形术后,对照组采用基础治疗,观察组在常规治疗基础上按照益气温阳活血化瘀法给予中药熏浴治疗。两组均治疗6周,比较两组血流量、内瘘管径、血浆D-二聚体、凝血功能及不良反应。结果:术后1 d,两组血流量、内瘘管径比较,差异均无统计学意义(P>0.05),观察组术后6周的血流量、内瘘管径均高于对照组,差异均有统计学意义(P<0.05)。两组治疗前血浆D-二聚体比较,差异无统计学意义(P>0.05),观察组治疗后血浆D-二聚体低于对照组与治疗前,差异均有统计学意义(P<0.05)。治疗前,组内凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)比较,差异均无统计学意义(P>0.05),治疗后,观察组APTT、FIB均低于治疗前,差异均有统计学意义(P<0.05),对照组治疗前后PT、APTT、FIB比较,差异均无统计学意义(P>0.05)。两组吻合口狭窄、皮疹不良发生率比较,差异无统计学意义(P>0.05)。结论:对自体动静脉内瘘的慢性肾衰竭患者施以益气温阳活血化瘀法治疗,可以有效改善血流量,扩宽内瘘管径,降低血浆D-二聚体,安全性较高。

Objective:To observe the effect of Yiqi Wenyang Huoxue Huayu method on autologous arteriovenous fistula in patients with chronic renal failure.Method:A total of 60 patients with chronic renal failure admitted to Ganzhou Hospital of TCM from January 2022 to December 2023 were selected as the study objects,and were divided into two groups by a simple randomized,single-blind and cross-control experimental design method,all were after autologous arteriovenous internal fistula,the control group was treated with basic treatment,and the observation group was treated with traditional Chinese medicine fumigation bath according to the method of Yiqi Wenyang Huoxue Huayu on the basis of conventional treatment.Both groups were treated for 6 weeks.Blood flow,internal fistula diameter,plasma D-dimer,coagulation function and adverse reactions were compared between the two groups.Result:One day after surgery,there were no statistical significance in blood flow and internal fistula diameter between the two groups(P>0.05),but the blood flow and internal fistula diameter of the observation group at 6 weeks after surgery were higher than those of the control group,with statistical significance(P<0.05).There was no significant difference in plasma D-dimer between the two groups before treatment(P>0.05),and the plasma D-dimer in the observation group after treatment was lower than that in the control group,the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)in two groups(P>0.05);after treatment,APTT and FIB in the observation group were lower than before treatment,there were statistically significant differences(P<0.05);there were no statistically significant differences in PT,APTT and FIB in control group before and after treatment(P>0.05).There was no significant difference in the incidence of anastomotic stenosis and adverse rash between the two groups(P>0.05).Conclusion:The treatment of chronic renal failure patients with autologous arteriovenous fistula using the method of Yiqi Wenyang Huoxue Huayu can effectively improve blood flow,widen the diameter of the fistula,reduce plasma D-dimer,and have high safety.