外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能临床观察

史月欣; 刘福生; 曹钋; 钟剑; 魏宇; 孙鲁英; 孙卫卫; 姚志; 刘正平

doi:10.3969/j.issn.2095-6606.2022.02.001

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外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能临床观察

临床研究 | 更新时间：2022-04-02

- 外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能临床观察
- Clinical study of externally used Huoxue Sanjie Formula for autologous arteriovenous fistula in maintenance hemodialysis patients
- 现代中医临床 2022年29卷第2期页码：1-6,18
- 作者机构：
  
  1.北京中医药大学东直门医院　北京　100700
  2.北京中医药大学东方医院
  3.北京中医药大学房山医院
- 作者简介：
  
  史月欣，女，在读硕士生
  # 曹钋，女，教授、主任医师，硕士生导师，E-mail：caoposun@126.com
- 基金信息：
  
  国家科技支撑计划项目(2011BAI10B01);中央高校基本科研业务费专项资金资助(2018-JYB-JS086);北京中医药大学教育科学研究课题(XJYB1950)
- DOI：10.3969/j.issn.2095-6606.2022.02.001
  中图分类号： R256.6
- 纸质出版日期：2022-03-30，
  
  收稿日期：2021-04-13，
- 稿件说明：
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史月欣, 刘福生, 曹钋, 等. 外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能临床观察[J]. 现代中医临床, 2022,29(2):1-6,18.

Yuexin SHI, Fusheng LIU, Po CAO, et al. Clinical study of externally used Huoxue Sanjie Formula for autologous arteriovenous fistula in maintenance hemodialysis patients[J]. Modern Chinese Clinical Medicine, 2022,29(2):1-6,18.
史月欣, 刘福生, 曹钋, 等. 外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能临床观察[J]. 现代中医临床, 2022,29(2):1-6,18. DOI： 10.3969/j.issn.2095-6606.2022.02.001.

Yuexin SHI, Fusheng LIU, Po CAO, et al. Clinical study of externally used Huoxue Sanjie Formula for autologous arteriovenous fistula in maintenance hemodialysis patients[J]. Modern Chinese Clinical Medicine, 2022,29(2):1-6,18. DOI： 10.3969/j.issn.2095-6606.2022.02.001.

摘要

目的

观察外用活血散结方改善维持性血液透析患者自体动静脉内瘘功能的临床疗效。

方法

将98例维持性血液透析的患者建立1个队列，按是否接受外用活血散结方治疗作为暴露因素分为治疗组和对照组。剔除脱落病例后治疗组40例、对照组52例。对照组患者采用常规内瘘保护措施，治疗组在对照组治疗的基础上外用活血散结方。观察2组内瘘首次通畅丧失情况、内瘘并发症发生情况、因内瘘问题就诊或住院情况、内瘘首次通畅率及首次通畅时间，并对可能影响内瘘首次通畅的相关因素进行单因素和多因素分析。

结果

6个月随访时治疗组与对照组内瘘首次通畅丧失情况比较差异无统计学意义(

0.05)。12个月和18个月随访时治疗组内瘘首次通畅丧失比率均低于对照组(

0.05)。截至末次随访，治疗组与对照组内瘘并发症发生率比较差异均无统计学意(

0.05)。6个月随访时治疗组与对照组因内瘘问题就诊或住院情况比较差异无统计学意义(

0.05)。12个月和18个月随访时治疗组因内瘘问题就诊或住院率均低于对照组 (

0.05)。Log-rank检验显示，治疗组内瘘的首次通畅率高于对照组，首次通畅时间长于对照组，差异有统计学意义(

0.05)。单因素分析结果显示血磷≥1.8 mmol/L、血浆白蛋白≥40 g/L、外用活血散结方、透析中发生低血压对内瘘首次通畅的影响有统计学意义(

0.01)。多因素分析结果显示透析中发生低血压是内瘘首次通畅丧失的独立危险因素，外用活血散结方、血浆白蛋白≥40 g/L是内瘘首次通畅丧失的独立保护性因素。

结论

外用活血散结方对改善维持性血液透析患者自体动静脉内瘘功能具有较好的临床疗效。

Abstract

Objective

To observe the clinical efficacy of externally used

Huoxue Sanjie

Formula in improving autologous arteriovenous fistula in patients with maintenance hemodialysis.

Methods

Ninety-eight patients with maintenance hemodialysis were assigned to the treatment group and the control group according to whether they used externally

Huoxue Sanjie

Formula. There were 40 left in the treatment group and 52 left in the control group

with the withdrawals excluded. The control group was treated with routine protection measures

and the treatment group was additionally treated with

Huoxue Sanjie

Formula. The primary patency loss of autologous arteriovenous fistula

the occurrence of autologous arteriovenous fistula complications

the situation of seeking medical treatment or hospitalization due to fistula problems

the primary patency rate and the primary patency time of autologous arteriovenous fistula in the two groups were observed

and the related factors that may affect the primary patencyth of internal fistula were analyzed by single factor and multi factor analysis.

Results

There was no significant difference in the primary patency loss of internal fistula between the treatment group and the control group at 6th month follow-up (

0.05). At the 12th month and 18th month follow-ups

the primary patency loss rate of autologous arteriovenous fistula was lower in the treatment group than in the control group (

0.05). As of the last follow-up

there was no significant difference in the incidence of autologous arteriovenous fistula complications between the treatment group and the control group (

0.05). At the 6th month follow-up

there was no significant difference between the treatment group and the control group (

0.05). At the 12th month and 18th month

the rate of seeking medical treatment or hospitalization due to fistula problems was lower in the treatment group than in the control group (

0.05). Log rank test showed that the primary patency rate of internal fistula was higher in the treatment group than in the control group

and the primary patency time was longer in the treatment group than in the control group (

0.05). The results of single factor analysis showed that phosphorus ≥1.8 mmol/L

plasma albumin ≥40 g/L

externally used

Huoxue Sanjie

Formula and hypotension during dialysis on the primary patency of autologous arteriovenous fistula were statistically significant (

0.01). Multi factor analysis showed that hypotension during dialysis was an independent risk factor for the primary patency loss of autologous arteriovenous fistula

and externally used

Huoxue Sanjie

Formula and plasma albumin ≥ 40 g/L were independent protective factors for the primary patency loss of autologous arteriovenous fistula.

Conclusions

Externally used

Huoxue Sanjie

Formula has a good clinical efficacy in improving the function of autologous arteriovenous fistula in maintenance hemodialysis patients.

关键词

血液透析自体动静脉内瘘队列研究活血散结方首次通畅

Keywords

hemodialysisautologous arteriovenous fistulacohort studyHuoxue Sanjie Formulaprimary patency

references

TREROTOLE S O. KDOQI clinical practice guideline for vascular access 2019 update: kinder gentler and more important than ever[J].Vasc Interv Radiol,2020,31(7):1156-1157.

ALLON M. Vascular access for hemodialysis patients: new data should guide decision making[J].Clin J Am Soc Nephrol,2019,14(6):954-961.

赵鹏飞，孙茹.血液透析患者动静脉内瘘功能不良的中西医治疗现状及进展[J].山西医药杂志,2020,49(20):2778-2780.

CHANG T I, CHAN C H, HSIEH H L, et al.Effects of cardiovascular medications on primary patency of hemodialysis arteriovenous fistula[J].Sci Rep,2020,10(1):121-135.

韩霞，马文强，夏丽华.参芪通脉方防治糖尿病肾病患者自体动静脉内瘘早期失功的疗效及对纤溶系统功能、脂质代谢与转化生长因子－β1的影响[J].现代中西医结合杂志,2021,30(8):838-842.

熊江艳，王松，熊元梅，等.单味红花酊维持血液透析患者动静脉内瘘正常功能的临床研究[J].时珍国医国药,2018,29(11):2691-2693.

谢娟，李正胜，张雄峰，等.桂龙护瘘酊促进血透患者自体动静脉内瘘成熟的临床观察[J].贵阳中医学院学报,2017,39(6):48-51.

魏宇，宋雅丽，曹钋，等.活血散结方对血液透析患者自体动静脉内瘘瘢痕的影响[J].中医学报,2020,35(12):2677-2681.

SIDAWY A N, GRAY R, BESARAB A, et al.Recommended standards for reports dealing with arteriovenous hemodialysis accesses[J].Vasc Surg,2002,35(3):603-610.

金其庄，王玉柱，叶朝阳，等.中国血液透析用血管通路专家共识(第2版)[J].中国血液净化,2019,18(6):365-381.

杨翠萍，王荣宝，祝晶.活血通络法预防血液透析患者动静脉内瘘并发症[J].吉林中医药,2018,38(2):174-177.

林燕婷，吴禹池，杨敏，等.中医药促进血液透析患者动静脉内瘘成熟的用药规律[J].中国中西医结合肾病杂志,2020,21(3):224-227.

韩世盛，何湘俊，顾耀东，等.中医外治法保护血液透析动静脉内瘘疗效评价与用药分析的系统评价[J].中国中西医结合肾病杂志,2020,21(12):1060-1063.

赵容，李小会，陈丽名，等.积雪草及其复方制剂治疗慢性肾病的研究进展[J].中医药导报,2020,26(16):127-132.

朱梦洁，包自阳，俞立强，等.积雪草制剂对血液透析患者动静脉内瘘狭窄及血TGF-β、IL-6表达的影响[J].浙江中医杂志,2020,55(11):787-789.

刘春雨，曹广超，王彦多，等.中药蜈蚣研究进展[J].化工时刊,2017,31(7):41-43.

杨媚月，张志国，李求，等.蜈蚣外用的现状与展望[J].中成药,2012,34(7):1343-1346.

杨春艳，张剑，李艳，等.中药五倍子治疗寻常型银屑病的研究进展[J].世界临床药物,2020,41(10):828-832.

USMAN R, JAMIL M, NAVEED M. High preoperative neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) as independent predictors of native arteriovenous fistula failure[J]. Ann Vasc Dis, 2017, 10(3):205-210.

李时珍.本草纲目[M].北京：人民卫生出版社，1975：5-9.

刘原，凡永杰，苏坤莲，等.冰片在心血管疾病治疗中的佐使作用中西医研究概况[J].中华中医药学刊,2020,38(4):64-66.

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