当归补血汤联合可调钠曲线血液透析对糖尿病性心肌病患者心肌跨壁复极离散度的影响  

Effect of Danggui Buxue Decoction combined with adjustable sodium curve hemodialysis on transmural dispersion of repolarization in patients with diabetic cardiomyopathy

作　　者：王琳娜[1] 郭存霞[1] 陈小永 

机构地区：[1]河南省中医院肾内科,河南郑州450002 [2]河南中医学院第二附属医院肾内科,河南郑州450002

出　　处：《中国现代医学杂志》2015年第23期52-56,共5页China Journal of Modern Medicine

基　　金：河南省中医药科学研究专项课题(No:2014ZY02021)

摘　　要：目的探讨当归补血汤联合可调钠曲线血液透析对糖尿病性心肌病(DCM)患者透析低血压及心肌跨壁复极离散度(TDR)的影响。方法选取2014年1月-2014年12月在河南省中医院血液净化中心维持性血液透析患者,符合DCM诊断标准。观察全部8例患者12周血液透析,前4周以恒定钠浓度透析,中间4周以可调钠曲线透析,后4周当归补血汤联合可调钠曲线透析,观察每次透析时血压、脱水量、平均动脉压、透后血糖,每次透析结束时心电图检测Tp-Te和校正TDR(TDRc)。结果前、中、后4周透析前患者血压、每次透析脱水量和透后血糖比较,差异无统计学意义,但中、后4周透析中患者平均动脉压明显高于前4周,差异有统计学意义(P<0.05);前4周,患者在上机后1.5 h易于发生透析低血压反应,中、后4周透析中,在透析进行1.5 h后患者血压较前4周明显增加,差异有统计学意义(P<0.05);中、后4周透析后患者Tp-Te、TDRc较前4周明显减少,差异有统计学意义(P<0.05)。中、后4周比较,上机后1.5 h平均动脉压较中4周明显升高,Tp-Te和TDRc较中4周明显减少,差异有统计学意义(P<0.01)。结论当归补血汤联合可调钠曲线透析能改善糖尿病患者透析低血压,减少Tp-Te和TDRc;联合应用效果强于单独可调钠曲线透析治疗。[Objective] To investigate the effect of Danggui Buxue Decoction combined with adjustable sodium curve hemodialysis on transmural dispersion of repolarization in patients with diabetic cardiomyopathy （DCM）. [Methods] Patients for maintenance hemodialysis in the Blood Purification Center of Henan Provincial Traditional Chinese Medicine Hospital between January 2014 and December 2014 were selected. All the eight patients met the diabetic eardiomyopathy diagnosis standard. The patients were observed for 12 weeks. They had constant-concentration sodium hemodialysis in the first 4 weeks, with adjustable sodium curve hemodialy- sis in the second 4 weeks and with Danggui Buxue Decoction combined adjustable sodium curve hemodialysis in the last 4 weeks. Blood pressure, dewatering amount, serum glucose after dialysis and mean arterial pressure of every hemodialysis were observed. Tp-Te and TDRc were recorded with electrocardiograph at the end of every hemodialysis. [Results] There were no obvious differences in blood pressure before dialysis, dewatering amount of every dialysis or serum glucose after dialysis in the first, second and last 4 weeks. But the mean arterial pressure was significantly higher in the second and last 4 weeks than that in the first 4 weeks of dialysis （P〈 0.05）. In the first 4 weeks, the patients were more prone to dialysis hypotension 1.5 hours after dialysis, but in the second and last 4 weeks the patients blood pressure significantly increased 1.5 hours after dialysis （P 〈 0.05）. Tp-Te and TDRc in the second and last 4 weeks were statistically less than those in the first 4 weeks （P〈 0.05）. The mean arterial pressure and blood pressure 1.5 hours after dialysis were significantly increased in the last 4 weeks compared with that in the second 4 weeks （P〈 0.01）, while Tp-Te and TDRc were significantly reduced in the last 4 weeks compared with those in the second 4 weeks （P 〈 0.01）. [Conclusions] Danggui Buxue Decoction combined with adjustable sodium curve dialysis

关 键 词：糖尿病性心肌病 可调钠曲线血液透析 心肌跨壁复极离散度 当归补血汤 

分 类 号：R459.5[医药卫生—治疗学] R587.2[医药卫生—临床医学]