隔三七饼艾灸劳宫穴对自体动静脉内瘘的影响  

Effect of Moxibustion with Pseudo-gineng at Laogong on Autogenous Areeriovenous Fistula

作　　者：陈雨柔 徐琳[1] 陈冬平 秦学花 蒋宇峰[1] 吴锋[1] 王骆冰[1] 叶朝阳 CHEN Yurou;XU Lin;CHEN Dongping(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203)

机构地区：[1]上海中医药大学附属曙光医院肾病科,上海中医药大学中医肾病研究所,肝肾疾病病证教育部重点实验室(上海中医药大学),上海市中医临床重点实验室,上海201203

出　　处：《中国中西医结合肾病杂志》2022年第5期404-407,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市进一步加快中医药事业发展三年行动计划(2018~2020年)项目[No.ZY(2018-2020)-CCCX-2003-08,ZY(2018-2020)-FWTX-7005];上海市浦东新区卫生系统重点学科群建设资助项目(No.PWZxq2017-07)。

摘　　要：目的:观察隔三七饼艾灸劳宫穴对自体动静脉内瘘近期成熟率和远期通畅性的临床疗效。方法:根据纳入标准筛选进行桡动脉-头静脉内瘘成型术的预透析患者74例,随机分成对照组和治疗组各37例。术后,对照组采用传统功能训练法,治疗组用隔三七饼艾灸劳宫穴的中医外治疗法,干预治疗12周。在术前、术后2周、4周、8周、12周、24周共6个时间点进行随访,彩色多普勒超声测量吻合口直径、瘘体直径和血流量,评估内瘘成熟情况。结果:术后2周,治疗组的瘘体直径、血流量和成熟率都显著高于对照组(P<0.05);术后4周,治疗组的内瘘成熟率显著高于对照组(P<0.05);术后12周,治疗组的血流量显著高于对照组(P<0.05)。两组在观察期间中均未出现明显的不良反应。结论:隔三七饼艾灸劳宫穴可以扩张瘘体血管、增加内瘘血流量,促进自体动静脉内瘘成熟,提高近期成熟率。本法温和无创且安全性好,值得在临床推广应用。Objective:Observation on the clinical effect of moxibustion at Laogong with Pseudo-gineng on the short-term vascular maturation rate and the long-term patency of autogenous arteriovenous fistula.Methods:According to the accepting standard,74 pre-dialysis patients received radial artery-cephalic vein fistular operation were selected and randomly divided into the control group and the treatment group,with 37 cases in each group.After AVF creation,the patients in control group were treated with traditional functional training,while those in the treatment group were treated with moxibustion at Laogong separated by pseudo-gineng for 12 weeks.The patients were followed up at 6 time points:before operation and 2 weeks,4 weeks,8 weeks,12 weeks,24 weeks after operation.The maturity of AVF was evaluated by the diameter and blood flow of vascular access,which were measured by Doppler ultrasound.Results:At 2 weeks after operation,the vein diameter,blood flow and maturation rate of the treatment group were significantly higher than those of the control group(P<0.05).At 4 weeks after operation,the fistula maturation rate of the treatment group was markedly higher than that of the control group(P<0.05).At 12 weeks after operation,the blood flow of the treatment group was apparently higher than that of the control group(P<0.05).There were little obvious adverse reactions in the two groups during the observation period.Conclusion:Moxibustion with pseudo-gineng at Laogong could enlarge the diameter of fistula and increase the blood flow to promote the maturity,enhancing the short-term maturity rate.The method was safe,noninvasive,worthy of clincal application.

关 键 词：隔物灸 三七 劳宫穴 自体动静脉内瘘 

分 类 号：R692.5[医药卫生—泌尿科学]