失笑散外敷防治血液透析患者自体动静脉内瘘局部硬结的临床应用及其机制研究  

Clinical application and mechanism of Shixiao San in the prevention and treatment of local indurations of autogenous arteriovenous fistula in hemodialysis patients

作　　者：陈娟[1] 陈拉斯 王自强 朱美娟 张琼果 林亚妹[1] CHEN Juan;CHEN Lasi;WANG Ziqiang;ZHU Meijuan;ZHANG Qiongguo;LIN Yamei(Department of Nephrology,the First Affiliated Hospital of Hainan Medical University,Haikou 570000,China)

机构地区：[1]海南医学院第一附属医院肾内科,海口570000

出　　处：《吉林中医药》2022年第10期1175-1178,共4页Jilin Journal of Chinese Medicine

基　　金：2020年海南省卫生健康委员会科研项目(2001320243A2012)。

摘　　要：目的探讨与研究失笑散外敷防治血液透析患者自体动静脉内瘘局部硬结的效果与机制。方法选择2018年5月-2020年7月在海南医学院第一附属医院进行维持性血液透析的终末期肾病患者60例作为研究对象,将患者分为失笑散组与对照组,各30例。对照组在常规血液透析结束后,给予常规治疗;失笑散组在对照组的治疗基础上给予失笑散外敷治疗。结果失笑散组的穿刺部位局部硬结发生率、局部硬结发生程度、自体动静脉内瘘的血流量、动脉阻力指数、血管壁厚度、血管弹性、杂音比例、血清炎症因子(CRP、PCT、TNF-α、IL-6)均显著优于对照组(P<0.05);失笑散组总有效率(98.3%)显著优于对照组(84.5%),差异具有统计学意义(P<0.05)。结论失笑散外敷能有效防治血液透析患者自体动静脉内瘘局部硬结的形成,也能提高内瘘血流速度与降低静脉压,从而减少并发症的发生,提高治疗总体疗效。Objective To investigate the effect and mechanism of Shixiao San applied externally in the prevention and treatment of local indurations of autogenous arteriovenous fistula in hemodialysis patients.Methods A total of 60 patients with end-stage nephrosis who underwent maintenance hemodialysis in the First Affiliated Hospital of Hainan Medical University from May 2018 to July 2020 were selected as the study subjects,and divided into a Shixiao San group and a control group,with 30 patients in each group.The control group was given a routine treatment after the routine hemodialysis while the Shixiao San group was treated with the external application of Shixiao San on the basis of the control group.Results The incidence and degree of local indurations at the puncture site,the blood flow of autogenous arteriovenous fistula,the arterial resistance index,the thickness of vessel walls,the vascular elasticity,the murmur ratio,and the levels of serum inflammatory factors(CRP,PCT,TNF-α,IL-6)in the Shixiao San group were significantly better than those in the control group(P<0.05).The total effective rate of the Shixiao San group(98.3%)was significantly higher than that of the control group(84.5%),with a statistically significant difference(P<0.05).Conclusion The external application of Shixiao San can effectively prevent the formation of local indurations of autologous arteriovenous fistula in hemodialysis patients,improve the blood flow velocity of the fistula and reduce the venous pressure,thereby reduce the occurrence of complications and improve the overall therapeutic effect.

关 键 词：失笑散 血液透析 自体动静脉内瘘 局部硬结 炎症因子 

分 类 号：R654.3[医药卫生—外科学]