黄芪生脉饮联合盐酸米多君治疗血液透析相关性低血压45例临床疗效分析  

Clinical effects of Huangqi Shengmai Yin plus Midodrine hydrochloride on 45 cases of hemodialysis-related hypotension

作　　者：任永强 董晖 苏蕊 REN Yongqiang;DONG Hui;SU Rui

机构地区：[1]武警北京市总队医院,北京100027

出　　处：《中医临床研究》2023年第15期42-45,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:观察黄芪生脉饮联合盐酸米多君治疗血液透析相关性低血压的疗效。方法:收集2012年12月-2017年12月原武警北京市总队第三医院门诊透析治疗的尿毒症患者45例,入选患者透析时间≥1年,血液透析治疗中收缩压下降到90 mm Hg(1 mm Hg≈0.133 kPa)以下或平均动脉压较透析前下降30 mm Hg以上,并且伴有头晕、大汗、心慌、胸闷、腹痛、恶心、呕吐、视物模糊等症状,甚至需要紧急处理或终止治疗。使用随机对照法将观察对象分为两组,观察组25例,对照组20例,两组性别、年龄、透析龄、原发病等指标的差异没有统计学意义(P>0.05)。对照组给予常规血液透析和治疗,观察组在相同的血液透析治疗的基础上给予黄芪生脉饮10 mL,口服,每日3次;盐酸米多君片5 mg,透析前1小时口服。治疗3个月后记录两组的血压和临床症状,并进行统计分析。结果:经过3个月治疗,观察组的临床症状如头晕、恶心、呕吐、心慌、胸闷等好转,有效率71.13%(537/755)、好转率24.24%(183/755)、总有效率95.36%(720/755)均高于对照组,差异有统计学意义(P<0.05)。观察组和对照组血压比较,在透析前两组收缩压和舒张压的差异没有统计学意义(P>0.05);透析中和透析结束后比较,观察组的收缩压和舒张压均高于对照组。并且,在治疗过程中血压维持稳定(P<0.05)。结论:黄芪生脉饮联合盐酸米多君可以有效治疗透析相关性低血压,维持正常血液透析治疗,提高患者的生存率和生存质量,值得在临床应用推广。Objective:To observe the effect of Huangqi Shengmai Yin(黄芪生脉饮)plus Midodrine hydrochloride on hemodialysis-related hypotension.Methods:A total of 45 uremia patients received dialysis treatment in the Outpatient Department of the Third Hospital of Beijing Armed Police Contingents from December 2012 to December 2017 were collected.The dialysis time of the selected patients was not less than 1 year,and the systolic blood pressure decreased to less than 90 mm Hg(1 mm Hg≈0.133 kPa)or the mean arterial pressure decreased by more than 30 mm Hg compared with that before dialysis.And the patients were accompanied by dizziness,sweating,palpitation,chest tightness,abdominal pain,nausea,vomiting,blurred vision and other symptoms,and even needed emergency treatment or termination of treatment.Randomized control method was used to divide the observation subjects into two groups,with 25 cases in the observation group and 20 cases in the control group.There were no statistical differences in gender,age,dialysis age,primary disease and other indicators between the two groups(P>0.05).The control group was given routine hemodialysis and treatment,and the observation group was given Huangqi Shengmai Yin(10 mL)orally,3 time a day,on the basis of the same hemodialysis treatment,combined with Midodrine hydrochloride tablets(5 mg)orally,1 hour before dialysis.After 3 months of treatment,blood pressure and clinical symptoms in the two groups were recorded and statistically analyzed.Results:After 3 months of treatment,the clinical symptoms in the observation group,such as dizziness,nausea,vomiting,palpitation,chest tightness,etc.,were relieved,with an effective rate of 71.13%(537/755),an amelioration rate of 24.24%(183/755),and a total effective rate of 95.36%(720/755),all of which were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no difference in systolic and diastolic blood pressure between the observation group and the control group before dialysis(P>0.05).The s

关 键 词：血液透析 低血压 黄芪生脉饮 盐酸米多君 

分 类 号：R459.5[医药卫生—治疗学]