通脉四逆汤联合盐酸米多君治疗透析中低血压的临床观察  

Clinical Observation on Tongmai Sini Decoction Combined with Midodrine Hydrochloride in the Treatment of Intradialytic Hypotension

作　　者：顾银颖 沈康飞 易继飞 沈惠芬 周忆烈 GU Yinying;SHEN Kangfei;YI Jifei;SHEN Huifen;ZHOU Yilie(Suzhou Wujiang District Hospital of Traditional Chinese Medicine,Suzhou 215200,China;不详)

机构地区：[1]苏州市吴江区中医医院,江苏苏州215200

出　　处：《中外医学研究》2023年第21期35-39,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究通脉四逆汤联合盐酸米多君治疗透析中低血压(intradialytic hypotension,IDH)患者的效果。方法:选取2020年1月—2022年12月苏州市吴江区中医医院肾内科收治的86例IDH患者为研究对象,按照随机数表法将其分为治疗组(43例)与对照组(43例)。对照组使用盐酸米多君治疗,治疗组使用盐酸米多君联合通脉四逆汤治疗。比较两组IDH发生率、血压、疗效、左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室射血分数(left ventricular ejection fraction,LVEF)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)水平。结果:治疗期间,治疗组IDH发生率低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者透析中最低收缩压、舒张压均有升高,且治疗组高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者透析前后收缩压、舒张压差值均下降,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗组治疗后LVEF较对照组高,LVEDD较对照组低,差异有统计学意义(P<0.05)。治疗前后,两组AST、ALT水平比较,差异无统计学意义(P>0.05)。结论:对IDH患者使用通脉四逆汤联合盐酸米多君可获得良好效果,能够显著改善其血压,降低IDH发生率,改善心功能,且不会对肝功能造成太大影响,用药安全性较高。Objective:To explore the effect of Tongmai Sini Decoction combined with Midodrine Hydrochloride in the treatment of intradialytic hypotension(IDH).Method:A total of 86 patients with IDH admitted to the Department of Nephrology,Suzhou Wujiang District Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were selected as study objects,they were divided into treatment group(43 cases)and control group(43 cases)according to random number table method.The control group was treated with Midodrine Hydrochloride,and the treatment group was treated with Midodrine Hydrochloride combined with Tongmai Sini Decoction.The incidence of IDH,blood pressure,efficacy,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels were compared between the two groups.Result:The incidence of IDH in treatment group during treatment was lower than that in control group,the difference was statistically significant(P<0.05).After treatment,the lowest systolic blood pressure and diastolic blood pressure in dialysis in both groups were increased,those in the treatment group were higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,the difference of systolic blood pressure and diastolic blood pressure before and after dialysis in both groups decreased,and those in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the treatment group was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,LVEF in the treatment group was higher than that in the control group,LVEDD in the treatment group was lower than that in the control group,the differences were statistically significant(P<0.05).Before and after treatment,there were no significant differences in AST and ALT levels between the two groups(P>0.05).Conclusion:Tongmai Sini Deco

关 键 词：通脉四逆汤 盐酸米多君 透析中低血压 

分 类 号：R692.5[医药卫生—泌尿科学] R544.2[医药卫生—外科学]