中药熏蒸联合艾灸对血液透析患者自体动静脉内瘘成熟率及内瘘功能不良的临床研究及作用机制  

Clinical Study and Mechanism of Traditional Chinese Medicine Fumigation Combined with Moxibustion on Maturation Rate of Autologous Arteriovenous Fistula and Internal Fistula Dysfunction in Hemodialysis Patients

作　　者：周敏 朱小红 江新爱 ZHOU Min;ZHU Xiaohong;JIANG Xin’ai(Hemodialysis Room,the Second People's Hospital of Jingdezhen,Jingdezhen 333000,China)

机构地区：[1]景德镇市第二人民医院血液透析室,江西景德镇333000

出　　处：《中国医学创新》2025年第11期90-94,共5页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2023B0915)。

摘　　要：目的:分析中药熏蒸联合艾灸对血液透析患者自体动静脉内瘘功能的影响。方法:选取2023年3月—2024年1月于景德镇市第二人民医院建立自体动静脉内瘘的90例血液透析慢性肾脏病患者,采用随机数字表法分为A组(n=30,接受常规干预)、B组(n=30,接受常规干预和中药熏蒸)和C组(n=30,在A组基础上接受中药熏蒸联合艾灸)。比较三组内瘘成熟情况、内瘘功能、炎症因子、血管活性因子及高凝、内瘘功能不良发生情况。结果:干预后,三组内瘘直径、内瘘血流量比较,差异均有统计学意义(P<0.05);干预后,C组内瘘直径、内瘘血流量均大于B组和A组,B组均大于A组(P<0.05);C组内瘘成熟时间早于B组和A组,B组早于A组,差异均有统计学意义(P<0.05)。C组内瘘成熟率高于B组、A组(P<0.05)。干预后,C组透析时血流量、动脉端压力均大于B组和A组,B组均大于A组,C组静脉端压力小于B组和A组,B组小于A组,差异均有统计学意义(P<0.05)。干预后,三组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子-A(VEGF-A)比较,差异均有统计学意义(P<0.05);干预后,C组IL-6、TNF-α、VEGF-A均低于B组和A组,B组均低于A组,差异均有统计学意义(P<0.05)。C组高凝发生率低于A组(P<0.05)。三组内瘘功能不良发生率比较,差异有统计学意义(P<0.05);C组内瘘功能不良发生率明显低于A组,差异有统计学意义(P<0.05)。结论:中药熏蒸联合艾灸干预可促进血液透析患者自体动静脉内瘘成熟并提高内瘘功能,减少内瘘功能不良发生。Objective:To analyze the effect of traditional Chinese medicine fumigation combined with moxibustion on the function of autogenous arteriovenous fistula in hemodialysis patients.Method:A total of 90 hemodialysis patients with chronic kidney disease who were established with autologous arteriovenous fistula in the Second People's Hospital of Jingdezhen from March 2023 to January 2024 were selected and divided into group A(n=30,received routine intervention),group B(n=30,received routine intervention and traditional Chinese medicine fumigation)and group C(n=30,received traditional Chinese medicine fumigation combined with moxibustion on the basis of group A)by random number table method.The internal fistula maturity,internal fistula function,inflammatory factors,vasoactive factors and the incidence of internal hypercoageulation and fistula dysfunction were compared among the three groups.Result:After intervention,there were statistically significant differences in internal fistula diameter,internal fistula blood flow among the three groups(P<0.05).After intervention,the internal fistula diameter and internal fistula blood flow in group C were greater than those in group B and group A,those in group B were greater than those in group A(P<0.05).The maturity time of internal fistula in group C was earlier than that in group B and group A,and that in group B was earlier than that in group A,the differences were statistically significant(P<0.05).The rate of fistula maturation in group C was higher than that in group B and group A(P<0.05).After intervention,the blood flow during dialysis and arterial end pressure in group C were higher than those in group B and group A,those in group B were higher than those in group A,and the venous end pressure in group C was lower than that in group B and A,and that in group B was lower than that in group A,the differences were statistically significant(P<0.05).After intervention,there were statistically significant differences in interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)an

关 键 词：血液透析 自体动静脉内瘘 中药熏蒸 艾灸 内瘘成熟 内瘘功能不良 

分 类 号：R277.5[医药卫生—中医学]