中药熏洗联合艾灸治疗对动静脉内瘘早期失功的保护作用

目的 探讨中药熏洗联合艾灸治疗对维持性血液透析患者自体动静脉内瘘早期失功的保护效应。方法 选择首次接受自体动静脉内瘘术的血液透析患者共50例，随机分为治疗组26例和对照组24例，其中治疗组予以中药熏洗联合艾灸治疗，对照组仅予常规术后观察。观察治疗前后2组患者术后3个月内瘘失功例数、内瘘血流速度、内瘘内径变化情况。结果 共8例患者发生术后失功，其中对照组7例，治疗组1例，主要原因为血栓形成。内瘘血流速度、内瘘内径及透析中血流量比较，治疗组优于对照组，但差异无统计学意义（P>0.05）。二项分类Logistic回归分析结果显示，年龄、糖尿病、低血压是内瘘早期失功的危险因素。结论 中药熏洗联合艾灸治疗可减少维持性透析患者自体动静脉内瘘早期失功。

Protective Effect of Traditional Chinese Medicine Fumigation and Washing Combined with Moxibustion against Early Dysfunction of Arteriovenous Fistula

Objective To investigate the protective effect of traditional Chinese medicine (TCM) fumigation and washing combined with moxibustion against early dysfunction of autogenous arteriovenous fistula in patients on maintenance hemodialysis. Methods A total of 50 patients on maintenance hemodialysis who underwent autogenous arteriovenous fistula surgery for the first time were enrolled and randomly divided into treatment group with 26 patients and control group with 24 patients. The patients in the treatment group were given TCM fumigation and washing combined with moxibustion after surgery, and those in the control group were given conventional observation after surgery. The two groups were observed in terms of number of patients with dysfunction of arteriovenous fistula, blood flow velocity in fistula, and inner diameter of fistula at 3 months after surgery. Results Of all patients, 8 experienced dysfunction after surgery (seven patients in the control group and one in the treatment group), and the major cause was thrombosis. The treatment group had better blood flow velocity in fistula, inner diameter of fistula, and blood flow during dialysis than the control group, but there were no significant differences between the two groups (P>0.05). The binary logistic regression analysis showed that age, diabetes, and hypotension were the risk factors for early dysfunction of fistula. Conclusion TCM fumigation and washing combined with moxibustion can reduce the incidence of early dysfunction of autogenous arteriovenous fistula in patients on maintenance hemodialysis.