健脾解毒生肌方罨敷对慢性肾衰竭透析患者自体动静脉内瘘功能的影响

Effect of Jianpi Jiedu Shengji Formula Compress on Autogenous Arteriovenous Fistula Function in Chronic Renal Failure Patients Undergoing Dialysis

摘要: 目的：观察健脾解毒生肌方罨敷对慢性肾衰竭维持性血液透析患者自体动静脉内瘘(AVF)功能的干预效果。方法：选取浙江省兰溪市中医院肾病科血液净化中心73例以AVF为血管通路的慢性肾衰竭维持性血液透析患者，按随机数字表法分为对照组37例(实施常规护理联合单纯热水罨敷)与观察组36例(常规护理基础上加用健脾解毒生肌方罨敷)。干预周期3月，分别于干预前后检测两组内瘘血流量、内瘘血管直径，采用视觉模拟评分评价穿刺疼痛，统计干预期间血管通路并发症发生率与内瘘通畅情况。结果：干预3月后，研究组内瘘血流量、血管内径均高于对照组，且研究组穿刺疼痛视觉模拟评分也低于对照组，两者差异有统计学意义(P < 0.05)；同时我们也发现尽管研究组血管并发症发生数量较对照组少，但两者在内瘘通畅率上并无明显统计学差异(P > 0.05)。结论：通过对健脾生肌方罨敷3个月的短期干预观察研究中，发现其对慢性肾衰竭透析患者自体动静脉内瘘功能维护有一定积极维护作用，毕竟3月时间较短，其是否能对AVF长期功能保持发挥更大作用还有待进一步深入研究。

Abstract: Objective: To observe the interventional effect of Jianpi Jiedu Shengji Formula compress on autogenous arteriovenous fistula (AVF) function in chronic renal failure patients undergoing maintenance hemodialysis. Methods: A total of 73 chronic renal failure patients on maintenance hemodialysis with AVF as vascular access were selected from the Blood Purification Center, Department of Nephrology, Lanxi Hospital of Traditional Chinese Medicine in Zhejiang Province. They were assigned using a random number table to a control group (n = 37) receiving routine nursing care combined with plain hot water compress, and an observation group (n = 36) receiving routine nursing care plus Jianpi Jiedu Shengji Formula compress. The intervention lasted 3 months. AVF blood flow and AVF vessel diameter were measured in both groups before and after intervention. Puncture pain was assessed using a Visual Analogue Scale (VAS). The incidence of vascular access complications and AVF patency during the intervention period were also recorded. Results: After 3 months of intervention, the fistula blood flow and vascular internal diameter in the study group were higher than those in the control group, and the visual analog scale score for puncture pain in the study group was also lower than that in the control group, with statistically significant differences (P < 0.05). At the same time, we found that although the number of vascular complications in the study group was lower than that in the control group, there was no statistically significant difference in fistula patency rates between the two groups (P > 0.05). Conclusion: Through a 3-month short-term intervention observation study on the application of compresses of Jianpi Shengji Formula, it was found that it has certain positive effects on maintaining the function of autogenous arteriovenous fistulas in chronic renal failure patients undergoing dialysis. However, since the 3-month period is relatively short, further in-depth research is needed to determine whether it can play a greater role in the long-term functional maintenance of AVF.