艾灸改善维持性血液透析患者低血压的临床研究

Clinical study on moxibustion improving hypotension in maintenance hemodialysis patients

关键词:  艾灸  维持性血液透析  并发症  低血压

Key words:  moxibustion  maintenance hemodialysis  complications  hypotension

摘要:

[目的] 评价艾灸对维持性血液透析（MHD）患者收缩压、透析相关性低血压（IDH）发生率、透析中断率、血红蛋白（Hb）、血清白蛋白（ALB）及中医证候积分的影响。[方法] 将60例MHD患者按照随机数字表法随机分为治疗组与对照组，每组各30例，对照组行基础治疗联合规律血液透析，治疗组在对照组基础上，每次透析30 min且生命体征趋于平稳后于双侧足三里、双侧三阴交、双侧血海、关元施温和灸，两组均治疗12周，随访12周，共24周，比较两组治疗前后的透析前收缩压、Hb、ALB、中医证候积分、IDH发生率及透析中断率。[结果] 治疗后治疗组透析前收缩压高于对照组，治疗后Hb及ALB水平升高，且高于对照组，治疗期及随访期治疗组IDH发生率、因IDH导致透析中断率均低于对照组（P<0.05）。[结论] 艾灸可改善MHD患者收缩压、降低IDH的发生率及透析中断率，同时有效改善患者Hb及ALB水平，降低患者中医证候积分，提高患者生存质量。

Abstract:

[Objective] To evaluate the effects of moxibustion on systolic blood pressure，incidence of intradialytic hypotension（IDH），dialysis interruption rate，hemoglobin（Hb），serum albumin（ALB） and traditional Chinese medicine（TCM） symptom score in maintenance hemodialysis（MHD） patients. [Methods] The 60 cases of MHD patients with IDH were divided into treatment group and control group according to the random number table method，with 30 cases in each group. The control group received basic treatment combined with regular hemodialysis，and on the basis of the control group，the treatment group was treated with mild moxibustion at bilateral Zusanli，bilateral Sanyinjiao，bilateral Xuehai and Guanyuan after 30 minutes of dialysis each time and then the vital signs became stable，both groups were treated for 12 weeks，followed up 12 weeks，with total 24 weeks long treatment. Systolic blood pressure，Hb，ALB，TCM syndrome score，IDH incidence and dialysis interruption rate were compared between the two groups before and after treatment. [Results] The systolic blood pressure in dialysis in the treatment group was higher than that in the control group，and the levels of Hb and ALB were increased after treatment and higher than that in the control group. The incidence of IDH and the rate of dialysis interruption due to IDH in the treatment group were lower than that in the control group during the treatment and follow-up periods（P<0.05）. [Conclusion] Moxibustion therapy can improve systolic blood pressure in maintenance hemodialysis patients，reduce the incidence of IDH and the rate of dialysis interruption，effectively improve the levels of hemoglobin and serum albumin，reduce the score of traditional Chinese medicine symptoms，and improve the life quality of patients.