The Influence Of Tong Mai Oral To The Function Of AVF After It Was Creation

BackgroundDespite the technology of creation the long-term hemodialysis access is maturing, but the effective protection of the vascular access was unsatisfactory. Especially with the social and economic development, the constitute the dialysis population has changed a lot:elderly patients, diabetics, obese patients increased significantly, whitch make us facing greater challenges in the area maintenance of vascular access. With the hemodialysis has widely promoted in China, one way of effective to maintain vascular access is growing concern by the people, especially the value of traditional medicine in this field.ObjectivesThe purpose of this subject is observe the influence of Tongmai Oral to the AVF model animals and AVF patients, And investigate the value of traditional medicine in the field of maintenance of vascular access.MethodsLiterature Review:Retrieve the literature of AVF in the CNKK、VIP and Pubmed from1989to2011. Analysis of domestic and foreign scholars to move autologous arteriovenous fistula of the research progress.Animals experiments:30SPF grade New Zealand rabbits were randomly divided into Tongmai group, the western medicine group and model control group, n=10; all the animals were creation Created AVF in the left femoral artery-vein; the day after surgery, Tong Mai group were given liquid Tongmai Oral (5ml/kg, qd), and western medicine group were given0.77mg/ml aspirin (5ml/kg, qd), model control group was given saline (5ml/kg, qd), ig14d. Observe the level of endothelin-1(ET-1) and nitric oxide (NO) of all groups, at the time point of the day before ang after opreation and theld,3d,7d and15d after surgery. In the15d after surgery, the AVF and the same location of the contralateral femoral artery and vein blood flow wre measured by Transonic blood flow under anesthesia. At the same time, thrombosis, tissue adhesion was observed and recorded.Clinical research:30inpatients of Guangdong Provincial Hospital of the University City Department of Nephrology, who underwent surgery from October2011to February2012were randomly divided into Tongmai group and control group (n=15). The control group received conventional treatment, whitch not include the use of antithrombotic drugs, and the use of Traditional medicine of blood stasis and promoting blood circulation; Tongmai group were given oral Tongmai Oral20ml, tid,14d of treatment, on the basis of the above-mentioned conventional treatment. AVF blood flow were measured at the time of Postoperative and after1month.ResultReview of the Literature:From1989to2011, the AVF literature number which published on hemodialysis was increasing year by year. And Larger proportion about function, less experimental research.Animal experiments:under anesthesia, the blood flow of contralateral femoral artery/vein of all groups was no significant difference; The fistula blood flow volume of western medicine group and model control group is less than the contralateral artery side, the difference was statistically significant; But the Tongmai group show no difference. The blood flow volume of fistula is less than the contralateral vein side of all groups, but the difference was not statistically significant; Compared with Control group or western medicine group, the fistula blood flow of Tongmai group was significantly increased. Compared with the model group, The fistula blood flow volume of western medicine group shows no difference;Tongmai Oral show a statistically significant difference on the impact of ET-1, at postoperative dayl and day7, and in the operation day, postoperative days1and7on impacts of NO. Clinical research:the AVF blood flow of both groups was no significant difference after the AVF were created. Compared with the control group, the AVF blood flow of Tongmai group has increased significantly.ConclusionTongmai Oral can improve the AVF blood flow of experimental AVF model rabbits and AVF patients at the Early stage.