| Objective To observe the clinical effect of modified Simiao Yong’an Decoction on relieving pain and other complications and restenosis after percutaneous transluminal angioplasty(PTA)for autologous arteriovenous fistula(AVF).Methods Patients undergoing PTA for AVF(including type I and type II AVF stenosis)in Wuhan Central Hospital from January 2018 to January2019 were selected and divided randomly into the control group and the treatment group,with 25 cases in each group.The control group was treated with the routine western medicine,while the treatment group was treated with modified Simiao Yong’an decoction on the basis of western medicine,starting on the day of the operation,with10 days as a course of treatment.Patients’ pain of wound or arm was evaluated on the day of returning to wards,Day 1,Day 2 and Day 3 after PTA.The diameters of two arms were measured and the presence or absence and extent of ecchymosis were observed on 1 hour,Day 1,Day 7 and Day 10 after the operation.Color Doppler ultrasound reexamination for AVF was conducted 24 hours after the operation and every 3 months,and residual blood vessel diameter,stenosis percentage,brachial artery blood flow and brachial artery resistance index were compared.The primary patency after PTA of AVF in 50 patients was observed.Results Vascular index of the treatment group and the control group were evaluated before and immediately after the operation.Before and after the operation,there were statistically significant differences in residual blood vessel diameter,stenosis percentage and brachial artery blood flow(P< 0.001),but no statistically significant differences in brachial artery resistance index(P= 0.326,P = 0.152).There was no statistically significant difference in residual blood vessel diameter,stenosis percentage,brachial artery blood flow and brachial artery resistance index between the two groups before and immediately after the operation(P > 0.05).There was no statistically significant difference between the two groups in the diameter of the specified site 1 hour after the operation(1.50 ± 0.42 vs 1.52 ± 0.38,P = 0.262).The diameter differences were compared between the two groups on Day1,Day 7 and Day10 after the operation(1.03±0.09 vs 1.17±0.03,P=0.035;0.32±0.15 vs 0.61±0.11,P=0.048;0.24±0.12 vs 0.40± 0.08,P = 0.159),and the result showed that there was statistically significant difference between the two groups on Day1 and 7 after the operation,but there was no significant difference between the two groups on Day 10 after the operation.The two groups were compared in the regression time of arm ecchymosis(5.15±2.04 vs 10.24 ± 4.54,P = 0.014),with statistically significant difference.The two groups were compared in vascular Index,residual blood vessel diameter,stenosis percentage,brachial artery blood flow and brachial artery resistance index 24 hours after the operation(3.21±0.22 vs 3.30±0.15;14.05±3.10 vs 13.28±2.54;1032.24±359.36 vs 981.88±310.74;0.54±0.10 vs 0.57±0.09,P>0.05),without statistically significant difference.After six months,there was also no significant difference in vascular index between the two groups.The surgical technical success rate and clinical success rate in both groups were 100%.There was no statistically significant difference between the two groups in score of visual analogue scale(VAS)after returning to wards(5.14± 1.22 vs 5.31 ± 1.56,P = 0.061).There was statistically significant difference between Day 1 and Day 2(3.55±1.02 vs 5.20±1.48,P=0.036;2.23±1.12 vs 3.93±1.19,P=0.048),and there was no statistically significant difference on Day 3(2.10±1.01 vs 2.51±1.04,P=0.097).Patients were followed up for 12 months after PTA.The primary patency rates of the treatment group 3 months,6 months and 12 months after the operation were 95.8%,65.6% and38.5% respectively,while those of the control group were 91.8%,63.8% and 28.6% respectively.The primary patency after the operation was 9.660±2.118 months in the treatment group and 9.210±1.640 months in the control group.There was no significant difference on the primary patency rates(X~2=0.644,P=0.422)between the two groups.Conclusions The short-term use of modified Simiao Yong’an decoction after PTA can relieve postoperative pain,promote the recovery of ecchymosis and arm swelling after operation effectively,but cannot delay restenosis of AVF after PTA. |
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