Clinical Therapeutic Research Of Dialectical Herbal Fomentation By Zhao Huanan To Promote The Maturity Of Autogenous Arteriovenous Fistula

Objective:Observe the distinguished veteran doctor of traditional Chinese medicine Zhao Huanan dialectical medicine fomentation for hemodialysis patients with arteriovenous internal fistula mature clinical curative effect.And a preliminary study of herbal fomentation promote arteriovenous fistula in mature, improve arteriovenous fistula blood flow within the possible mechanism.Methods:A prospective cohort study method was utilized in this clinical trial. All 60 cases come from Nephrology department of Lianyungang Hospital of Traditional Chinese Medicine who will have an operation of arteriovenous internal fistula, all cases were randomly divided into observation group 30 cases and control group 30 cases. All patients choose wrist radial artery distal end with cephalic vein in autogenous arteriovenous fistula plasty, consistent way to the end-side anastomosis way. Control operations in quasi intravenous fistula in just five days before surgery with a hot towel hot compress,2 days after surgery in the hirudoid inunction internal fistula;observation group five days before the proposed action intravenous fistula surgery using Zhao Huanan Yiqi Huoxue Tongluo recipe to hot compress,2 days after surgery adopted Qingre Jiedu Huoxue Tongluo recipe to hot compress. Every 30 minutes, twice a day, a course of 2 weeks. Close monitoring of internal fistula blood vessels, timely change dressings, pay attention to monitor blood pressure and postoperative limb pressure defense. Observation indexes as follows:(1) Within a month after surgery of arteriovenous fistula in flow. (2) Internal fistula first use of time. (3)One month after internal fistula blood was measured doppler ultrasound. And record the treatment process of adverse reactions. Application SPSS 16.0 statistical software for data analysis, measurement data with mean ± standard deviation (±s), two groups compare using t test, count data using X2 test, P< 0.05 there are significant differences.Results:1.Two groups of internal fistula smooth:fistula unobstructed 29 cases in observation group 1 month,1 case appeared embolism; The control group 6 cases with embolization. Observation group internal fistula unobstructed condition is better than that of control group, the difference was statistically significant (P< 0.05).2. Internal fistula first time of use:first use fistula in observation group of (30 ±6) days, the control group of (35±5) days, the difference was statistically significant (P< 0.01); Prompt local hot compress traditional Chinese medicine has a good effect to promote internal fistula mature.3. Postoperative 1 month doppler exceeds determination:observation group internal fistula blood flow (280±54) ml/min, the control group (240±62) ml/min, the difference was statistically significant (P< 0.01); Prompt local hot compress traditional Chinese medicine has a good effect to improve internal fistula blood flow.Conclusion:1.Zhao Huanan distinguished veteran doctor of traditional Chinese medicine dialectical medication local hot compress promoting internal fistula using mature clinical curative effect, can improve the success rate of hemodialysis patients with arteriovenous fistula in anastomosis of. And has good security.2.Before the operation of local dialectical more for qi deficiency blood stasis, using Yiqi Huoxue Tongluo recipe to local hot compress, softening and expansion veins, increase blood flow, improve the conditions of preoperative blood vessels, can improve the success rate of surgery;3.After surgery, local dialectical more for stasis thermal resistance network, using Qingre Jiedu Huoxue Tongluo recipe to local hot compress, reduce postoperative vascular inflammation effusion, swelling, and reduce the complications such as bleeding, pain, and reduce neointimal hyperplasia, can promote arteriovenous fistula in postoperative mature.4.Surgery before and after the prescription in the local hot compress are promoting blood circulation to remove blood stasis, the formulas may be through improving hemorrheology and hemodynamic effects and improve the operation condition of blood vessel, improve the arteriovenous internal fistula operation success rate; Its antithrombotic anti-inflammatory effects can prevent early arteriovenous fistula in fistula thrombosis, inhibit neointimal inflammation. The specific mechanism remains to be further experimental study.