益气活血熏洗方预防自体动静脉内瘘早期失功的临床观察*

作者：周逸珊，皮 鹰，钟阳红，曹宇宇，邹逸红，饶克瑯

单位：广州中医药大学第七临床医学院/深圳市宝安区中医院，广东 深圳 518133

引用：引用：周逸珊，皮鹰，钟阳红，曹宇宇，邹逸红，饶克瑯.益气活血熏洗方预防自体动静脉内瘘早期失功的临床观察[J].中医药导报,2025,31(8):114-120,127.

DOI：10.13862/j.cn43-1446/r.2025.08.018

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摘要：目的：探讨益气活血熏洗方预防自体动静脉内瘘早期失功的临床疗效。方法：将72例自体动静脉内瘘术后患者按照随机数字表法分为治疗组和对照组，每组各36例。治疗组患者在一般治疗基础上使用中药熏洗治疗，对照组患者在一般治疗基础上使用温水熏洗治疗，两组均连续干预8周后评价治疗效果。比较两组患者不同时间节点内瘘血管指标，比较两组患者治疗前后血清炎症因子水平、血脂、凝血功能及中医证候积分，统计两组患者的临床疗效和早期失功率，观察两组患者治疗期间不良反应发生情况。结果：对照组总有效率为78.13%（25/32），治疗组总有效率为97.06%（33/34），治疗组总有效率高于对照组（P<0.05）。两组患者治疗后肱动脉直径、肱动脉血流量、桡动脉直径、头静脉直径均逐渐增加；治疗4周，治疗组患者肱动脉血流量、桡动脉直径、头静脉直径均大于对照组（P<0.05）；治疗8周、术后12周，治疗组患者肱动脉直径、肱动脉血流量、桡动脉直径、头静脉直径均大于对照组（P<0.05）。两组患者失功率比较，差异无统计学意义（P＞0.05）。治疗组患者治疗后血小板与淋巴细胞比值（PLR）、血清C反应蛋白（CRP）、D-二聚体、中医证候积分均较治疗前降低（P＜0.05），且治疗组患者治疗后PLR、血清CRP、D-二聚体、中医证候积分均低于对照组（P＜0.05）。结论：益气活血熏洗方可以提高动静脉内瘘血流量，促进动静脉内瘘成熟，提高内瘘成功率，减轻炎症反应，改善凝血功能，且安全性佳。

关键词：自体动静脉内瘘；中药熏洗；益气活血熏洗方；早期失功；慢性肾衰竭

Abstract：

Objective: To evaluate the clinical efficacy of Yiqi Huoxue fumigation-wash formula in preventing early failure of autogenous arteriovenous fistula (AVF). Methods: 72 post-AVF patients were randomly divided into control group (n=36) and treatment group (n=36) using a random number table. The treatment group received Yiqi Huoxue fumigation-wash formula plus conventional therapy, while the control group received warm-water fumigation-wash plus conventional therapy. Interventions lasted 8 weeks. Outcome measures included: AVF vascular parameters (brachial artery diameter, brachial artery blood flow, radial artery diameter, cephalic vein diameter) at multiple timepoints; Serum inflammatory factors, lipid profiles, coagulation function, and TCM syndrome scores pre-/post-treatment; Clinical efficacy rates and early failure rates; Adverse events. Results: The total effective rate was 78.13% (25/32) in the control group and 97.06% (33/39) in the treatment group, the treatment group showed significantly higher total effective rate than control group (P<0.05). Both groups exhibited progressive increases in vascular parameters postoperatively. At 4 weeks, the treatment group demonstrated superior brachial artery blood flow, radial artery diameter, and cephalic vein diameter versus controls (P<0.05). At 8 and 12 weeks, all vascular parameters were significantly bigger in the treatment group (P<0.05). No statistical difference in failure rates was observed (P>0.05). Post-treatment reductions in platelet-to-lymphocyte ratio (PLR), serum C-reactive protein (CRP), D-dimer levels, and TCM syndrome scores were significantly greater in the treatment group versus both baseline (P<0.05) and control group (P<0.05). Conclusion: Yiqi Huoxue fumigation-wash formula enhances AVF blood flow, promotes fistula maturation, improves success rates, reduces inflammatory responses, optimizes coagulation function, and demonstrates favorable safety.

Key words：autogenous arteriovenous fistula; herbal fumigation-wash; yiqi huoxue fumigation-wash formula; early fistula failure; chronic kidney disease

发布时间：2026-01-06

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