Chen Yurou, Xu Lin, Huang Di, Chen Dongping, Wu Feng, Wang Luobing, Zhou Jie, Lan Tianying, Qin Xuehua, Ye Chaoyang
Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Pudong New District, Shanghai, 201200, China.
TCM Institute of Kidney Disease, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Chin Med. 2022 Apr 20;17(1):49. doi: 10.1186/s13020-022-00604-9.
We aim to study the clinical effect of moxibustion at Laogong interval with Panax notoginseng on the short-term maturation and long-term patency of arteriovenous fistula.
Seventy-four pre-dialysis uremic patients who received distal forearm radial-cephalic fistula creations were enrolled in this study and randomly assigned to the control group and experimental group. After arteriovenous fistula creations, the control group underwent handgrip exercise, and the experimental group received moxibustion at Laogong acupoint interval with Panax notoginseng. Both groups received a 12-week treatment and were followed up for 24 weeks in all at the following time points: before creations and 2, 4, 8, 12, 24 weeks after creations. The diameter of anastomosis, the diameter and outflow of draining-veins 5 cm above anastomosis, the diameter and outflow of brachial arteries evaluated the maturation and patency of arteriovenous fistula. Enzyme linked immunosorbent assay determined serum levels of endothelin and nitric oxide.
The maturity rate in the experimental group was significantly higher than that in the control group at 4 weeks after arteriovenous fistula creations (P = 0.048). The diameter of anastomosis, the diameter of draining veins, and the blood flow of draining veins increased in both groups during the whole 24 weeks. The diameter and blood flow of brachial arteries ascended in both groups during the previous 12 weeks. Compared with the control group, moxibustion at Laogong interval with Panax notoginseng significantly improved the value of the diameter of draining-veins (P = 0.016), the blood flow of draining-veins (P = 0.015), the diameter of brachial arteries (P < 0.001), and the blood flow of brachial arteries (P = 0. 012) at 2 weeks, and enhanced the blood flow of draining-veins (P = 0.029) and brachial arteries (P < 0.001) at 12 weeks. Serum levels of endothelin were significantly lower (P = 0.047), and serum levels of nitric oxide were markedly higher (P < 0.001) in the experimental group than that in the control group at 2 weeks after creations.
Moxibustion at Laogong interval with Panax notoginseng was non-invasive and promoted the maturation of arteriovenous fistula at 4 weeks after creations. However, its long-term beneficial effect on patency at 24 weeks after creations was not significant. Trial registration Chinese Clinical Trial Registry, No. ChiCTR1900024042. Registered, http://www.chictr.org.cn/index.aspx.
我们旨在研究劳宫穴隔三七艾灸对动静脉内瘘短期成熟及长期通畅情况的临床效果。
本研究纳入74例接受前臂远端桡动脉-头静脉内瘘成形术的透析前尿毒症患者，随机分为对照组和实验组。动静脉内瘘成形术后，对照组进行握力锻炼，实验组采用劳宫穴隔三七艾灸。两组均接受为期12周的治疗，并在以下时间点进行总共24周的随访：术前以及术后2、4、8、12、24周。通过吻合口直径、吻合口上方5 cm处引流静脉的直径和血流量、肱动脉的直径和血流量来评估动静脉内瘘的成熟情况和通畅情况。采用酶联免疫吸附测定法测定血清内皮素和一氧化氮水平。
动静脉内瘘成形术后4周，实验组的成熟率显著高于对照组（P = 0.048）。在整个24周内，两组的吻合口直径、引流静脉直径和引流静脉血流量均增加。在前12周内，两组的肱动脉直径和血流量均上升。与对照组相比，劳宫穴隔三七艾灸在术后2周时显著改善了引流静脉直径（P = 0.016）、引流静脉血流量（P = 0.015）、肱动脉直径（P < 0.001）和肱动脉血流量（P = 0.012）的值，并在术后12周时增加了引流静脉血流量（P = 0.029）和肱动脉血流量（P < 0.001）。术后2周时，实验组的血清内皮素水平显著低于对照组（P = 0.047），血清一氧化氮水平显著高于对照组（P < 0.001）。
劳宫穴隔三七艾灸无创，可促进动静脉内瘘成形术后4周的成熟。然而，其对术后24周通畅情况的长期有益作用并不显著。试验注册 中国临床试验注册中心，注册号：ChiCTR1900024042。注册地址：http://www.chictr.org.cn/index.aspx。
