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[目的]观察通脉口服液与大黄胶囊联合维持性血液透析(MHD)治疗尿毒症疗效及肺动脉高压相关因素。[方法]将100例住院患者血液透析(4008S型透析仪1.3~1.6m2三醋酸膜,透析液流量500 mL/min,透析血流量180至250mL/min)通脉口服液,10mL/次,2次/d,口服。大黄胶囊,0.9g/次,3次/d。连续治疗7d为1疗程。观测临床症状、肺动脉压、右房内径、生化指标(血红蛋白、血浆白蛋白、血钙、红细胞压积、射血分数、血尿素氮)、不良反应。连续治疗3疗程,判定疗效。[结果]痊愈34例,显效31例,有效19例,无效16例,总有效率为84.00%。肺动脉压发生率增加(P<0.05)。动静脉内瘘、右房内径与MHD并发PAH显著相关(P<0.05)。[结论]通脉口服液与大黄胶囊联合维持性血液透析(MHD)治疗尿毒症效果显著,值得推广。
[Objective] To observe the therapeutic effect of Tongmai Oral Liquid and Rheum palmatum combined with maintenance hemodialysis (MHD) on uremia and related factors of pulmonary hypertension. [Methods] 100 cases of hospitalized patients with hemodialysis (4008S dialysis machine 1.3 ~ 1.6m2 triacetate membrane, dialysate flow 500 mL / min, dialysis blood flow 180 to 250 mL / min) Tongmai oral solution, 10mL / Times / d, orally. Rhubarb capsules, 0.9g / time, 3 times / d. Continuous treatment 7d for a course of treatment. Clinical symptoms, pulmonary arterial pressure, right atrial diameter, biochemical parameters (hemoglobin, serum albumin, serum calcium, hematocrit, ejection fraction, blood urea nitrogen) and adverse reactions were observed. Continuous treatment of 3 courses to determine the efficacy. [Result] 34 cases were cured, 31 cases were markedly effective, 19 cases were effective and 16 cases were ineffective. The total effective rate was 84.00%. Pulmonary arterial pressure increased (P <0.05). Arteriovenous fistula, right atrial diameter and MHD complicated with PAH were significantly correlated (P <0.05). [Conclusion] Tongmai Oral Liquid combined with Rhubarb Capsule in combination with maintenance hemodialysis (MHD) is effective in treating uremia and is worth promoting.