| Objective:Through the clinical related factors of the Maintenance Hemodialysis(MHD)patients and the syndrome of Traditional Chinese Medicine(TCM)’s distribution analysis,the author further studies the clinical related factors,the syndrome of Traditional Chinese Medicine and the dialysis blood pressure changes,and found that the influence factors of blood pressure fluctuations in the dialysis process and the relationship with the syndrome of Traditional Chinese Medicine,so as to intervene,reduce the dialysis blood pressure fluctuations,and the author uses the clinical method of TCM syndrome differentiation to provide theoretical support for the diagnosis and treatment.Methods:The authors uses a retrospective analysis to select 300 MHD patients meeting the inclusion criteria in the 2021.4-6 month in linked hemodialysis centers.In this study,patients’ BP changes during dialysis were classified in three groups: decreased BP,stable BP and increased BP.The author collects relevant clinical data to identify the patients’ TCM syndrome differentiation and classification.And the author applies SPSS 23.0 statistical software to explore whether the trend of blood pressure was correlated with TCM syndrome during hemodialysis,and to find out the influencing factors leading to the change in blood pressure.Results:(1)There are statistical differences between the three groups in age,pre-permeable systolic blood pressure,take three antihypertensive drugs before the transmission,diabetes,coronary disease,pre-penetration sodium level,renin levels,and pre-permeable hemoglobin index.Then the author performs univariate analysis and multivariate Logistic regression analysis for the elevated and stable BP groups.The results showed that the high blood sodium content before dialysis,before dialysis taking three or more antihypertensive drugs are the independent risk factors for hypertension in dialysis;and age 60,with coronary disease and anemia(hemoglobin<100g/L)are independent risk factors for hypotension in dialysis,and the differences are significant(P <0.05).(2)In the characteristic analysis of TCM syndrome of 300 patients,the distribution of deficiency syndrome from high to low is: deficiency of vital energy of spleen and kidney,deficiency of both qi and yin,syndrome of yang deficiency of spleen and kidney,syndrome of yin deficiency of liver and kidney and deficiency syndrome of both yin and yang.The standard empirical evidence from high to low is: damp-turbidity,stagnation and deficiency of blood syndrome,damp-heat syndrome,heat toxin syndrome,syndrome of stirring wind.There are more proportion of deficiency of vital energy of spleen and kidney in the elevated blood pressure and blood pressure stable group,and more proportion of syndrome of yang deficiency of spleen and kidney in the group with decreased blood pressure,but there was no statistical difference in the distribution of the five syndrome types in the three groups(P>0.05).The five empirical evidence types show that the damp-turbidity and stagnation and deficiency of blood syndrome in the three groups are is more,and there are statistical differences.The highest constitutive ratio of damp-turbidity syndrome in the patients with elevated blood pressure group was statistically significant(P=0.0115).The blood pressure drop group had the highest composition ratioof stagnation and deficiency of blood syndrome,and there are statistical differences(P=0.0124).(3)The influencing factors of damp-turbidity and stagnation and deficiency of blood syndrome associate with blood pressure fluctuations in western medicine dialysis are further analyzed,and the results suggested that there was no statistical difference between the distribution of patients with damp-turbidity and non-damp-turbidity.There was no statistical difference in the distribution of blood stasis and nonstasis in patients at age>60 years,diabetes,taking more than three antihypertensive drugs,high sodium,anemia,low albumin,and renin levels,but there were more blood stasis distribution in MHD patients with coronary disease,and there are statistical differences(P<0.001).Conclusions:(1)According to TCM syndrome differentiation,hypertensive patients on dialysis should take the treatment of dampness and turbidity,and attention should be paid to the spleen and kidney,dampness and detoxification.The blood pressure reduction in the group of blood stasis evidence is the most,so most dialysis hypotension patients are blood stasis or damp and heat suppression.The treatment should be nourishing qi and nourishing yin,but also need to pay attention to promoting blood circulation and removing blood stasis,improving dampness and clearing heat.(2)The dialysis process for patients with blood stasis and coronary disease should closely monitor their blood pressure,be alert to the occurrence of hypotension,early detection,and treat the blood pressure fluctuations during dialysis from the treatment of stagnation and deficiency of blood syndrome. |
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