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目的:探讨血府逐瘀汤对终末期肾病(ESRD)维持性血液透析患者血液高凝状态的影响。方法:采用随机按数字表法将90例患者分为对照组和观察组各45例。两组均进行血液透析,给予西医综合对症处理措施。对照组口服肾炎四味胶囊,6粒/次,3次/d。观察组内服血府逐瘀汤,1剂/d。两组疗程均为12周。观察治疗前后纤维蛋白原(FIB),D-二聚体(DD),血管假性血友病因子(v WF),同型半胱氨酸(Hcy)和血栓前体蛋白(Tp P),血液流变学,血浆组织纤溶酶原激活物(t-PA)和组织纤溶酶原抑制物(PAI)等指标的变化情况。结果:治疗后观察组D-D,FIB,v WF,Hcy和Tp P水平均低于对照组(P<0.01);治疗后观察组全血黏度(高切、低切)、血浆黏度、红细胞压积、血小板聚集率等指标均较治疗前明显改善(P<0.01),并优于治疗后对照组(P<0.01);两组治疗后t-PA水平较治疗前升高,观察组上升更为显著(P<0.01);治疗后观察组PAI水平下降,并低于对照组(P<0.01)。结论:血府逐瘀汤能降低ESRD维持血液透析患者促凝血因子水平,抑制血小板活性,改善微循环,从而改善了患者血液高凝状态,有利于防止血栓的形成,减少血栓栓塞性疾病的发生。
Objective: To investigate the effect of Xuefu Zhuyu Decoction on blood hypercoagulability in patients with end-stage renal disease (ESRD) maintenance hemodialysis. Methods: Ninety patients were randomly divided into control group and observation group with 45 cases in each group. Hemodialysis was performed in both groups, giving symptomatic treatment of Western medicine. Control group of oral Shenyimi Siwei capsules, 6 capsules / time, 3 times / d. Observation group oral administration Xuefu Zhuyu decoction, 1 / d. The two groups were treated for 12 weeks. The levels of fibrinogen (FIB), D-dimer (DD), vWF, homocysteine (Hcy) and thrombospondin (TpP) Rheology, plasma tissue plasminogen activator (t-PA) and tissue plasminogen inhibitor (PAI) and other indicators of changes. Results: After treatment, the levels of DD, FIB, v WF, Hcy and Tp P in the observation group were lower than those in the control group (P <0.01); after treatment, the whole blood viscosity (high and low cut), plasma viscosity, hematocrit , Platelet aggregation rate and other indicators were significantly improved than before treatment (P <0.01), and better than the control group after treatment (P <0.01); t-PA levels in both groups than before treatment increased, the observation group increased more (P <0.01). After treatment, PAI level in observation group decreased and was lower than that in control group (P <0.01). Conclusion: Xuefu Zhuyu decoction can reduce the level of serum coagulation factors, heighten platelet activity and improve microcirculation in hemodialysis patients, so as to improve the blood hypercoagulability, prevent thrombus formation and reduce the occurrence of thromboembolic diseases .