经皮穴位电刺激预处理对透析相关性低血压的影响(1)
[摘要]目的 观察透析前采用经皮穴位电刺激(TEAS)预处理对患者透析期间血压的影响。方法 选取2018年1月～2019年3月于常州市中医医院行血液透析的80例终末期肾病(ESRD)患者作为研究对象，根据随机数字表法分为对照组和观察组，每组各40例。透析前30 min，观察组患者取双侧内关穴、足三里穴接受TEAS 30 min，对照组患者在相同部位粘贴电极片，但不给予电刺激。比较两组患者透析期间血压的变化以及低血压的发生率。结果 透析中和透析后，观察组患者的收缩压、舒张压以及平均动脉压均高于对照组，差异有统计学意义(P<0.05);观察组患者透析相关性低血压发生率低于对照组，差异有统计学意义(P<0.05)。结论 透析前应用TEAS内关及足三里预处理能有效预防透析期间低血压的发生。
[关键词]低血压;血液透析;经皮穴位电刺激
[Abstract] Objective To observe the effect of transcutanclus electrical acupoint stimulation (TEAS) pretreatment on blood pressure during hemodialysis. Methods Eighty patients with end stage renal disease (ESRD) who underwent hemodialysis in Changzhou TCM Hospital from January 2018 to March 2019 were selected as the subjects， and divided into the control group and observation group， with 40 cases in each group. At 30 min before hemodialysis， the observation group received bilateral Neiguan points and Zusanli points for TEAS for 30 min. The control group attached electrode pads at the same site， but no electrical stimulation was given. The blood pressure and the incidence of hypotension during hemodialysis were compared between the two groups. Results During hemodialysis and after hemodialysis， the systolic blood pressure， diastolic blood pressure and mean arterial pressure of the observation group were higher than those in the control group， the differences were statistically significant (P<0.05). The incidence of intradialytic hypotension of the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05). Conclusion The application of TEAS to Neiguan and Zusanli pretreatment before hemodialysis can effectively prevent hypotension during hemodialysis.
[Key words] Hypotension; Hemodialysis; Transcutanclus electrical acupoint stimulation
中國成人慢性肾病发生率高达13.4%[1]，而治疗终末期肾病(end stage renal disease，ESRD)的首选方案是血液透析。随着透析技术的进展，目前已成为一项非常成熟的医学治疗手段，能够比较安全地替代ESRD患者的肾脏滤过功能。但透析期间，高达20%～30%[2]的患者可能会出现低血压，症状轻重不一。透析相关性低血压(intradialytic hypotension，IDH)除了给患者带来强烈不适外，常常导致透析中断、心肌受损、冠心病及动静脉内瘘血栓形成等不良后果，甚至可能增加透析患者的全因死亡率[3]。既往已有研究表明，穴位刺激可以疏通经络，调理气血，双向良性调节患者的血流动力学变化[4]，但其对持续性透析患者透析期间血压的影响尚不清楚。本研究选取行持续性透析的ESRD患者作为研究对象，在透析前采用经皮穴位电刺激(transcutanclus electrical acupoint stimulation，TEAS)预处理，观察其对患者透析期间血压的影响，现报道如下。
1资料与方法
1.1一般资料
选取2018年1月～2019年3月于常州市中医医院行血液透析的80例ESRD患者作为研究对象，根据随机数字表法分为对照组和观察组，每组各40例。对照组中，男28例，女12例;年龄58～72岁，平均(59.02±11.43)岁;透析时间18～31个月，平均(24.35±6.43)个月。观察组中，男26例，女14例;年龄52～71岁，平均(60.25±10.32)岁;透析时间17～35个月，平均(26.42±5.55)个月。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究已经医院医学伦理委员审核批准。, 百拇医药(郭蕾 汤洁)
[关键词]低血压;血液透析;经皮穴位电刺激
[Abstract] Objective To observe the effect of transcutanclus electrical acupoint stimulation (TEAS) pretreatment on blood pressure during hemodialysis. Methods Eighty patients with end stage renal disease (ESRD) who underwent hemodialysis in Changzhou TCM Hospital from January 2018 to March 2019 were selected as the subjects， and divided into the control group and observation group， with 40 cases in each group. At 30 min before hemodialysis， the observation group received bilateral Neiguan points and Zusanli points for TEAS for 30 min. The control group attached electrode pads at the same site， but no electrical stimulation was given. The blood pressure and the incidence of hypotension during hemodialysis were compared between the two groups. Results During hemodialysis and after hemodialysis， the systolic blood pressure， diastolic blood pressure and mean arterial pressure of the observation group were higher than those in the control group， the differences were statistically significant (P<0.05). The incidence of intradialytic hypotension of the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05). Conclusion The application of TEAS to Neiguan and Zusanli pretreatment before hemodialysis can effectively prevent hypotension during hemodialysis.
[Key words] Hypotension; Hemodialysis; Transcutanclus electrical acupoint stimulation
中國成人慢性肾病发生率高达13.4%[1]，而治疗终末期肾病(end stage renal disease，ESRD)的首选方案是血液透析。随着透析技术的进展，目前已成为一项非常成熟的医学治疗手段，能够比较安全地替代ESRD患者的肾脏滤过功能。但透析期间，高达20%～30%[2]的患者可能会出现低血压，症状轻重不一。透析相关性低血压(intradialytic hypotension，IDH)除了给患者带来强烈不适外，常常导致透析中断、心肌受损、冠心病及动静脉内瘘血栓形成等不良后果，甚至可能增加透析患者的全因死亡率[3]。既往已有研究表明，穴位刺激可以疏通经络，调理气血，双向良性调节患者的血流动力学变化[4]，但其对持续性透析患者透析期间血压的影响尚不清楚。本研究选取行持续性透析的ESRD患者作为研究对象，在透析前采用经皮穴位电刺激(transcutanclus electrical acupoint stimulation，TEAS)预处理，观察其对患者透析期间血压的影响，现报道如下。
1资料与方法
1.1一般资料
选取2018年1月～2019年3月于常州市中医医院行血液透析的80例ESRD患者作为研究对象，根据随机数字表法分为对照组和观察组，每组各40例。对照组中，男28例，女12例;年龄58～72岁，平均(59.02±11.43)岁;透析时间18～31个月，平均(24.35±6.43)个月。观察组中，男26例，女14例;年龄52～71岁，平均(60.25±10.32)岁;透析时间17～35个月，平均(26.42±5.55)个月。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究已经医院医学伦理委员审核批准。, 百拇医药(郭蕾 汤洁)
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