【摘要】 目的 ：探讨中医定向透药疗法配合红外线照射提高慢性肾衰竭患者动静脉内瘘成熟质量的临床效果。方法：纳入2019年9月—2021年12月江西省萍乡市中医院需行自体动静脉内瘘成形术的慢性肾衰竭患者50例，随机分成两组各25例。对照组术后接受西医内科常规治疗，观察组在对照组基础上接受造瘘口中医定向透药+红外线照射治疗。连续治疗10 d。比较两组患者动静脉内瘘成熟度、动静脉内瘘成熟时间、开始使用时间、术前1 d与术后第三十天吻合口内瘘血管的血流量与头静脉内径变化情况、术后第一天与第三十天血小板计数和活化部分凝血活酶时间（APTT）变化情况。结果 ：观察组动静脉内瘘成熟度评分高于对照组（P <0.05），动静脉内瘘成熟时间以及开始使用时间均短于对照组（P <0.05）。观察组术后第三十天头静脉血流量及头静脉内径均高于对照组（P <0.05），血小板计数低于对照组（P <0.05）,APTT高于对照组（P <0.05）。结论 ：中医定向透药疗法配合红外线照射能够促进慢性肾衰竭患者动静脉内瘘成熟，提高动静脉内瘘成熟质量，减轻患者高凝状态，值得临床推荐。更多还原

【Abstract】 Objective: To investigate the clinical effect of traditional Chinese medicine directional penetration therapy combined with infrared radiation in improvement of the mature quality of arteriovenous fistula in patients with chronic renal failure. Methods: From September 2019 to December 2021, 50 patients with chronic renal failure who needed autologous arteriovenous fistuloplasty in our hospital were included and randomly divided into two groups with 25 cases each. The control group received routine treatment of western internal medicine after operation, while the observation group received traditional Chinese medicine directional penetration combined with infrared radiation treatment at the stoma of fistula on the basis of the control group. The continuous treatment was for 10 days. The maturity of arteriovenous internal fistula, the maturity time of arteriovenous internal fistula, the time of starting to use, changes of blood flow and internal diameter of cephalic vein in anastomotic fistula on the first day before operation and the 30th day after operation, the changes of platelet count and activated partial thromboplastin time(APTT) on the first day and the 30th day after operation were compared between the two groups.Results: The score of maturity of arteriovenous fistula in the observation group was higher than that in the control group(P<0.05),and the maturity time and starting time of arteriovenous fistula in the observation group were shorter than those in the control group(P<0.05). The blood flow and internal diameter of cephalic vein in the observation group were higher than those in the control group on the 30th day after operation(P<0.05), platelet count in the observation group was lower than that in the control group, while APTT in the observation group was higher than that in the control group(P<0.05). Conclusion: Traditional Chinese medicine directional penetration therapy combined with infrared radiation can promote the maturity of arteriovenous fistula in patients with chronic renal failure, improve the quality of the maturity of arteriovenous fistula, and reduce the hypercoagulable state of patients, which is worthy of clinical recommendation.更多还原