Ultrasound-Guided Non-Invasive Repair of AVF Stenosis Using Xilang Loubao Combined with Standardized TCM Nursing Massage: A Randomized Controlled Trial

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Abstract

BACKGROUND: Autologous arteriovenous fistula (AVF) stenosis threatens long-term dialysis access viability. Invasive interventions carry risks of trauma and recurrence, creating a clinical need for safe non-invasive adjunct care options. This trial evaluated a nurse-led Xilang Loubao(a food-grade bioactive peptide formulation) standardized TCM nursing massage protocol as AVF maintenance, with Doppler ultrasound supporting real-time nursing assessment. METHODS: From January to June 2025, 82 AVF stenosis outpatients from Liaoyuan Central Hospital were recruited patients were recruited and 1:1 randomized into two groups of 41 each. The experimental group received Xilang Loubao plus TCM nursing massage, with 1 withdrawal leaving 40 completers. The control group used Mucopolysaccharide Polysulfate Cream plus routine care, with 6 withdrawals leading to 35 completers. The primary endpoint was 90-day change in AVF stenotic diameter via Doppler; secondary endpoints included hemodynamics and nursing-related adverse events. RESULTS: At baseline, groups were comparable in age, vessel diameter, and blood flow. By day 90, intervention group had mean AVF stenotic-site diameter 4.3±0.7mm and brachial artery flow 1086.6±253.5mL/min, while controls were 2.0±0.4mm and 482.9±123.1mL/min (all P<0.001). CONCLUSIONS: Under color Doppler ultrasound guidance, this nurse-led combined nursing approach showed potential to improve vascular outcomes in AVF stenosis patients with good safety, serving as an adjunct nursing option to help prolong AVF patency in AVF stenosis patients.

Abstract as published, via PubMed.