丝胶蛋白对维持性血液透析患者尿毒症性瘙痒疗效的研究

Study on curative effect of sericin on uremic pruritus in patients with maintenance hemodialysis

目的研究丝胶蛋白治疗尿毒症性瘙痒的安全性和有效性。方法采用随机双盲设计,将25例尿毒症性瘙痒患者随机分为试验组和对照组,每例患者肢体瘙痒处按分组涂抹丝胶蛋白或安慰剂,分别在试验前和试验6 w后,检测患者肢体瘙痒处皮肤水化程度、色素沉积面积等指标,并采用视觉类比标度等对瘙痒改善进行评价。结果试验组(使用丝胶蛋白制剂)自觉瘙痒评分较试验前明显改善(P<0.05),对照组(使用甘油制剂)自觉瘙痒评分无明显改善(P>0.05);皮肤水分含量试验组较对照组增加,色素沉着面积均较对照组减小(P<0.05),且未出现不良反应病例。另外,试验前后两组在生化指标、血红蛋白、甲状旁腺激素等指标比较无统计学差异(P>0.05)。结论丝胶蛋白治疗尿毒症性瘙痒症,可显著减轻临床瘙痒症状,并增加瘙痒处皮肤水化程度,减少瘙痒处皮肤色素沉着面积,且安全性好。

Objective To study the safety and effectiveness of sericin in the treatment of uremic pruritus.Methods A total of 25 patients with uremic pruritus were randomly divided into an experiment group and a control group, and sericin or placebo was applied to the itching place of the patients in the corresponding group. Before and six weeks after the application, the hydration, pigmentation area and other indicators of the itching places were detected, and a visual analog scale was used for evaluating the improvement of uremic pruritus.Results The self-conscious itching scores in the experiment group （sericin preparation） were significantly improved in comparison with those before the experiment（P 〈 0.05）, while those in the control group（glycerol preparation） had no significant improvement （P 〉 0.05）; the moisture content of skin in the experiment group was higher than that in the control group while the area of pigmentation was lower than that in the control group（P 〈 0.05）, and there was not any adverse reaction cases. In addition, before the experiment, there was no significant difference in biochemical index, hemoglobin and parathyroid hormone between the two groups （P 〉 0.05）.Conclusion In the treatment of uremic pruritus, sericin can significantly reduce the clinical symptoms of itching, increase skin hydration, reduce the area of pigmentation, and has high security.