枸橼酸透析液改善尿毒症患者瘙痒17例

Clinical Observation of Citrate Dialysate on Improving Pruritus of 17 Uremic Patients

目的:观察枸橼酸透析液对维持性透析患者瘙痒症状、炎症指标的影响。方法:从高安市中医院血透室进行规律血透的92例患者,拟入选病例50例,随机数字法分为枸橼酸组17例,普通组17例,针灸组(普通透析液+针灸治疗)16例。观察患者瘙痒面积、瘙痒程度、皮损形态的影响等疗效指标;生化指标(ESR、CRP及血常规、尿常规、肝肾功能)。结果:(1)治疗后枸橼酸组患者瘙痒症状、体征及实验室结果有明显改善,对比普通组,有明显统计学意义(P<0.01);(2)治疗后枸橼酸组患者症状、体征及实验室检查对比针灸组有差异,有统计学意义(P<0.05);(3)治疗后枸橼酸组患者治疗后瘙痒总积分比针灸组有差异,有统计学意义(P<0.05);(4)枸橼酸透析液组患者治疗后瘙痒总积分与普通透析液组比较,有差异,有明显统计学意义(P<0.01);(5)通过临床观察发现三组未见明显不良反应。结论:(1)枸橼酸透析液可以减轻尿毒症患者的瘙痒不适;(2)枸橼酸透析液组缓解尿毒症患者瘙痒不适优于普通透析液组及针灸普通透析液加针灸治疗组。

Objective： To observe the effect of citrate dialysate on maintenance hemodialysis patients with symptoms of itching,inflammatory index. Methods： 92 cases of hemo-dialysis patients from the hemodialysis room of Gao＇an hospital of Traditional Chinese Medicine,the selected 50 patients were randomly divided into citrate group of 17 cases,17 cases of normal group,acupuncture group（ normal dialysis fluid ＋ acupuncture treatment） of 16 cases. Patients with pruritus pruritus,lesion area,the effect of therapeutic effect index; biochemical indexes（ ESR,CRP and blood routine,urine routine,liver and kidney function）. Results： After the treatment of citric acid group of patients with symptoms of itching,signs and laboratory results were significantly improved,compared with the common group,there was statistical significance（ P〈0. 01）; citrate group after treatment the symptoms,signs and laboratory examinations compared with acupuncture group difference was statistically significant（ P〈0. 05） after treatment;citrate group after treatment in patients with pruritus than acupuncture group total score difference was statistically significant（ P〈0. 05）; citrate dialysate groups of patients after treatment of pruritus total integral comparison,and ordinary dialysis group difference was statistically significant（ P〈0. 01）; the three group found no obvious adverse reactions. Conclusion：Through clinical observation of citrate dialysate in uremic patients can relieve itching and discomfort; the citrate.The analysis group relieved the pruritus of uremia patients better than the ordinary dialysis group and the acupuncture and general dialysis solution plus acupuncture treatment group.