中药皮肤透析联合血液灌流治疗慢性肾脏病5期顽固性皮肤瘙痒临床观察

Clinical Observation of Chinese Medicine Combined with Hemoperfusion in the Treatment of Stage 5 Refractory Pruritus of Chronic Kidney Disease

目的:观察中药复方经皮肤透析联合血液灌流治疗尿毒症皮肤瘙痒患者的疗效性及安全性。方法:选择在血液透析中心行维持性血液透析患者37例,随机分为观察组18例,对照组19例。2组均行1周3次规律性血液透析(HD),对照组在常规血液透析基础上,每2周1次血液透析(HD)串联血液灌流(HP);观察组在对照组基础上,加用每周3次中药复方透析液皮肤透析治疗,观察周期12周,比较治疗前、治疗12周后实验室指标及皮肤瘙痒程度评分。结果:在清除小分子毒素方面,有显著差异,观察组优于对照组;在清除大分子毒素方面,无显著差异;皮肤瘙痒程度积分,有显著差异,观察组优于对照组。结论:中药皮肤透析联合血液灌流能够改善患者皮肤瘙痒,与血液灌流联合起协同作用,比单纯血液灌流效果好。

Objective:To observe the efficacy and safety of traditional Chinese medicine compound prescription combined with skin dialysis and hemoperfusion to treat patients with uremia skin pruritus.Methods:37 patients undergoing maintenance hemodialysis in the hemodialysis center,and randomly divided them into an observation group of 18 cases and a control group of 19 cases.Both groups underwent regular hemodialysis (HD) three times a week.The control group was on the basis of conventional hemodialysis,with hemodialysis (HD) and hemoperfusion (HP) every two weeks;the observation group was on the basis of the control group.Add Chinese medicine compound dialysate skin dialysis treatment 3 times a week.The observation period is 12 weeks.The laboratory indexes and skin pruritus scores before and after 12 weeks of treatment are compared.Results:There are significant differences in the removal of small molecule toxins,and the observation group is better than the control group;there is no significant difference in removal of macromolecular toxins;there is a significant difference in the degree of skin itching,and the observation group is better than the control group.Conclusion:Traditional Chinese medicine skin dialysis combined with hemoperfusion can improve patients’ skin pruritus,and it has a synergistic effect when combined with hemoperfusion,which is better than hemoperfusion alone.