自拟乌蛇荣皮止痒方配合氯雷他定治疗尿毒症MHD伴发皮肤瘙痒血虚风燥夹瘀证的临床观察

Clinical Observation of Using Self-made Wushe Rongpi Zhiyang Decoction Combined with Loratadine in the Treatment of Uremia MHD with Skin Itching of Blood Deficiency, Wind-dryness and Stasis Syndrome

目的:观察自拟乌蛇荣皮止痒方配合氯雷他定治疗尿毒症维持性血液透析(MHD)伴发皮肤瘙痒血虚风燥夹瘀证的临床效果。方法:选取2019年1月-2020年1月我院收治84例尿毒症性皮肤瘙痒(UP)患者,按随机数字表法分为对照组与研究组,每组各42例。两组患者均给予基础治疗,对照组患者再此基础上加氯雷他定治疗,研究组患者则使用自拟乌蛇荣皮止痒方配合氯雷他定治疗。对比两组患者治疗前、治疗2个月后中医症候疗效、皮肤瘙痒评分、肾功能指标[血肌酐(SCr)、尿氮素(BUN)、血钙、血磷]、炎症指标[白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)]。结果:治疗2个月后,研究组总有效率为88.10%,显著高于对照组69.05%(P<0.05)。治疗2个月后,两组患者皮肤瘙痒评分、SCr、BUN、血磷、IL-6、IL-1β、hs-CRP较治疗前均显著降低而血钙上升(P<0.05),且研究组患者上述指标与同期对照组对比差异显著(P<0.05)。结论:对尿毒症MHD伴发皮肤瘙痒患者,应用自拟乌蛇荣皮止痒方配合氯雷他定治疗效果显著,可有效缓解皮肤瘙痒,改善肾功能,减轻炎症反应,有较好的应用价值。

Objective:To observe the clinical effects of using Self-made Wushe Rongpi Zhiyang Decoction combined with Loratadine in the treatment of uremia maintenance hemodialysis(MHD)with skin itching of blood deficiency,wind-dryness and stasis syndrome.Methods:A total of 84 patients with uremic pruritus(UP)admitted to our hospital from January 2019 to January 2020 were selected and divided into controlled group and study group according to the random number table method,with 42 cases in each group.The two groups were given basic treatment,and the patients in the controlled group were treated with Loratadine on this basis,and patients in the study group were treated with Self-made Wushe Rongpi Zhiyang Decoction combined with Loratadine.Before treatment and after 2 months of treatment,the efficacy of TCM symptoms,skin itching score,renal function indexes[blood creatinine(SCr),blood urea nitrogen(BUN),blood calcium,blood phosphorus]and inflammation indexes[interleukin-6(IL-6),interleukin-1β(IL-1β),hypersensitive C-reactive protein(hs-CRP)]were compared between the two groups.Results:After 2 months of treatment,the total effective rate in the study group was significantly higher than that in the controlled group(88.10%vs 69.05%)(P<0.05).After 2 months of treatment,the skin itching score and levels of SCr,BUN,blood phosphorus,IL-6,IL-1βand hs-CRP in the two groups were significantly decreased compared with those before treatment while the blood calcium was increased(P<0.05),and the above-mentioned indicators of patients in the study group were significantly different from those in the controlled group during the same period(P<0.05).Conclusion:For patients with uremia MHD complicated with skin itching,Self-made Wushe Rongpi Zhiyang Decoction combined with Loratadine has a significant therapeutic effect,and can effectively relieve skin itching,improve renal function and reduce inflammatory response,and has good application value.