中药外洗对维持性血液透析患者并发皮肤瘙痒的临床效果

Clinical Effect of Traditional Chinese Medicine External Washing on Skin Pruritus in Patients with Maintenance Hemodialysis

目的:观察中药外洗治疗维持性血液透析(MHD)患者并发皮肤瘙痒的临床效果。方法:选取郑州人民医院2017年3月至2018年12月期间收治的60例MHD并发皮肤瘙痒患者,随机分为观察组和对照组,各30例。对照组给予常规治疗(每周2次血液透析,1次血液透析滤过),观察组在此基础上联合中药外洗治疗。比较两组疗效、治疗前后瘙痒症状评分、血磷(P)、全段甲状旁腺激素(iPTH)水平。结果:观察组患者的治疗总有效率为80.0 %,高于对照组的56.7 %,差异具有统计学意义(P<0.05)。治疗前两组患者的皮肤瘙痒评分比较,差异无统计学意义(P>0.05);治疗后观察组患者的皮肤瘙痒评分低于对照组,差异具有统计学意义(P<0.05)。治疗前两组患者的血P及iPTH比较,差异无统计学意义(P>0.05)。治疗后观察组患者的血P及iPTH低于对照组,差异具有统计学意义(P<0.05)。结论:中药外洗治疗血液透析患者并发皮肤瘙痒疗效显著,可显著减轻患者瘙痒的症状,且不会增加患者的水负荷情况。

Objective To observe the clinical effect of external washing with traditional Chinese medicine on skin pruritus in patients with maintenance hemodialysis (MHD).Methods A total of 60 patients with MHD complicated with skin pruritus admitted in People’s Hospital of Zhengzhou from March 2017 to December 2018 were selected and randomly divided into observation group and control group,with 30 cases in each group.The control group received routine treatment (hemodialysis twice a week and hemodiafiltration once a week),and the observation group received external washing with traditional Chinese medicine on this basis.The curative effect,pruritus symptom score,blood phosphorus (P) and intact parathyroid hormone (iPTH) levels before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 80.0%,which was higher than 56.7% of the control group,and the difference was statistically significant (P < 0.05).There was no significant difference in pruritus score between the two groups before treatment (P > 0.05).After treatment,pruritus score of the observation group was lower than that of the control group,the difference was statistically significant (P < 0.05).There was no significant difference in blood P and iPTH between two groups before treatment (P > 0.05).After treatment,blood P and iPTH in the observation group were lower than those in the control group,the differences were statistically significant (P < 0.05).Conclusion Traditional Chinese medicine external washing treatment for hemodialysis patients complicated with skin pruritus is effective,which can significantly reduce the symptoms of pruritus,and does not increase the water load of patients.