尿毒症皮肤瘙痒症的中医治疗进展

Advances in Traditional Chinese Medicine Treatment of Uremia Pruritus

尿毒症皮肤瘙痒症(uremic pruritus,UP)是终末期肾病患者常见的并发症,以全身或局部不同程度的瘙痒为主要表现,临床发病率高,严重影响患者的生活质量。目前西医大多针对症状和诱因进行对症治疗,但疗效欠佳。中医认为其病位主要在脾、肾两脏,与肝、肺密切相关,为本虚标实证,以脾肾亏虚为本,风、湿、热、瘀、毒为标,治法以补脾益肾、祛风止痒为主,兼以清热燥湿、活血化瘀、泄浊解毒等。现从辨证论治、分期论治、复方治疗、中成药治疗、针灸疗法、中药外洗、中药熏蒸、穴位贴敷等方面对UP的中医治疗进展进行综述。

Uremic pruritus (UP) is a common complication in patients with end-stage renal disease,with systemic or local pruritus as the main manifestation.At present,most western medicine treats symptomatically for symptoms and incentives,but the curative effect is not good.Traditional Chinese medicine believes that the disease location is mainly in the spleen and kidney,which are closely related to the liver and lung.The spleen nourishes the kidney,dispels wind and relieves itching,and also clears heat and dampness,promotes blood circulation and removes blood stasis,and relieves turbidity and detoxification.This article reviews the progress of TCM treatment of UP from the aspects of syndrome differentiation,treatment by stages,compound treatment,proprietary Chinese medicine,acupuncture,external washing with Chinese medicine,fumigation,and acupoint sticking.