肾毒止痒方联合氯雷他定治疗维持性血液透析相关皮肤瘙痒30例

Clinical effect of Shendu Zhiyang prescription combined with loratadine in treatment of maintenance hemodialysis-associated pruritus:An analysis of 30 cases

目的:观察肾毒止痒方外洗联合氯雷他定口服治疗维持性血液透析相关皮肤瘙痒的临床疗效。方法:将60例维持性血液透析相关皮肤瘙痒患者随机分为治疗组和对照组,每组各30例。2组均予规律血液透析和基础治疗,对照组在此基础上给予氯雷他定片口服治疗,治疗组在对照组基础上加用肾毒止痒方外洗治疗。比较2组临床疗效、瘙痒视觉模拟评分法(VAS)评分、改良Duo’s瘙痒评分及匹兹堡睡眠质量指数(PSQI)评分。结果:总有效率治疗组为90.0%(27/30),高于对照组的70.0%(21/30),差异有统计学意义(P<0.01)。2组瘙痒VAS评分、改良Duo’s瘙痒评分及PSQI评分治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P<0.05或P<0.01)。结论:肾毒止痒方外洗联合氯雷他定口服可有效改善血液透析相关皮肤瘙痒的症状,提高患者睡眠质量,具有较好疗效,值得临床推广应用。

Objective:To investigate the clinical effect of Shendu Zhiyang prescription for external washing combined with loratadine in the treatment of maintenance hemodialysis-associated pruritus.Methods:A total of 60 patients with maintenance hemodialysis-associated pruritus were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group were given regular hemodialysis and basic treatment combined with oral administration of loratadine tablets,and those in the treatment group were given Shendu Zhiyang prescription for external washing in addition to the treatment in the control group.The two groups were compared in terms of clinical outcome,Visual Analogue Scale(VAS)score of pruritus,modified Duo’s pruritus score,and Pittsburgh Sleep Quality Index(PSQI)score.Results:The treatment group had a significantly higher overall response rate than the control group[90.0%(27/30)vs 70.0%(21/30),P<0.01].Both groups had significant changes in VAS score of pruritus,modified Duo’s pruritus score,and PSQI score after treatment,and there were significant differences in these indices between the two groups after treatment(P<0.05 or P<0.01).Conclusion:Shendu Zhiyang prescription for external washing combined with oral administration of loratadine has a marked clinical effect in the treatment of maintenance hemodialysis-associated pruritus and can effectively improve the symptoms and sleep quality of patients,and therefore,it holds promise for clinical application.