中药内服及外洗联合血液灌流治疗维持性血液透析伴皮肤瘙痒患者的效果研究

Study on the Effect of Traditional Chinese Medicine Oral Administration and External Washing Combined with Hemoperfusion on Patients with Maintenance Hemodialysis Complicated with Pruritus

目的:研究中药内服及外洗联合血液灌流治疗维持性血液透析伴皮肤瘙痒患者的效果。方法:选择2022年7月—2023年7月萍乡矿业集团有限责任公司总医院收治的80例维持性血液透析伴皮肤瘙痒患者为研究对象,按随机数字表法分为治疗组和对照组,各组40例。两组均接受血液透析联合血液灌流治疗,对照组接受皮肤瘙痒非药物治疗,治疗组在对照组基础上接受中药内服及经验方祛风止痒安神汤外洗治疗,两组治疗时间均为4周。比较两组实验室指标、瘙痒情况、睡眠质量、生活质量、不良反应。结果:治疗4周后,治疗组组胺(HIS)、甲状旁腺激素(PTH)、血尿素氮(BUN)、血肌酐(Scr)、β_(2)-微球蛋白(β_(2)-MG)均明显低于对照组,血钙、血磷达标率均明显高于对照组,差异均有统计学意义(P<0.05)。治疗4周后,治疗组瘙痒评分、阿森斯失眠量表(AIS)评分均明显低于对照组,治疗组世界卫生组织生存质量测定量表(WHOQOL-BREF)各维度评分及总分均高于对照组,差异均有统计学意义(P<0.05)。治疗期间两组均未出现严重不良反应。结论:中药内服及外洗联合血液灌流治疗维持性血液透析伴皮肤瘙痒患者的效果明显,有助于维持钙磷代谢平衡,对改善皮肤瘙痒及睡眠质量有积极作用,可提高患者生活质量。

Objective:To study the effect of traditional Chinese medicine oral administration and external washing combined with hemoperfusion on patients with maintenance hemodialysis complicated with pruritus.Method:A total of 80 patients with maintenance hemodialysis complicated with pruritus admitted to the General Hospital of Pingxiang Mining Group Co.from July 2022 to July 2023 were selected as the study objects,and were divided into treatment group and control group according to random number table method,with 40 cases in each group.Both groups received hemodialysis combined with hemoperfusion treatment,the control group received non-drug treatment for pruritus,and the treatment group received traditional Chinese medicine oral administration and the empirical prescription Qufeng Zhiyang Anshen Decoction external washing treatment on the basis of the control group.The treatment time of both groups was 4 weeks.Laboratory indexes,pruritus,sleep quality,quality of life and adverse reactions were compared between the two groups.Result:After 4 weeks of treatment,histamine(HIS),parathyroid hormone(PTH),blood urea nitrogen(BUN),serum creatinine(Scr)andβ_(2)-microglobulin(β_(2)-MG)in the treatment group were significantly lower than those in the control group,and the compliance rates of blood calcium and blood phosphorus were significantly higher than those in the control group,the differences were statistically significant(P<0.05).After 4 weeks of treatment,the pruritus scores and the Assens insomnia scale(AIS)scores of the treatment group were significantly lower than those of the control group,and the scores of each dimension and total scores of the world health organization quality of life scale(WHOQOL-BREF)of the treatment group were higher than those of the control group,the differences were statistically significant(P<0.05).No serious adverse reactions occurred in both groups during treatment.Conclusion:Traditional Chinese medicine oral administration and external washing combined with hemoperfusion have obvious effects on patients with maintenance hemodialysis complicated with pruritus,which is helpful to maintain the balance of calcium and phosphorus metabolism,has a positive effect on improving pruritus and sleep quality,and can improve the quality of life of patients.