中药熏蒸联合加巴喷丁及血液灌流对血液透析患者皮肤瘙痒的影响

Chinese Herbal Fumigation Combined with Gabapentin and Hemoperfusion Has Effect on Pruritus in Hemodialysis Patients

目的:观察中药熏蒸联合血液灌流与口服加巴喷丁在治疗血液透析患者皮肤瘙痒的临床疗效。方法:将60例尿毒症需要维持血液透析的患者随机分为2组各30例。对照组给予血液灌流与口服加巴喷丁治疗,观察组在对照组基础上给予中药熏蒸治疗。观察2组患者治疗前后视觉模拟评分法(VAS)评价皮肤瘙痒程度以及总体治疗效果的情况;观察治疗前后血磷、血钙、甲状旁腺激素(PTH)以及血β2微球蛋白(β2-MG)的变化。结果:观察组总有效率为90.00%,高于对照组的76.67%,差异有统计学意义(P <0.05)。与治疗前比较,2组VAS评分均下降,差异有统计学意义(P <0.05)。与对照组比较,观察组治疗后VAS评分降低,差异有统计学意义(P <0.05)。与治疗前比较,2组治疗后血钙、血磷均改善,差异有统计学意义(P <0.05)。与对照组比较,观察组治疗后血钙显著升高、血磷降低,差异有统计学意义(P <0.05)。与治疗前比较,2组治疗后PTH、β2-MG均改善,差异有统计学意义(P <0.05)。与对照组比较,观察组治疗后PTH、β2-MG降低,差异有统计学意义(P <0.05)。结论:中药熏蒸联合血液灌流与口服加巴喷丁治疗血液透析患者皮肤瘙痒效果满意,能改善患者生活质量,减轻瘙痒带来的痛苦。

Objective:To observe the clinical effect of Chinese herbal fumigation combined with gabapentin and hemoperfusion for pruritus in hemodialysis patients.Methods:Divided 60 cases of uremia patients with maintenance hemodialysis into two groups randomly,with 30 cases in each group.Both groups received the treatment of hemoperfusion as well as the oral administration of gabapentin,while the observation group additionally received Chinese herbal fumigation.Observed the degree of pruritus evaluated by visual analogue scale(VAS)and the general therapeutic efficiency in the two groups before and after treatment;observed the changes of serum phosphorus,blood calcium,parathyroid hormone(PTH)and serumβ2 microglobulin(β2-MG)before and after treatment.Results:The total effective rate in the observation group was90.00%,being higher than that of 76.67%in the control group,difference being significant(P<0.05).VAS scores in both groups were lower than those before treatment,difference being significant(P<0.05).Compared with that in the control group,VAS score in the observation group after treatment was decreased,difference being significant(P<0.05).Compared with those before treatment,blood calcium and phosphorus were improved in both groups after treatment,difference being significant(P<0.05).Compared with that in the control group,blood calcium was significantly increased and serum phosphorus was decreased in the observation group after treatment,difference being significant(P<0.05).Compared with those before treatment,PTH andβ2-MG were improved in both groups after treatment,difference being significant(P<0.05).Compared with those in the control group,PTH andβ2-MG in the observation group after treatment were reduced,difference being significant(P<0.05).Conclusion:The application of Chinese herbal fumigation combined with hemoperfusion and oral administration of gabapentin achieves satisfactory results in the treatment for pruritus in hemodialysis patients,improves the quality of life of patients and relieves the pain caused by pruritus.