Role of narrow band ultra violet radiation as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus

AIM To assess the role of narrow band ultraviolet B(UVB) as a treatment option in peritoneal dialysis patients with refractory uremic pruritus.METHODS In this retrospective study, 29 adult patients with end stage renal failure on peritoneal dialysis, and who had refractory uremic pruritus, were given narrow band UVB radiation as an add-on therapy to standard care for a duration of 12 wk. The response to the pruritus was assessed both weekly and at the end of the study period using a visual analogue score(VAS).RESULTS The average VAS score at the end of the study was 3.14 ± 1.59, which was significant compared to the baseline value of 7.75 ± 1.02(P < 0.05). Improvements in symptoms were noted in 19 out of 21(90.4%) patients. However, relapse occurred in six out of the 19 patients who responded. The dropout rate was high during the study period(33.3%).CONCLUSION Narrow band UVB is effective as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus. However, the present regime is cumbersome and patient compliance is poor.

高通量透析联合硫代硫酸钠治疗尿毒症的效果

目的:探究高通量透析联合硫代硫酸钠治疗尿毒症的效果。方法:选取2021年8月至2023年1月收治的尿毒症患者68例作为研究对象,按照随机原则分为对照组与观察组,每组34例。对照组采用高通量血液透析治疗,观察组采用高通量透析联合硫代硫酸钠治疗。治疗后,比较两组的血清Ca^(2+)、肌酐(Scr)、尿素氮(BUN)和甲状旁腺激素水平,分析两组的机体功能、生活状况以及不良反应。结果:治疗3个月后,观察组的生活状况UP-Dial评分、PSQI评分低于对照组,SF-36评分高于对照组,差异有统计学意义(P<0.05)。观察组的机体功能指标动脉血氧分压(PaO_(2))、经皮血氧饱和度(SpO_(2))高于对照组(P<0.05)。观察组血清Ca^(2+)、Scr、BUN和PTH水平低于对照组。结论:高通量透析联合硫代硫酸钠治疗尿毒症,可有效缓解皮肤瘙痒症状,改善机体功能,提升患者生活质量。

非透析期尿毒症瘙痒患者瘙痒程度与中医证型的关系研究

【目的】探讨非透析期尿毒症瘙痒(UP)患者瘙痒程度与实验室指标及中医证型的关系。【方法】通过问卷调查,以视觉模拟量表(VAS)评分法评估瘙痒程度,将97例UP患者分为轻度瘙痒组54例、中度瘙痒组26例和重度瘙痒组17例,分析各组患者瘙痒程度与实验室指标[C反应蛋白(CRP)、血沉(ESR)、血小板(PLT)、血尿素氮(BUN)、血肌酐(Scr)、肾小球滤过率(eGFR)、血红蛋白(HGB)]和中医证型分布的关系。【结果】(1)实验室指标方面:经单因素方差分析,3组患者的ESR、CRP、PLT、Scr、BUN、eGFR及HGB均存在显著性差异(P<0.01)。其中轻度瘙痒组患者的CRP、ESR、PLT、Scr、BUN明显低于中度瘙痒组和重度瘙痒组,eGFR和HGB明显高于中度瘙痒组和重度瘙痒组,差异均有统计学意义(P<0.05或P<0.01),而中度瘙痒组患者的ESR、PLT、Scr低于重度瘙痒组,e GFR和HGB高于重度瘙痒组,差异均有统计学意义(P<0.05)。(2)中医证型分布方面:在本虚证中,分布频次从高到低依次为:脾肾气虚>脾肾阳虚>肝肾阴虚>气阴两虚>阴阳两虚,其中轻、中度瘙痒患者以脾肾气虚为主,而重度瘙痒患者以气阴两虚为主;在标实证中,分布频次从高到低依次为:湿浊证>湿热证>瘀血证>热毒证>风动证,其中轻、中度瘙痒患者以湿浊证及湿热证为主,而重度瘙痒患者以瘀血证为主。【结论】采用中药内服治疗非透析期UP患者时,应在补益脾肾、通腑泄浊的基础上,辨证兼顾清热、化瘀、滋阴、止痒等;同时,配合西医的抗炎、加快毒素排泄、纠正贫血等治疗手段,对缓解UP症状也有积极的作用。

耳穴贴压对血透合并瘙痒患者白细胞介素水平的影响

目的:观察耳穴贴压对血透合并瘙痒患者白细胞介素水平的影响并探讨其可能机制。方法:筛选我院长期进行维持性血液透析并发皮肤瘙痒病例,将其分为对照组和治疗组,对照组采用基础治疗加耳穴贴治疗(不含王不留行籽),治疗组采用基础治疗加耳穴贴治疗(内含王不留行籽)。结果:耳穴贴压治疗组与对照组数据比较,瘙痒VAS评分(2.656±0.8654 vs 4.194±0.9202)、FIIQ量表评分(8.563±1.759 vs 10.08±1.842)、中医症候积分(29.38±4.470 vs 36.33±4.980)以及IL-6含量(5.798±0.6576 vs 6.239±0.8250)数据比较显著下降,差异有统计学意义(P<0.05),IL-2含量(999.7±226.8 vs 1076±237.2)、IL-8(56.41±8.420 vs 60.36±8.093)、IL-10(6.629±1.098 vs 6.263±1.134)数据比较差异无统计学意义(P>0.05)。结论:耳穴贴压可以改善维持性血液透析患者皮肤瘙痒,提高患者的整体生活质量。