实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (12): 1281-1283.doi: 10.3969/j.issn.1003-9198.2021.12.018

• 临床研究 • 上一篇    下一篇

血液灌流联合针刺治疗对老年尿毒症病人皮肤瘙痒的疗效

蒋娟娟, 叶晓霜, 江露月, 杨娟, 严文艳, 陈燕, 徐吉敏, 孙世竹   

  1. 210024 江苏省南京市,南京医科大学附属老年医院肾内科(蒋娟娟,叶晓霜,江露月,杨娟,严文艳,陈燕);中医科(徐吉敏,孙世竹)
  • 收稿日期:2020-12-26 出版日期:2021-12-20 发布日期:2021-12-28
  • 通讯作者: 陈燕,Email:chenyanwws@sina.com

Effects of hemoperfusion combined with acupuncture on pruritus in the elderly patients with uremia

JIANG Juan-juan, YE Xiao-shuang, JIANG Lu-yue, YANG Juan, YAN Wen-yan, CHEN Yan, XU Ji-min, SUN Shi-zhu   

  1. JIANG Juan-juan, YE Xiao-shuang, JIANG Lu-yue, YANG Juan, YAN Wen-yan, CHEN Yan. De-partment of Nephrology;
    XU Ji-min, SUN Shi-zhu. Depaurtmenl of 'Traditional Chinese Medicine, GeriatricHospital of Nanjing Medical University, Nanjing 210024, China
  • Received:2020-12-26 Online:2021-12-20 Published:2021-12-28

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摘要： 目的 探讨血液灌流联合针刺治疗对老年尿毒症病人皮肤瘙痒的治疗效果。 方法 选取2020年1~6月在江苏省老年病医院行血液净化的老年尿毒症病人45例,随机分为对照组、血液灌流组、针刺+灌流组3组,每组15例。记录基线及治疗8周后病人临床资料,检测血BUN、肌酐、全段甲状旁腺激素(intact parathyroid hormone, iPTH)、血钙、血磷、血清hs-CRP、IL-6水平,并计算单室尿素清除指数(single-pool Kt/V,spKt/V)、尿素下降率(urea reduction rate, URR);采用VAS以及5-D瘙痒评分量表评估治疗前后病人的瘙痒情况。 结果 42例病人完成随访,每组14例。治疗前,3组BUN、肌酐、BMI、spKt/V、URR、血钙、血磷、iPTH、hs-CRP、IL-6水平以及VAS、5-D瘙痒评分差异无统计学意义(P＞0.05)。治疗后,与对照组相比,灌流组和针刺+灌流组病人血磷、iPTH、hs-CRP、IL-6、VAS、5-D瘙痒评分均明显下降(P＜0.05);与灌流组相比,针刺+灌流组血磷、hs-CRP、IL-6、VAS、5-D瘙痒评分下降,差异均有统计学意义 (P＜0.05)。 结论 血液灌流联合针刺治疗改善老年尿毒症病人的皮肤瘙痒效果更佳。

关键词: 老年人, 尿毒症, 皮肤瘙痒, 针刺, 血液灌流

Abstract: Objective To investigate the effect of hemoperfusion combined with acupuncture on pruritus in the elderly patients with uremia. Methods The clinical data of 45 cases of elderly uremic patients who received blood purification in Jiangsu Province Geriatric Hospital were collected from January to June 2020. The patients were divided into the hemoperfusion group, hemoperfusion with acupuncture group and control group. The treatment was for 8 weeks. The serum level of urea nitrogen, creatinine, calcium, phosphorus, intact parathyroid hormone(iPTH), high sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), visual analogue scale(VAS)and 5-D itch score were recorded before and after the intervention. And the levels of single-pool Kt/V(spKt/V) and urea reduction rate(URR) were calculated. Results There were 42 patients included in this study. Before treatment, there were no significant difference in the levels of urea nitrogen, creatinine, spKt/V, URR, body mass index(BMI), calcium, phosphorus, iPTH, hs-CRP, IL-6, VAS scores and 5-D itch scores among the three groups. The serum levels of phosphorus, iPTH, hs-CRP, IL-6, VAS scores and 5-D itch scores in the hemoperfusion group and the hemoperfusion with acupuncture group were significantly lower than those in the control group after intervention(P＜0.05).The serum levels of phosphorus, hs-CRP, IL-6, VAS scores and 5-D itch scores in the hemoperfusion with acupuncture group were significantly lower than those in the hemoperfusion group after intervention(P＜0.05). Conclusions The effect of hemoperfusion combined with acupuncture on the improvement of pruritus in the elderly patients with uremia is more apparent.

Key words: aged, uremia, pruritus, acupuncture, hemoperfusion

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