加巴喷丁治疗血液透析患者顽固性皮肤瘙痒的效果(1)
[摘要]目的 探讨加巴喷丁治疗血液透析患者顽固性皮肤瘙痒的效果。方法 选取我院2014年9月～2015年12月收治的86例顽固性皮肤瘙痒血液透析患者作为研究对象，随机分为参照组和研究组，各43例。所有研究对象每周均实施血液透析2～3次，灌流频率为2次/个月。参照组每天服用10 mg氯雷他定，研究组每次透析结束后，于晚间服用0.1～0.3 mg加巴喷丁。治疗3个月后，记录两组的VAS评分与瘙痒VAG评分，评估治疗效果，并观察其不良反应情况。结果 两组治疗前的VAS、VAG评分比较，差异无统计学意义(P>0.05)。两组治疗后的VAS、VAG评分低于治疗前，差异有统计学意义(P<0.05)。研究组治疗后的VAS、VAG评分低于参照组，差异有统计学意义(P<0.05)。2例患者在使用加巴喷丁进行治疗后，产生轻微的恶心症状，未立即停药，7 d后，该症状消除，且未产生其他不良反应。结论 短时间内使用较小剂量的加巴喷丁有助于改善血液透析患者顽固性皮肤瘙痒症状，提升患者的睡眠质量，效果显著，安全可靠，但长时间服用以及远期疗效仍有待深入研究。
[關键词]血液透析；顽固性皮肤瘙痒；加巴喷丁；效果
[中图分类号] R758.3+1 [文献标识码] A [文章编号] 1674-4721(2017)05(a)-0029-04
[Abstract]Objective To explore the effect of gabapentin in the treatment of hemodialysis patients with intractable pruritus.Methods 86 cases of hemodialysis with intractable pruritus from September 2014 to December 2015 in our hospital were selected and randomly divided into the reference group and the study group，43 cases in each group.All the subjects were given hemodialysis 2 to 3 times a week，and the frequency of irrigation was about 2 times per month.The reference group was given Loratadine，10 mg daily，and the study group was given 0.1 to 0.3 mg Gabapentin in the evening after each dialysis.After 3 months of treatment，the VAS score and the VAG score of the two groups were recorded，the therapeutic effect was evaluated，and the adverse reactions was observed.Results There was no significant difference between the two groups before treatment in the score of VAS，VAG (P>0.05).The VAS and VAG scores after treatment of the two groups were lower than that before treatment，with significant difference (P<0.05).The scores of VAS and VAG of the study group was lower than that of the reference group，with significant difference (P<0.05).2 patients had mild nausea after treatment with gabapentin，did not immediately stop，7 days later，the symptoms disappeared，and no other adverse reactions.Conclusion Gabapentin used a small dose of a short period of time will help to improve the hemodialysis patients with pruritus symptoms，improve the sleep quality of patients，the effect is significant，safe and reliable，but a long time use and long-term effect still needs to be further researched.
[Key words]Hemodialysis；Stubborn skin itching；Gabapentin；Effect
加巴喷丁于1993年在英国上市，1994年于美国上市，之后陆陆续续被全球多个国家应用于癫痫疾病的治疗[1]。该药物的抗异常性疼痛作用较佳，因此常用于治疗或辅助治疗三叉神经痛、癌性神经痛、带状疱疹后神经痛、糖尿病神经痛等疾病，将加巴喷丁用于改善血液透析患者顽固性皮肤瘙痒的研究较少。近年来，国内外的专家学者通过研究发现，加巴喷丁在治疗透析患者皮肤瘙痒症方面具有令人满意的效果。顽固性皮肤瘙痒是血液透析患者最为常见的一类并发症，对患者的睡眠质量造成极为不利的影响，重则引起抑郁症，对患者的生活质量及预后造成较大的负面效应[2]。针对该疾病，临床通常应用紫外线光疗、皮肤软化剂或者抗组胺类药物开展治疗，但临床疗效欠理想。血液透析联合血液灌流能够缓解皮肤瘙痒症状，但是价格高昂。本研究在原有治疗方案的基础上应用加巴喷丁对患者实施治疗，取得了较为显著的效果，现报道如下。 (余兰)
[關键词]血液透析；顽固性皮肤瘙痒；加巴喷丁；效果
[中图分类号] R758.3+1 [文献标识码] A [文章编号] 1674-4721(2017)05(a)-0029-04
[Abstract]Objective To explore the effect of gabapentin in the treatment of hemodialysis patients with intractable pruritus.Methods 86 cases of hemodialysis with intractable pruritus from September 2014 to December 2015 in our hospital were selected and randomly divided into the reference group and the study group，43 cases in each group.All the subjects were given hemodialysis 2 to 3 times a week，and the frequency of irrigation was about 2 times per month.The reference group was given Loratadine，10 mg daily，and the study group was given 0.1 to 0.3 mg Gabapentin in the evening after each dialysis.After 3 months of treatment，the VAS score and the VAG score of the two groups were recorded，the therapeutic effect was evaluated，and the adverse reactions was observed.Results There was no significant difference between the two groups before treatment in the score of VAS，VAG (P>0.05).The VAS and VAG scores after treatment of the two groups were lower than that before treatment，with significant difference (P<0.05).The scores of VAS and VAG of the study group was lower than that of the reference group，with significant difference (P<0.05).2 patients had mild nausea after treatment with gabapentin，did not immediately stop，7 days later，the symptoms disappeared，and no other adverse reactions.Conclusion Gabapentin used a small dose of a short period of time will help to improve the hemodialysis patients with pruritus symptoms，improve the sleep quality of patients，the effect is significant，safe and reliable，but a long time use and long-term effect still needs to be further researched.
[Key words]Hemodialysis；Stubborn skin itching；Gabapentin；Effect
加巴喷丁于1993年在英国上市，1994年于美国上市，之后陆陆续续被全球多个国家应用于癫痫疾病的治疗[1]。该药物的抗异常性疼痛作用较佳，因此常用于治疗或辅助治疗三叉神经痛、癌性神经痛、带状疱疹后神经痛、糖尿病神经痛等疾病，将加巴喷丁用于改善血液透析患者顽固性皮肤瘙痒的研究较少。近年来，国内外的专家学者通过研究发现，加巴喷丁在治疗透析患者皮肤瘙痒症方面具有令人满意的效果。顽固性皮肤瘙痒是血液透析患者最为常见的一类并发症，对患者的睡眠质量造成极为不利的影响，重则引起抑郁症，对患者的生活质量及预后造成较大的负面效应[2]。针对该疾病，临床通常应用紫外线光疗、皮肤软化剂或者抗组胺类药物开展治疗，但临床疗效欠理想。血液透析联合血液灌流能够缓解皮肤瘙痒症状，但是价格高昂。本研究在原有治疗方案的基础上应用加巴喷丁对患者实施治疗，取得了较为显著的效果，现报道如下。 (余兰)