摘要
目的观察口服药用炭对维持性血液透析患者尿毒症皮肤瘙痒的疗效。方法合并中重度尿毒症皮肤瘙痒(视觉模拟评分法VAS≥6分)的血液透析患者35例,予口服药用炭(1.5g/次,3次/d)治疗,持续4周。观察治疗前后VAS评分及皮肤瘙痒程度的变化,并比较肾功能及血清钙、磷、全段甲状旁腺素(iPTH)水平的变化。结果口服药用炭4周后,患者VAS评分较前明显下降[(4.80±2.62)vs.(8.17±1.22),P<0.01],皮肤瘙痒程度减低。血清肌酐、尿素、尿酸水平较前下降(P<0.01或P<0.05);血磷及钙磷乘积较前降低(P<0.01);血钙及iPTH水平未见显著变化。结论口服药用炭对尿毒症皮肤瘙痒具有较为明显的缓解作用,其机制可能与药用炭对尿毒症毒素的清除和降低血磷有关。
Objective To investigate the effect of oral activated charcoal on uremic pruritus in patients undergoing hemodialysis. Methods Thirty-five chronic uremic patients on maintenance hemodialysis and suffering from moderate to severe pruritus（visual analog scales,VAS≥6） were treated with activated charcoal （4.5 g daily p.o.） for 4weeks. The serum creatinine,urea,uric acid,calcium,phosphorus,the product of calcium and phosphorous （Ca x P）,intact parathyroid hormone（iPTH） of all patients were examined before and after the treatment and the intensity of cutaneous prurtius（VAS）were recorded before and after treatment. Results Compared with pretreatment,the intensity of cutaneous pruritus of patients after treatment was obviously alleviated （4.80±2.62 vs 8.17±1.22,P 0.01）compared with that before the treatment. Patients＇ serum creatinine,urea and uric acid were declined（P 0.01 or P 0.05） after treatment. Serum levels of phosphorus and Ca x P were lower after treatment compared to that before the treatment（P 0.01）,but the levels of calcium and iPTH did not changed obviously. Conclusion Oral activated charcoal could alleviate the intensity of uremic prurtius in chronic hemodialysis patients. Clearing the uremic toxin and lowering the serum level of phosphorus are possible mechanisms.
出处
《北京医学》
CAS
2011年第2期128-130,共3页
Beijing Medical Journal
