| Objective:Based on the observation of hemodialysis,the clinical efficacy and safety of the treatment of Uremic Pruritus were treated by Shufeng Huoxue prescription for external bathing.In addition,to explore the effects of Shufeng Huoxue decoction on blood calcium,phosphorus,urea nitrogen,serum β2-MG and parathyroid hormone.Methods:1.basic scheme:A questionnaire survey was conducted on hemodialysis patients in Garden hill Hemodialysis Center of Hubei Provincial Hospital of TCM,To understand the skin itching condition of Uremic Pruritus and to make statistical analysis of relevant factors.Choose from June 2016 to October 2017,the Garden hill Hemodialysis Center of Hubei Provincial Hospital of TCM will receive hemodialysis treatment and meet the criteria for the inclusion of the standard uremia in 45 patients.Randomly divided into control group,irrigation group,Chinese medicine group,15 cases.The three groups were given diet guidance and basic treatment: limited quality protein low phosphorus diet,control weight gain,control of blood glucose,blood pressure and other basic diseases.The control group was given a basic regimen of hemodialysis five times on two weeks,and the duration of dialysis was not less than 10 hours per week.On the basis of the control group,the perfusion group was treated with hemoperfusion;On the basis of the control group,the traditional Chinese medicine group was washed by Shufeng Huoxue decoction,and washed with the pure cotton handkerchief,twice a day.The trial period is two weeks.Before and after treatment,itch score and laboratory related indicators were examined.2.observation indexes(1)Comparison of curative effect before and after treatment: Visual Analogue Scale/Score and itch degree integral;(2)Laboratory observation indexes before and after treatment:Effects of itchy skin(calcium,phosphorus,parathyroid hormone);Dialysis sufficiency index(urea nitrogen,serum β2-MG).(3)Security Index: blood routine examination(WBC、HG、PLT)、liver function test(ALT、AST).Results:1.Comparison of curative effect before and after treatment1.1 Visual Analogue Scale/Score: compare within groups: The control effective rate was 46.7%;the perfusion group effective rate was73.3%;the Chinese medicine group effective rate was93.3%.Comparison among groups:There was significant difference in total effective rate between group and control each groups(P<0.05).1.2 Itch level integral comparison: compare within groups:compare within groups: The control effective rate was 60%;the perfusion group effective rate was 86.7%;the Chinese medicine group effective rate was 100%.Comparison among groups:There was significant difference in total effective rate between group and control each groups(P<0.05).2.Before and after treatment,skin pruritus affected factor level comparison.2.1 Calcium: compare within groups: There was no statistical difference between the three groups before and after treatment(P>0.05);comparison among groups: There was no significant difference in calcium levels between groups before and after treatment.2.2 Phosphorus: compare within groups: The difference of phosphorus level before and after treatment was statistically significant(P<0.05).comparison among groups: There was no significant difference in phosphorus level between the perfusion group and the TCM group(P>0.05),There were statistically significant differences in the phosphorus level between the perfusion group and the control group and the traditional Chinese medicine group(P<0.05).2.3 PTH: compare within groups: The PTH level of patients in the control group was no different before and after treatment(P>0.05);the perfusion group and the TCM group have difference of PTH level before treatment and after treatment was statistically significant(P<0.05).comparison among groups: There was no significant difference of PTH level between the the perfusion group and Chinese medicine group(P>0.05),There were statistically significant differences of PTH level between the perfusion group and the control group and the traditional Chinese medicine group(P<0.05).3.Before and after treatment,the index was compared.3.1 Kt/v: compare within groups:There was no statistical difference between the three groups before and after treatment(P>0.05);comparison among groups: There was no significant difference in urea clearance in the three groups(P>0.05).3.2 BUN: compare within groups:There was no statistical difference between the three groups before and after treatment(P>0.05);comparison among groups: There was no significant difference in urea clearance in the three groups(P>0.05).3.3 Scr: compare within groups:There was no statistical difference between the three groups before and after treatment(P>0.05);comparison among groups: There was no significant difference in urea clearance in the three groups(P>0.05).3.4 Serum β 2-MG level: compare within groups: There was no statistical difference of Serum β 2-MG level between the control group and the Chinese medicine group before and after treatment(P>0.05);The difference of perfusion group was statistically significant(P<0.05);comparison among groups: The level ofβ2-MG in the perfusion group was significantly lower than that in the control group and the Chinese medicine group,and the difference was statistically significant(p<0.05).4.Safety index evaluation: There was no significant difference in blood analysis and liver function before and after treatment(P>0.05).There was no obvious allergic reaction and other adverse reactions during the whole experiment.Conclusion:The principle of blood perfusion treatment by adsorption reduce blood phosphorus,PTH and β 2-MG,based on its the Shufeng Huoxue prescription for external bathing of uremia can significantly improve the patient’s symptoms,safe and without side effects.Especially in the case of insufficient hemodialysis,it can be used as one of the methods to treat the skin itching of uremia. |
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