滋阴润肤方熏洗与综合护理在糖尿病皮肤瘙痒中的应用  

Application of Ziyinrunfu herbal fumigation and comprehensive nursing in patients with diabetic skin pruritus

作　　者：陆静波[1] 沈永红[1] 王璐[1] 荣丽媛[1] 马天[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海护理》2017年第1期14-18,共5页Shanghai Nursing

基　　金：国家临床重点专科经费资助(017.03);中医药管理局"十二五"重点专科培育项目(21.03.30.11);上海市卫计委中医药科研基金项目(30304113472)资助

摘　　要：目的探讨滋阴润肤方熏洗疗法与综合护理在糖尿病皮肤瘙痒中的应用。方法选择2015年1月—2016年7月在上海中医药大学附属岳阳中西医结合医院内分泌科门诊和病房治疗的糖尿病皮肤瘙痒患者60例,分为观察组27例和对照组33例;观察组采用滋阴润肤方熏洗,对照组采用清水熏洗,其症状无缓解则加用止痒药物。两组患者都采取规范的综合护理干预措施,1个疗程10 d。比较治疗前后两组患者的临床疗效,包括瘙痒视觉模拟评分(Visual Analogue Scale,VAS)、皮损愈合时间及使用止痒药物的例次、血清瘙痒介质指标(P物质、β-内啡肽及γ-干扰素)、血糖(空腹及餐后2 h)及肾功能(肌酐、尿素氮)。结果 1个疗程后,观察组患者的VAS评分和皮损愈合时间均优于对照组(P<0.05),观察组患者使用止痒药物的例次少于对照组(P<0.01);两组患者治疗后血清P物质、β-内啡肽及γ-干扰素指标比较差异有统计学意义(P<0.01);两组患者治疗后血清血糖、肌酐和尿素氮指标比较差异无统计学意义(P>0.05)。结论滋阴润肤方熏洗治疗糖尿病性皮肤瘙痒的疗效优于清水熏洗,规范的综合护理干预措施是提高疗效的重要保证。Objective To study the clinical efficiency of Ziyinrunfu herbal fumigation in the patients with diabetic skin pruritus and the related comprehensive nursing intervention measures.Methods A total of 60 patients with diabetic skin pruritus in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine were chosen between January 2015 and July2016.They were randomly divided into two groups：27 cases in the treatment group and 33 cases in the control group.The treatment group was treated with Ziyinrunfu herbal fumigation and the control group was treated with water fumigation.Antipruritics would be used if pruritus symptoms were not relieved.Standardized comprehensive nursing intervention measures were applied in the two groups.The therapy course of both groups was 10 d.Clinical effect [pruritus Visual Analogue Scale（VAS） score,days of skin lesion healing and frequency of using antipruritics],serum itch mediators [substance P,β-endorphin（β-EP） and interferon γ（INF-γ） ],blood glucose（fasting and 2-hour postprandial） and renal function indexes [creatine（Cr） and blood urea nitrogen（BUN） ] were observed before and after treatment.Results Pruritus VAS score and days of skin lesion healing in the treatment group were better than those in the control group（P〈0.05）.The frequency of using antipruritics in the treatment group was less than that in the control group（P〈0.01） as well.There were also significant differences in serum substance P,β-EP and INF-γ between the two groups（P〈〈0.01）.There was no significant difference in blood glucose,Cr and BUN between the two groups（P〉0.05） after treatment.Conclusion Ziyinrunfu herbal fumigation has better effects on diabetic skin pruritus than water fumigation alone.Comprehensive nursing intervention measures are important guarantee to improve the clinical effect.

关 键 词：糖尿病 皮肤瘙痒 熏洗 滋阴润肤方 综合护理 

分 类 号：R473.5[医药卫生—护理学]