尿毒症腹膜透析患者皮肤瘙痒症与中医证型的相关性研究  

Study on Correlation Between Skin Pruritus and Traditional Chinese Medicine Syndrome Types in Uremic Patients Receiving Peritoneal Dialysis

作　　者：王郑辛夷 黄琳 WANG Zhengxinyi;HUANG Lin(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan Guangdong 528400,China)

机构地区：[1]广州中医药大学附属中山中医院,广东中山528400

出　　处：《新中医》2024年第19期76-80,共5页New Chinese Medicine

基　　金：国家临床重点专科建设项目(粤财社〔2014〕80号)。

摘　　要：目的:观察尿毒症腹膜透析患者皮肤瘙痒症的中医证型分布规律及其发生的影响因素。方法:回顾性分析235例尿毒症腹膜透析患者的临床资料,根据瘙痒情况分为瘙痒组112例及无瘙痒组123例。比较2组中医证型分布、实验室指标值[血红蛋白(Hb)、碱性磷酸酶(ALP)、前白蛋白(PAB)、低密度脂蛋白胆固醇(LDL-C)、胱抑素C(CysC)、β_(2)-微球蛋白(β_(2)-MG)、血清铁蛋白(TRF)、C-反应蛋白(CRP)、钾(K)、镁(Mg)、磷(P)、钙(Ca)、全段甲状旁腺素(iPTH)、血清白蛋白(Alb)、尿酸(UA)、尿素氮(BUN)、肌酐(Cr)、甘油三酯(TG)、总胆固醇(TC)、血糖、体质量指数(BMI)]的差异。结果:瘙痒组男性、糖尿病、非在职及使用普瑞巴林或加巴喷丁胶囊患者的占比高于非瘙痒组,差异有统计学意义(P<0.05)。瘙痒组CysC、CRP、P、Ca水平均高于无瘙痒组,差异均有统计学意义(P<0.05)。2组瘀血证分布比较,差异有统计学意义(P<0.05);其余中医证型分布比较,差异无统计学意义(P>0.05)。多因素logistic回归模型结果显示,糖尿病、CRP升高、P升高是皮肤瘙痒影响因素。结论:尿毒症行腹膜透析的皮肤瘙痒症患者中医证型分布以瘀血证为主,糖尿病、CRP升高、P升高是尿毒症皮肤瘙痒的影响因素。Objective:To observe the distribution rules of traditional Chinese medicine syndrome types of skin pruritus in uremic patients undergoing peritoneal dialysis and its influencing factors.Methods:The clinical data of 235 uremic patients undergoing peritoneal dialysis were retrospectively analyzed,and they were divided into the pruritus group and non-pruritus group according to pruritus profile,with 112 and 123 in each group.The distribution of traditional Chinese medicine syndrome types and differences of laboratory indexes[hemoglobin(Hb),alkaline phosphatase(ALP),prealbumin(PAB),low-density lipoprotein cholesterol(LDL-C),cystatin C(CysC),β_(2)-microglobulin(β_(2)-MG),serum transferrin(TRF),C-reactive protein(CRP),potassium(K),magnesium(Mg),phosphorus(P),calcium(Ca),intact parathyroid hormone(iPTH),serum albumin(Alb),uric acid(UA),blood urea nitrogen(BUN),creatinine(Cr),triglyceride(TG),total cholesterol(TC),blood glucose and body mass index(BMI)]were compared between the two groups.Results:The proportion of male,diabetes,non-working patients and using Pregabalin or Gabapentin Capsules in the pruritus group was respectively higher than that in the non-pruritus group,the difference being significant(P<0.05).The levels of CysC,CRP,P and Ca in pruritus group were higher than those in non-pruritus group,differences being significant(P<0.05).There was significant difference being found in the comparison of distribution of blood stasis syndrome between the two groups(P<0.05);there was no significant difference being found in the comparison of distribution of remaining traditional Chinese medicine syndrome types(P>0.05).The results of multivariate logistic regression model showed that diabetes and elevated levels of CRP,P were the influencing factors of skin pruritus.Conclusion:The distribution of traditional Chinese medicine syndrome types in uremic pruritus patients undergoing peritoneal dialysis is mainly the blood stasis syndrome,and diabetes and elevated levels of CRP,P were the influencing factors of skin pruritus

关 键 词：尿毒症 皮肤瘙痒症 腹膜透析 中医证型 

分 类 号：R692.5[医药卫生—泌尿科学]