维持性血液透析患者辛辣饮食与尿毒症瘙痒关系探讨  

Study on relationship between spicy diet and uremia pruritus in maintenance hemodialysis patients

作　　者：柏晓鑫 杨凌 何焱 向春静 张雨婷 王沂芹 李墨奇 BAI Xiaoxin;YANG Ling;HE Yan;XIANG Chunjing;ZHANG Yuting;WANG Yiqin;LI Moqi(Department of Nephrology,Second Affiliated Hospital of Army Military Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院肾内科,重庆400037

出　　处：《重庆医学》2024年第21期3289-3294,共6页Chongqing Medical Journal

基　　金：陆军军医大学第二附属医院院管基金项目(2018YLC15)。

摘　　要：目的研究维持性血液透析(MHD)患者辛辣饮食与尿毒症瘙痒(UP)的关系。方法选取2023年12月至2024年2月在该院血液净化中心接受治疗的403例患者作为研究对象,以患者摄入辣椒的频率和程度得分之和进行分组。采用视觉模拟评分量表(VAS)对所有患者进行初步瘙痒评分,得分>0分的患者采用14项尿毒症皮肤瘙痒量表进行多维度评估。检测所有患者的血常规、瘙痒相关血生化指标水平。结果清淡饮食组65例,微辣饮食组119例,辛辣饮食组219例,各组间性别例数比较差异无统计学意义(P>0.05)。各组间年龄、透析龄、淋巴细胞计数比较,差异有统计学意义(P<0.05)。各组间瘙痒程度比较差异无统计学意义(Z=9.301,P=0.157),但可见微辣饮食组和辛辣饮食组中的中度和重度瘙痒比例下降,无瘙痒与轻度瘙痒比例上升;清淡饮食组瘙痒评分高于微辣饮食组、辛辣饮食组,差异均有统计学意义(P<0.05),但微辣饮食组与辛辣饮食组比较差异无统计学意义(P>0.05)。各组40~60岁患者瘙痒评分比较差异有统计学意义(P<0.05);各组>60岁和<40岁患者瘙痒评分比较差异无统计学意义(P>0.05)。各组患者瘙痒相关血生化指标比较差异均无统计学意义(P>0.05)。结论辛辣饮食可降低MHD患者瘙痒程度,且不受年龄等因素的影响,可能与降低患者的淋巴细胞水平有关。Objective To investigate the relationship between spicy diet and uremic pruritus(UP)in the patients with maintenance haemodialysis(MHD).Methods A total of 403 patients receiving the treatment in the blood purification center of this hospital from December 2023 to February 2024 were selected as the study subjects and grouped by the sum of the scores of frequency and degree of pepper intake.The visual analogue rating scale(VAS)was used to conduct the preliminary pruritus score in all patients,and the patients with the score>0 point conducted the multidimensional evaluation by the 14-item uremic skin pruritus scale.The blood routine and itch-related blood biochemical indexes levels of all patients were measured.Results There were 65 cases in the bland diet group,119 cases in the mild spicy diet group and 219 cases in the spicy diet group,and there was no significant difference in the number of genders between the groups(P>0.05).There were statistically significant differences in age,dialysis age and lymphocyte count among the groups(P<0.05).There was no statistically significant difference in the degree of pruritus among the groups(Z=9.301,P=0.157),but it was seen that the proportion of moderate and severe pruritus in the mild spicy diet group and the spicy diet group was decreased,and the proportions of no pruritus and mild pruritus showed the increasing trend.The itching score of the bland diet group was higher than that of the mildly spicy diet group and spicy diet group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between the mild spicy diet group and spicy diet group(P>0.05).There was a statistically significant difference in the itch score of the patients aged 40-60 years in each group(P<0.05),and there was no statistically significant difference in the itch score between the patients aged>60 years old and<40 years old in each group(P>0.05).There was no statistically significant difference in the itch-related blood biochemical indexes among the

关 键 词：辛辣饮食 尿毒症瘙痒 维持性血液透析 淋巴细胞 

分 类 号：R692.5[医药卫生—泌尿科学]