摘要
本文概述慢性肾脏病皮肤瘙痒症发病的临床特点、机制以及中西医的治疗进展。随着血液净化技术水平日渐提高,尿毒症患者存活时间延长,皮肤瘙痒的发生率显著增加,会影响患者的生活质量,是患者最常见、最苦恼的临床症状之一。临床表现一般为全身或局部不同程度的瘙痒,西医发病机制可能与体内微炎症状态、皮肤干燥、周围神经病变、甲状旁腺激素水平升高和继发性甲状旁腺功能亢进等因素有关;通常采用的治疗方法包括局部外用药物、系统治疗药物、改变透析模式及优化透析充分性、光疗法、手术切除甲状旁腺治疗及肾移植等。病情较轻者可给予局部皮肤保湿治疗;重者优化透析充分性,调控钙、磷水平。中医主要病机为本虚标实、虚实夹杂,与“风、湿、毒、虚、瘀”等因素相关,主要以“扶正祛邪、标本兼顾”为总原则,通过中药内服、外洗、熏蒸、药浴、灌肠、针灸、贴敷等方法治疗。目前西医对此病的发病机制尚不十分明确,仍需深入研究;中医学对慢性肾脏病皮肤瘙痒症的治疗疗效可观,且治疗方式多样,但缺乏统一的规范与标准。中、西医治疗可有效改善患者的临床症状,但在今后的临床工作中仍需寻找更加规范、有效、经济的治疗方案,中西医治疗结合,内治外治法相结合,解决患者的痛苦,提高患者的生活质量。
This paper is to summarize the clinical characteristics of skin pruritus after chronic kidney disease,its mechanism and treatment in traditional Chinese medicine and Western medicine.With the increasing improvement of blood purification technology,the survival time of uremic patients is prolonged,and the incidence of skin pruritus is significantly increased,which will affect the quality of life of patients to a large extent.It is one of the most common and distressing clinical symptoms of patients.The clinical manifestations are generally pruritus of different degrees in the whole body or local areas.The pathogenesis of Western medicine may be related to microinflammatory state,dry skin,peripheral neuropathy,elevated parathyroid hormone level and secondary hyperparathyroidism.The common treatment methods include topical medication,systemic therapy,changing dialysis mode and optimizing dialysis adequacy,phototherapy,parathyroid surgery and renal transplantation.Patients with mild condition can be given local skin moisturizing treatment;severe patients can optimize dialysis adequacy and regulate calcium and phosphorus levels.The main pathogenesis of TCM is based on deficiency and excess,mixed with deficiency and excess,which is related to“wind,dampness,toxin,deficiency,blood stasis”and other factors.It is mainly based on the general principle of“strengthening the body and eliminating pathogenic factors,and relieving both primary and secondary symptoms”.It is treated by oral administration,external washing,fumigation,medicine bath,enema,acupuncture and moxibustion,sticking and other methods.At present,the pathogenesis of this disease in Western medicine is not very clear,and it still needs to be further studied;the curative effect of TCM on skin pruritus after chronic kidney disease is considerable,and the treatment methods are diverse,but it is lack of unified norms and standards.TCM and Western medicine treatment can effectively ameliorate the clinical symptoms of patients,but in the future a more standard
作者
郭凯琴
肖振卫
GUO Kaiqin;XIAO Zhenwei
出处
《中医临床研究》
2021年第30期71-74,共4页
Clinical Journal Of Chinese Medicine
关键词
慢性肾脏病
皮肤瘙痒
中医治疗
西医治疗
中西医结合
Chronic kidney disease
Skin itching
TCM treatment
Western medicine treatment
Integrated traditional Chinese and Western medicine
