加巴喷丁对维持性血液透析尿毒症患者皮肤瘙痒症的疗效观察

目的探讨加巴喷丁（Gabapentin,GBP）对维持性血液透析尿毒症患者皮肤瘙痒症状的治疗效果。方法维持性血液透析尿毒症伴皮肤瘙痒症患者28例,随机分为对照组和加巴喷丁治疗组,每组各14例,两组均接受常规血液透析治疗,加巴喷丁治疗组口服加巴喷丁0.2g,3次/周,两组均1次/d进行瘙痒、睡眠评分,记录不良反应,治疗中每周1次常规监测血生化、肌酐、尿素氮、血常规、甲状旁腺激素等。结果加巴喷丁组患者瘙痒改善总有效率92.85%,明显高于对照组28.57%,瘙痒评分由治疗前（9.23±0.79）分下降至治疗后（2.82±1.48）分,睡眠评分由治疗前（6.51±1.49）分改善为（1.62±0.97）分,治疗前后比较差异均有统计学意义（P〈0.05）;加巴喷丁组偶有患者出现头昏,无其他不良反应;两组治疗前后血生化、血常规、尿素氮、甲肝及甲状旁腺激素无明显改变（P〉0.05）。结论加巴喷丁治疗尿毒症患者皮肤瘙痒症安全有效,患者睡眠改善,且该药对血生化、血常规、尿素氮、肌酐及甲状旁腺激素无明显影响。

Therapeutic effect of gabapentin on cutaneous.pruritus in uremia patients on maintenance hemodialysis

Objective To study the therapeutic effect of gabapentin on cutaneous pruritus in uremia patients on maintenance hemodialysis.Methods Twenty-eight patients with cutaneous pruritus on maintenance hemodialysis were randomly divided into control group and gabapentin treatment group,14 patients in each group.Patients in control group received routine hemodialysis and those in gabapentin treatment group were treated with gabapentin（0.2g,3 times a week） plus hemodialysis.Cutaneous pruritus and sleep were scored once a day and adverse events were recorded.Biochemical indexes,creatinine,urea nitrogen,routine blood examination results,parathyroid hormone were detected once a week during treatment.Results The total effective rate was 92.85% for the gabapentin treatment group and 28.57% for the control group.The scores of cutaneous pruritus decreased from 9.23±0.79 to 2.82±1.48 and the scores of sleep decreased from 6.51±1.49 to 1.62±0.97 after treatment（P〈0.05）.Dizziness occurred sometimes in gabapentin treatment group without other adverse reactions.No significant changes were observed in biochemical indexes,creatinine,urea nitrogen,routine blood examination results,parathyroid hormone before and after treatment between the two groups（P〉0.05）.Conclusion Gabapentin is an effective and safe drug for cutaneous pruritus in patients with uremia and can improve their sleep with no significant influence on their biochemical indexes,creatinine,urea nitrogen,routine blood examination results,parathyroid hormone.