加巴喷丁治疗腹膜透析病人皮肤瘙痒的疗效及安全性观察

    Efficacy and safety of gabapentin in the treatment of pruritus in peritoneal dialysis patients

    • 摘要:
      目的 观察加巴喷丁治疗腹膜透析病人皮肤瘙痒的疗效及安全性。
      方法 采用随机对照研究,选取腹膜透析伴瘙痒病人,随机分为对照组和观察组。对照组23例,每晚睡前口服抗组胺药物氯雷他定10 mg,观察组25例,每日睡前口服加巴喷丁100 mg。4周后根据视觉模拟评分(VAS)、5-D瘙痒量表评分观察疗效,记录不良反应。收集治疗前后病人血尿素氮、血肌酐、血红蛋白、Kt/V、血钙、血磷、甲状旁腺激素等实验室检查结果。
      结果 治疗后观察组VAS评分及5-D瘙痒量表评分较对照组下降(P < 0.05)。对照组4例出现嗜睡,观察组6例出现乏力和嗜睡,均未作处理症状自行缓解,无一例出现严重并发症而中止治疗。观察组中24 h尿量>400 mL、100~400 mL、 < 100 mL病人组间不良反应发生率差异均无统计学意义(P>0.05)。
      结论 加巴喷丁对于腹膜透析伴瘙痒病人改善瘙痒症状有较好的疗效,小剂量每日应用是一种较安全的给药方式。

       

      Abstract:
      Objective To observe the efficacy and safety of gabapentin in the treatment of pruritus in peritoneal dialysis patients.
      Methods A randomized controlled trial was performed. Peritoneal dialysis patients with pruritus were selected and randomly divided into experimental group and control group. Twenty-three patients in the control group received loratadine 10 mg orally before sleep every night, while 25 patients in the experimental group received gabapentin 100 mg orally before sleep every day. After 4 weeks, efficacy was observed according to visual analog score(VAS) and 5-D pruritus scale score, and adverse reactions were recorded. Laboratory data such as blood urea nitrogen, blood creatinine, hemoglobin, Kt/V, blood calcium, blood phosphorus and parathyroid hormone of patients before and after treatment were collected.
      Results After treatment, VAS score and 5-D pruritoneal scale score in the experimental group decreased compared with the control group, and the differences were statistically significant(P < 0.05). Four cases in the control group showed drowsiness and 6 cases in the experimental group showed fatigue and drowsiness, all of which were relieved without any treatment, and none of them developed serious complications that led to discontinuation of treatment. There was no significant difference in the incidence of adverse reactions among patients with 24 h urine volume >400 mL, 100-400 mL and < 100 mL in the observation group(P>0.05).
      Conclusions Gabapentin is effective in improving pruritus in patients with peritoneal dialysis complicated with pruritus and small-dose daily administration is a safe way for using.

       

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