尿毒性搔癢症：相關因子及現行治療方式成效的探討

Uremic Pruritus: Associated Factors and Effects of Present Treatment

對於接受透析治療的病患而言，尿毒性搔癢症始終為一常見且令人困擾的問題，但其病理生理機轉目前為止了解仍很有限。本研究的目的，在以一區域醫院的血液透析病患為對象，探討與尿毒性搔癢症之相關因子。共有168位病患被收案，收集其就醫資料並以標準化問卷評估尿毒性搔癢症的嚴重性，再加以統計分析。問卷中分別基於搔癢症的分布區域大小，嚴重程度，以及發作頻率予以評分，因此在有尿毒性搔癢症的病患最低得分為3分，最高得分為22分。本研究結果顯示：（一）尿毒性搔癢症的有無和病患的性別、有無糖尿病、B型肝炎或C型肝炎之間並無明顯的關聯。（二）目前抗組織胺藥物在使用上並無濫用情形，但此類藥物在成效上並無有意義之發現。（三）紫外線照光療法，似為一有效又安全之方法。

Uremic prutitus remains a frequent and bothersome problem in dialysis patients. However, understanding of the pathophysiology of uremic pruritus is still limited. We conducted a survey of 168 hemodialysis patients in a single territorial hospital for uremic pruritus experience and possible associated factors. All patients were interviewed using a revised standardized questionnaire while they received hemodialysis. The degree of pruritus was based on the distribution, severity and frequency of itching. When pruritus was present, the lowest possible pruritus score was 3 and the highest possible score was 22. The results showed (1) there was no significant association of uremic pruritus with gender, or the presence or absence of DM, HBsAg, or Anti-HCV; (2) the use of antihistamine agents in this patient group was appropriate, but there was no significant reduction found in the occurrence of pruritus; and (3) treatment with ultra-violent B light radiation appeared to be effective.