Clinical Efficacy and Mechanism Study on Lactulose Enema Intervention to MHD with UP / 世界科学技术-中医药现代化

ABSTRACT

This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.