RESUMEN
Uremic pruritus (UP) is a common complication in patients with end-stage renal disease, which seriously reduces the quality of life of patients. Compared with the internal treatment of TCM, the external treatment of TCM for UP is simpler and more effective, and can avoid the first pass effect caused by oral drugs and may cause liver and kidney damage. The treatment methods mainly include external washing of TCM, medicated bath, fumigation, wet compress, enema, scraping, acupuncture, auricular point sticking, acupoint application, acupoint iontophoresis, autologous blood acupoint injection and so on. At present, most studies are based on the conventional treatment of Western medicine, and the addition of external treatment of TCM can improve the efficacy, and has certain advantages in improving itching symptoms, inflammatory indicators, sleep quality, anxiety and depression. Some studies have selected parathyroid hormone, blood phosphorus, CRP, IL-6, histamine, SCr, BUN, β2-microglobulin and other indicators to evaluate the efficacy. The results suggest that external treatment of TCM can improve the micro-inflammatory state of patients and protect renal function, but further mechanism research is needed. The existing research has the following problems: the clinical efficacy evaluation scale is not uniform, and it is difficult to compare and summarize horizontally; the relief of pruritus symptoms is based on the scale evaluation, which is subjective; the course of treatment is short, and the long-term efficacy and safety can not be evaluated; some studies do not specify the patients' syndrome type, which is difficult to reflect the advantages of TCM syndrome differentiation and treatment, and needed to be improved in the future.
RESUMEN
Objective:To investigate the changes of biomarkers in peritoneal dialysis patients' peritoneal drainage fluid and their relationship with the peritoneal small molecule solute transport rate (PSTR).Methods:Seventy newly-tubed peritoneal dialysis patients from the Peritoneal Dialysis Center of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from September 29, 2014 to April 26, 2018 were selected. The levels of biomarkers plasminogen activator inhibitor-1 (PAI-1), matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in the peritoneal dialysis priming fluid were measured at different time points and 4 h dialysate/blood muscle (D/P) creatinine values at 2 years of follow-up, and the correlation between biomarkers in the extracted peritoneal fluid and 4 h D/P creatinine was examined.Results:Longitudinal studies showed an increase in PAI-1 ( P<0.001) and VEGF ( P=0.04) with increasing duration of peritoneal dialysis. PSTR levels at baseline and after 2 years of follow-up were significantly correlated with PAI-1, MMP-2, and VEGF levels at baseline. PSTR at 2 years was also correlated with MMP-2 levels at 6 months and PAI-1 levels at baseline. Conclusions:The biomarkers PAI-1, MMP-2, and VEGF in peritoneal dialysis drainage fluid are positively correlated with PSTR in peritoneal dialysis patients during the 2-year period.
