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目的探讨低剂量加巴喷丁联合阿米替林治疗维持性血液透析的尿毒症患者皮肤瘙痒症致抑郁症的临床有效性。方法选取龙岩市第二医院2010年1月至2014年5月维持性血液透析患者顽固性瘙痒后抑郁症患者40例,分为观察组20组和对照组20组。方法观察组患者每周3次透析后晚22:00服用加巴喷丁100mg+阿米替林12.5mg。对照组每天晚22:00服用阿米替林12.5mg。分别于治疗前,治疗后4周,进行瘙痒VAS评分及抑郁汉密尔顿量表(HAMD)评分。同时观察患者的对不良反应的耐受情况。结果观察组治疗前后VAS评分和HAMD评分有显著差异(P<0.01)观察组治疗后VAS评分和汉密尔顿量表评分均明显优于对照组(P<0.01),有统计学意义。两组均不良反应观察未见明显差异。结论低剂量阿米替林与加巴喷丁联合应用治疗维持性血液透析尿毒症患者皮肤瘙痒后抑郁症疗效明显,可以减少药物的剂量,提高药物的有效性,不良反应少,值得临床应用。
Objective To investigate the clinical efficacy of low-dose gabapentin combined with amitriptyline in treating pruritus-induced depression caused by maintenance hemodialysis in uremic patients. Methods From January 2010 to May 2014, 40 patients with post-itch-induced depression in maintenance hemodialysis patients from the Second Hospital of Longyan City were divided into observation group (20 cases) and control group (20 cases). Methods Patients in observation group were treated with gabapentin 100 mg + amitriptyline 12.5 mg three times a week after dialysis at 22:00. The control group took amitriptyline 12.5 mg every night at 22:00. Pruritus VAS score and Depression Hamilton Scale (HAMD) score were measured before treatment and 4 weeks after treatment. At the same time observe the patient’s tolerance of adverse reactions. Results The VAS scores and HAMD scores of the observation group before and after treatment were significantly different (P <0.01). The VAS scores and Hamilton scale scores of the observation group were significantly better than those of the control group (P <0.01). No adverse reactions observed in both groups showed significant differences. Conclusions The combination of low-dose amitriptyline and gabapentin in the treatment of post-pruritus depression patients with maintenance hemodialysis uremia has obvious curative effect, which can reduce the dosage of drugs and improve the effectiveness of drugs with less adverse reactions, which is worthy of clinical application.