慢性肾脏病相关性瘙痒的非药物干预研究进展

Research Progress on Non-Drug Intervention of Chronic Kidney Disease-Associated Pruritus

摘要: 目的：综述慢性肾脏病相关性瘙痒(CKD-aP)在维持性血液透析患者中的流行病学特征、病理机制及非药物干预方法，以期为临床实践提供新参考。方法：通过检索与分析国内外相关文献，总结CKD-aP的流行病学特征、发病机制及现有非药物干预的研究进展。结果：CKD-aP在维持性血液透析患者中发病率高，严重影响患者的生活质量和心理健康。其机制涉及尿毒症毒素蓄积、周围神经病变、免疫调节异常及内源性阿片系统失衡等。在治疗方面，除药物治疗外，改变透析方式、中药药浴、局部治疗等非药物方法显示出一定疗效，且有助于减少药物相关不良反应。结论：非药物干预方法在CKD-aP管理中具有重要价值，可作为临床干预的有效补充，有助于改善患者症状并提升生活质量，值得进一步推广应用与研究。

Abstract: Objective: To review the epidemiological characteristics, pathophysiological mechanisms, and non-pharmacological interventions for chronic kidney disease-associated pruritus (CKD-aP) in patients undergoing maintenance hemodialysis, aiming to provide new references for clinical practice. Methods: Relevant domestic and international literature was retrieved and analyzed to summarize the epidemiological characteristics, pathogenesis, and current research progress on non-pharmacological interventions for CKD-aP. Results: CKD-aP exhibits high prevalence among maintenance hemodialysis patients, significantly impairing quality of life and mental health. Its pathogenesis involves uremic toxin accumulation, peripheral neuropathy, dysregulation of immune responses, and imbalance of the endogenous opioid system. Beyond pharmacological interventions, non-pharmacological approaches such as modified dialysis techniques, traditional Chinese medicine herbal baths, and topical therapies demonstrate therapeutic efficacy while reducing medication-related adverse events. Conclusion: Non-pharmacological interventions hold significant value in managing CKD-aP, serving as an effective adjunct to clinical interventions. They contribute to symptom improvement and enhanced quality of life, warranting further promotion, application, and research.