Mansour-Ghanaei Fariborz, Taheri Amir, Froutan Hossein, Ghofrani Hadi, Nasiri-Toosi Mohsen, Bagherzadeh Amir-Hossein, Farahvash Mohammad-Jafar, Mirmomen Shahram, Ebrahimi-Dariani Naser, Farhangi Elham, Pourrasouli Zahra
Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Sardar-Jangle Ave, Razi Hospital, Rasht 41448 - 95655, Iran.
World J Gastroenterol. 2006 Feb 21;12(7):1125-8. doi: 10.3748/wjg.v12.i7.1125.
To determine the efficacy and potential complications of oral naltrexone used in the treatment of pruritus in cholestatic patients and to compare them with other studies.
Thirty-four enrolled cholestatic patients complaining of pruritus were studied. In the initial phase, pruritus scores during day and night were evaluated. Subsequently, patients were given a placebo for one week followed by naltrexone for one week. In each therapeutic course (placebo or naltrexone) day and night pruritus scores were distinguished by a visual analogue scale (VAS) system and recorded in patients' questionnaires.
Both naltrexone and placebo decreased VAS scores significantly. Naltrexone was more effective than placebo in decreasing VAS scores. Both day and night scores of pruritus decreased by half of the value prior to therapy in thirteen patients (38%). Daytime pruritus improved completely in two patients (5.9%), but no improvement in the nighttime values was observed in any patient. Sixteen patients (47%) suffered from naltrexone complications, eleven (32%) of them were related to its withdrawal. Complications were often mild. In the case of withdrawal, the complication was transient (within the first 24-28 h of therapy) and self-limited. We had to cease the drug in two cases (5.9%) because of severe withdrawal symptoms.
Naltrexone can be used in the treatment of pruritus in cholestatic patients and is a safe drug showing few, mild and self-limited complications.
确定口服纳曲酮治疗胆汁淤积性患者瘙痒症的疗效和潜在并发症，并与其他研究进行比较。
对34例纳入研究的胆汁淤积性瘙痒患者进行研究。在初始阶段，评估白天和夜间的瘙痒评分。随后，患者先服用一周安慰剂，接着服用一周纳曲酮。在每个治疗疗程（安慰剂或纳曲酮）中，通过视觉模拟量表（VAS）系统区分白天和夜间的瘙痒评分，并记录在患者问卷中。
纳曲酮和安慰剂均显著降低了VAS评分。纳曲酮在降低VAS评分方面比安慰剂更有效。13例患者（38%）白天和夜间的瘙痒评分均降至治疗前的一半。2例患者（5.9%）白天瘙痒完全改善，但夜间瘙痒评分在任何患者中均未改善。16例患者（47%）出现纳曲酮并发症，其中11例（32%）与停药有关。并发症通常较轻。在停药的情况下，并发症是短暂的（在治疗的最初24 - 28小时内）且为自限性。由于严重的停药症状，我们不得不在2例患者（5.9%）中停用该药物。
纳曲酮可用于治疗胆汁淤积性患者的瘙痒症，是一种安全的药物，并发症少、症状轻且为自限性。
