Reich Adam, Szepietowski Jacek C
Curr Probl Dermatol. 2016;50:29-34. doi: 10.1159/000446014. Epub 2016 Aug 23.
Measurement of itch intensity is essential to properly evaluate pruritic disease severity, to understand the patients' needs and burden, and especially to assess treatment efficacy, particularly in clinical trials. However, measurement of itch remains a challenge, as, per definition, it is a subjective sensation and assessment of this symptom represents significant difficulty. Intensity of itch must be considered in relation to its duration, localization, course of symptoms, presence and type of scratch lesions, response to antipruritic treatment, and quality of life impairment. Importantly, perception of itch may also be confounded by different cofactors including but not limited to patient general condition and other coexisting ailments. In the current chapter we characterize the major methods of itch assessments that are used in daily clinical life and as research tools. Different methods of itch assessment have been developed; however, so far none is without limitations and any data on itch intensity should always be interpreted with caution. Despite these limitations, it is strongly recommended to implement itch measurement tools in routine daily practice, as it would help in proper assessment of patient clinical status. In order to improve evaluation of itch in research studies, it is recommended to use at least two independent methods, as such an approach should increase the validity of achieved results.
瘙痒强度的测量对于正确评估瘙痒性疾病的严重程度、了解患者的需求和负担,尤其是评估治疗效果至关重要,在临床试验中更是如此。然而,瘙痒的测量仍然是一项挑战,因为根据定义,它是一种主观感觉,对这种症状的评估存在很大困难。瘙痒强度必须结合其持续时间、部位、症状过程、抓痕病变的存在和类型、对止痒治疗的反应以及生活质量受损情况来考虑。重要的是,瘙痒的感知也可能受到不同辅助因素的混淆,包括但不限于患者的一般状况和其他并存疾病。在本章中,我们将描述在日常生活和作为研究工具使用的主要瘙痒评估方法。已经开发出了不同的瘙痒评估方法;然而,到目前为止,没有一种方法是没有局限性的,任何关于瘙痒强度的数据都应始终谨慎解释。尽管有这些局限性,但强烈建议在日常临床实践中使用瘙痒测量工具,因为这将有助于正确评估患者的临床状况。为了在研究中改进对瘙痒的评估,建议至少使用两种独立的方法,因为这种方法应该会提高所获结果的有效性。