Yang Qiu Ping, Chen Yuan Yuan, Li Zhenzhen, Xu Mingming
Endocrinology Ward, Shenzhen Traditional Chinese Medicine Hospital (The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine), Shenzhen, China.
Nursing Department, Shenzhen Traditional Chinese Medicine Hospital (The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine), Shenzhen, China.
Front Surg. 2022 Feb 15;9:842884. doi: 10.3389/fsurg.2022.842884. eCollection 2022.
To observe the main risk factors for pruritic skin evidence complicating type 2 diabetes mellitus (T2DM) and the effectiveness of interventions with comprehensive care measures.
Two hundred and twenty four patients with T2DM admitted to our hospital from June 2020 to November 2021 were selected and divided into Diabetic pruritus group (DP group, = 71) and T2DM group ( = 153) according to the patients' complications of pruritus. General information such as gender, age, body mass index (BMI), duration of illness, family history, treatment modalities, other comorbidities, underlying illnesses were collected from all patients. Fasting plasma glucose (FPG), renal function [Serum creatinine (Scr), urea nitrogen (BUN), uric acid (BUA)], lipid levels [total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)] were measured in all patients on day 2 after admission. Risk factors for pruritus complicating T2DM were identified by single multifactorial analysis. Meanwhile, patients in the DP group were divided into group A ( = 35) and group B ( = 36) using the random number table method. Group A adopted the conventional care mode and group B patients adopted the comprehensive care interventions to compare the care effects [visual analog score (VAS) before and after care, treatment efficiency, care satisfaction rate] of patients in groups A and B; the levels of pruritus mediator indicators [substance P,β-endorphin (β-EP) and γ-interferon (INF-γ)] before and after care.
Risk factors for pruritus in T2DM were age, duration of DM, combined Diabetic peripheral neuropathy (DPN), combined diabetic retinopathy (DR), combined diabetic kidney disease (DKD) and serum FPG levels ( <0.05). Satisfaction rate of nursing care, treatment efficiency, post-care improvement in VAS scores, serum substance P, β-EP and INF-γ levels and other mediators of pruritus were better in Group B with integrated nursing intervention than in group A with conventional care only ( < 0.05).
Pruritus in T2DM is associated with age, duration of DM, combined DPN, combined DR, combined DKD and FPG levels. Comprehensive care according to the above risk factors can effectively relieve patients' clinical symptoms and signs, improve the level of pruritus mediators and patient-care relationship.
观察2型糖尿病（T2DM）合并皮肤瘙痒的主要危险因素及综合护理措施干预的效果。
选取2020年6月至2021年11月我院收治的224例T2DM患者，根据是否合并瘙痒并发症分为糖尿病瘙痒组（DP组，n = 71）和T2DM组（n = 153）。收集所有患者的性别、年龄、体重指数（BMI）、病程、家族史、治疗方式、其他合并症、基础疾病等一般资料。所有患者入院后第2天测定空腹血糖（FPG）、肾功能[血清肌酐（Scr）、尿素氮（BUN）、尿酸（BUA）]、血脂水平[总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]。通过单因素多因素分析确定T2DM合并瘙痒的危险因素。同时，采用随机数字表法将DP组患者分为A组（n = 35）和B组（n = 36）。A组采用常规护理模式，B组患者采用综合护理干预，比较A、B两组患者的护理效果[护理前后视觉模拟评分（VAS）、治疗有效率、护理满意度]；护理前后瘙痒介质指标[P物质、β-内啡肽（β-EP）和γ-干扰素（INF-γ）]水平。
T2DM瘙痒的危险因素为年龄、糖尿病病程、合并糖尿病周围神经病变（DPN）、合并糖尿病视网膜病变（DR）、合并糖尿病肾病（DKD）及血清FPG水平（P < 0.05）。综合护理干预的B组在护理满意度、治疗有效率、护理后VAS评分改善、血清P物质、β-EP和INF-γ水平及其他瘙痒介质方面均优于仅采用常规护理的A组（P < 0.05）。
T2DM瘙痒与年龄、糖尿病病程、合并DPN、合并DR、合并DKD及FPG水平有关。根据上述危险因素进行综合护理可有效缓解患者的临床症状和体征，提高瘙痒介质水平及患者与护理的关系。
