Gilchrest B A, Rowe J W, Brown R S, Steinman T I, Arndt K A
N Engl J Med. 1977 Jul 21;297(3):136-8. doi: 10.1056/NEJM197707212970304.
We studied the effect of ultraviolet-light phototherapy on severe persistent pruritus in 18 adult patients on hemodialysis. Patients were randomly assigned to one of two light sources. The experimental group received conventional sunburn-spectrum light in gradually increasing doses. The control group received time-matched exposures to long-wave ultraviolet light. All patients received eight exposures to the entire skin surface over a four-week treatment period. Nine of 10 patients in the sunburn-spectrum group reported marked decrease in pruritus as opposed to two of eight in the placebo group (P less than 0.01). of those responding to sunburn-spectrum light, improvement usually occurred two to three weeks into treatment. Mild sunburn, noted by some patients in this group, was the only side effect. The response to phototherapy was unaffected by the presence of secondary hyperparathyroidism. Ultraviolet phototherapy is a safe, convenient, inexpensive and effective treatment for uremic pruritus.
我们研究了紫外线光疗对18例成年血液透析患者严重持续性瘙痒的影响。患者被随机分配到两种光源之一。实验组接受剂量逐渐增加的传统晒伤光谱光照射。对照组接受与时间匹配的长波紫外线照射。在为期四周的治疗期间,所有患者均接受对整个皮肤表面进行八次照射。晒伤光谱组10例患者中有9例报告瘙痒明显减轻,而安慰剂组8例患者中只有2例有此效果(P小于0.01)。在对晒伤光谱光有反应的患者中,改善通常在治疗两到三周后出现。该组一些患者出现的轻度晒伤是唯一的副作用。光疗反应不受继发性甲状旁腺功能亢进症的影响。紫外线光疗是一种治疗尿毒症瘙痒安全、便捷、廉价且有效的方法。