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Register a new userGabapentin and uremic pruritus in hemodialysis patients
تأثير العلاج بالغابابنتين(GABAPENTIN) في علاج الحكة لدى المرضى الخاضعين للتحال الدموي في مشفى الأسد الجامعي
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فوز حسن( باحث )
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تعد الحكة من أكثر الأعراض إزعاجاً للمرضى المصابين بالداء الكلوي الانتهائي، وهي تصيب 60% من المرضى الخاضعين للتحال الدموي يهدف البحث إلى تحديد فعالية الغابابنتين بجرعة 200 مغ مرتين بالأسبوع ( في نهاية كل جلسة تحال) لدى المرضى الذين يعانون من الحكة والخاضعين للتحال الدموي. أُدرج في البحث المرضى الذين أعمارهم فوق 18 سنة والخاضعون للتحال الدموي منذ أكثر من ثلاثة أشهر، ويعانون من الحكة اليوريميائية، وذلك بعد إيقاف كل العلاجات الخاصة بعلاج الحكة لديهم لمدة أسبوع على الأقل. الدراسة هي تجربة علاجية مزدوجة التعمية تم إعطاء الغابابنتين 200 مغ مرتين بالأسبوع لمدة أربع أسابيع، ثم نافذة علاجية (إيقاف العلاج ) لمدة أسبوع، ومن ثمّ خضع المرضى للعلاج بالدواء الشاهد، ودوماً بطريقة عمياء، تم الكشف عن الدوائين في نهاية العلاج وبعد إجراء الدراسة الإحصائية من قبل اختصاصي في الإحصاء ( أ. د. رافع شعبان- كلية الطب). تم تقييم الحكة بعيار (VAS). أثبتت هذه الدراسة المصغرة وجود تأثير إيجابي وفعّال للعلاج بالغابابنتين بجرعة 200مغ مرتين بالأسبوع في نهاية جلسة التحال الدموي، على الحكة اليوريميائية، مقارنةً بالدواء الشاهد( Loratadine)
Uremic Pruritus is one of the most common and frustrating symptom experience by patients with end-stage renal disease. Approximately 60% of dialysis patients experience pruritis, sometimes worse during the dialysis session. The aim of this study was to determine the effect of gabapentin, 200 mg twice a week (after each hemodialysis session), on uremic pruritus. Patients older than 18 years who have undergone hemodialysis for more than three months will be enrolled in this double-blind clinical trial. The patients will be assigned to receive Gabapentin 200 mg following hemodialysis ( twice a week) for a period of four weeks, and after a washout week, they will receive the antihistamines for another four weeks. The patients will be asked to evaluate the severity of their pruritus using a visual analogue scale (VAS). Our results assured the efficacy of Gabapentin in the treatment of uremic pruritus, in comparison with Loratadine.
References used
Scheinfeld N. The role of gabapentin in treating diseases with cutaneous manifestations and pain. Int J Dermatol 2003;42:491-5.Bueller HA, Bernhard JD, Dubroff LM. Gabapentin treatment for brachioradial pruritus. J Eur Acad Dermatol Venereol 1999;13:227-8
Schwartz IF, Iaina A. Uraemic pruritus. Nephrol Dial Transplant 1999;14:834-9
Mettang T, Pauli-Magnus C, Alscher DM. Uraemic pruritus: new perspectives and insights from recent trials. Nephrol Dial Transplant 2002;17:558-63
Gunal AI, Ozalp G, Yoldas TK, Gunal SY, Kirciman E, Celiker H. Gabapentin therapy for pruritus in haemodialysis patients: a randomized, placebo-controlled, doubleblind trial. Nephrol Dial Transplant 2004
Naini AE, Gabapentin: a promising drug for the treatment of uremic pruritus. Saudi J Kidney Dis Transpl. 2007 Sep;18(3):378-81
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