简介:AbstractChronic pruritus is a very common clinical symptom that seriously affects people’s quality of life. Pruritus is associated not only with skin diseases but also with a variety of systemic diseases. It brings great challenges to clinical management. To standardize the management of chronic pruritus, experts of the Allergic Disease Committee of Chinese Dermatologist Association discussed many times and finally formed this guideline to provide reference and guidance for the clinical work of dermatologists and other physicians at all levels.
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简介:ObjectiveThisreviewaimedtosystematicallysummarizeandcriticallyevaluatetheclinicalevidencefororagainsttheeffectivenessofacupunctureasasymptomatictherapyforuremicpruritus(UP)inend-stagerenaldisease(ESRD)patients.Materialsandmethod:Wesearched16electronicdatabasesfromtheirinceptionstoNovember2009.Allprospectiveclinicalstudiesofneedleacupunctureforuremicpruritusinhemodialysispatientswithend-stagerenaldiseasewereincludedregardlessoftheirdesign.RiskofbiasoftheincludedstudieswereassessedusingtheCochranecriteria.ResultsOf464initiallylocatedarticles,458studieswereexcluded.Threerandomizedcontrolledtrials(RCTs),onenon-randomizedcontrolledtrial(CCT)andtwouncontrolledobservationalstudieswereincluded.InthreeRCTs,acupuncturewascomparedtosham-acupuncture(n=1),oralantihistamineplustopicalointment(n=1)andoralcalcitriol(n=1).InoneCCT,electroacupuncture(EA)wascomparedtosuperficialelectricalstimulation.Intwoobservationalstudies,EA(n=1)ormanualacupuncture(n=1)wereemployed.Fourof6includedstudiesmentionedmildornooccurrenceofadverseevents.Allofincludedtrialsreportedbeneficialeffectsofacupuncture.However,mostofthestudiesshowedhighriskofbias,whichleavetheirreportsunconvincing.ConclusionThecurrentevidenceisinsufficienttoshowthatacupunctureisaneffectivetreatmentforuremicpruritusinpatientswithend-stagerenaldiseaseduetosuboptimalqualityandlackofmethodologicalrigorofincludedstudies.Futuretrialsshouldovercomethelimitationsofthecurrentlyavailableevidence.