Chinese herbal bath therapy for the treatment of uremic pruritus: meta-analysis of randomized controlled trials

Xue, Wenxuan; Zhao, Yanhua; Yuan, Mengyun; Zhao, Zhiqiang

doi:10.1186/s12906-019-2513-9

BMC Complementary Medicine and Therapies

Table 1 Characteristics of randomized controlled trials of Chinese herbal bath therapy for HP

From: Chinese herbal bath therapy for the treatment of uremic pruritus: meta-analysis of randomized controlled trials

Source	Study setting (hospital/clinic)	Diagnostic criteria	Disease stage	Sample Size and Included Subject Age (Year)	Intervention (Regimen)	Control (Regimen)	Concomitant Treatments	Uremic Pruritus Measurement Tools
Du, 2009 [19]	hospital	Chinese diagnostic standard	CRF uraemia period	41 HD patients with UP CHBT: 45.7 Control: 44.9	CHBT+HD	CL + HD	Erythropoietin (skin-pop, 3000 IU each time, two or three times a w), treat acidosis, supplement iron, folic acid	Improvement of pruritus
Du et al., 2004 [20]	hospital	Chinese diagnostic standard	CRF uraemia period	29 HD patients with UP CHBT: 45 Control: 46	CHBT+HD	CL + HD	Erythropoietin (skin-pop, 2000 IU each time, two or three times a w), calcium carbonate (1.5 g per pill, 3 times a d), treat acidosis, supplement iron, folic acid	Improvement of pruritus
Gao and Ye, 2012 [21]	hospital	NKF	CKD Stage 5	41 HD patients with UP Mean: 53.9 ± 14.1	CHBT+HD	HP + HD	Medications (dose and frequency: n.r.): erythropoietin, calcium carbonate, calcitriol; healthy diet	DRKS
Guo et al., 2009 [22]	hospital	Chinese diagnostic standard	CRF uraemia period	45 HD patients with UP CHBT: 46.3 ± 12.8 Control: 44.6 ± 13.2	CHBT+HD	CL + HD	Control blood pressure, treat anaemia, maintain water electrolyte and acid-base balance, regulate calcium and phosphorus metabolism, healthy diet	Improvement of pruritus
Jia et al., 2012 [23]	hospital	NKF	CKD Stage 5	33 HD patients with UP CHBT: 52.9 Control: 53.2	CHBT+HD	HP + HD	Treat anaemia, maintain water electrolyte and acid-base balance, healthy diet	DRKS; Improvement of pruritus
Jia, Li and Fei, 2012 [24]	hospital	NKF	CKD Stage 5	30 HD patients with UP Mean: n.r.	CHBT+HD	CL + HD	treat anaemia, maintain water electrolyte and acid-base balance, healthy diet	Improvement of pruritus
Lan, 2017 [25]	hospital	NKF	CKD Stage 5	60 HD patients with UP CHBT: 47.32 ± 11.23 Control: 48.12 ± 10.73	CHBT+HD	CL + HD	Medications (dose and frequency: n.r.): Erythropoietin (skin-pop), calcium carbonate	Improvement of pruritus
Lin, 2014 [26]	hospital	NKF	CKD Stage 5	80 HD patients with UP CHBT: 51.4 ± 5.2 Control: 52.6 ± 3.1	CHBT+HP + HD	HP + HD	Maintain water electrolyte and acid-base balance, treat anaemia	Improvement of pruritus
Shen, 2014 [27]	hospital	NKF	CKD Stage 5	53 HD patients with UP	CHBT+HD	Cetirizine+CL + HD	n.r.	0–10 VAS
Wang et al., 2013 [28]	hospital	NKF	CKD Stage 5	54 HD patients with UP CHBT: 48.9 Control: 46.8	CHBT+HD	HD	maintain water electrolyte and acid-base balance, control blood pressure, diuresis, calcium supplement, anti-infection	100-mm VAS; Improvement of pruritus
Wen, 2007 [29]	hospital	Chinese diagnostic standard	CRF uraemia period	42 HD patients with UP CHBT: 48.2 Control: 48.6	CHBT+HD	CL + HD	Erythropoietin (skin-pop, 3000 IU each time, two or three times a w), treat acidosis, calcium supplement, supplement iron	Improvement of pruritus
Yao, 2015 [30]	hospital	NKF	CKD Stage 5	42 HD patients with UP Mean: 47.5 ± 20.2	CHBT+HD	CL + HD	Treat anaemia, maintain water electrolyte and acid-base balance, calcium supplement	Improvement of pruritus
Yu et al., 2017 [31]	hospital	NKF	CKD Stage 5	30 HD patients with UP Mean: 57.43 ± 10.23	CHBT+HD	CHWB+HD	Control blood pressure and blood sugar, treat anaemia, regulate calcium and phosphorus metabolism	DRKS
Zhang et al., 2014 [32]	hospital	NKF	CKD Stage 5	100 HD patients with UP CHBT: 46 Control: 45	CHBT+HD	CL + HD	Treat anaemia, maintain water electrolyte and acid-base balance, calcium supplement	Improvement of pruritus
Zhang et al., 2012 [33]	hospital	Chinese diagnostic standard	CRF uraemia period	156 HD patients with UP CHBT: 46 Control: 44	CHBT+HD	HD	Erythropoietin (skin-pop, 4000 IU each time, two times a w), calcium carbonate (1.0 g per pill, 3 times a d), supplement iron, folic acid	DRKS; Improvement of pruritus
Zhao, 2011 [34]	hospital	NKF	CKD Stage 5	24 HD patients with UP CHBT: 42.77 ± 13.19 Control: 49.27 ± 9.72	CHBT+HD	Sham CHBT+HD	Treat anaemia and control blood pressure Medications: including haemopoietin, iron, folic acid, calcium channel blockers, ACE inhibitor, angiotensin receptor inhibitor.	10-cm VAS
Zheng, 2016 [35]	hospital	NKF	CKD Stage 5	42 HD patients with UP CHBT: 47.5 ± 20.2 Control: 47.7 ± 20.5	CHBT+HD	HD	Treat anaemia, take calcium and vitamin D supplements, control blood pressure, blood sugar, healthy diet	DRKS

VAS visual analogue scale, ACE inhibitor angiotensin converting enzyme inhibitor, w weeks, d days, n.r. not reported, CHWB Clean hot water bath, CL calamine lotion (an external Chinese medicine for relieving itching. The main ingredients are calamine, zinc oxide and glycerine)
Diagnostic criteria:
(i) NKF: National Kidney Foundation. CKD Stage 5 is described as follows: established kidney failure (GFR < 15 ml/min/1.73 m²), permanent renal replacement therapy, or end-stage kidney disease
(ii) Chinese diagnostic standard: This is described in the second edition of Nephrology, edited by Haiyan Wang. CRF (uraemia period) is described as follows: Scr > 707 μmol/L, BUN> 28.6 mmol/L, accompanied by metabolic acidosis, renal anaemia and other corresponding clinical symptoms
Outcome definition and measurement:
(i) The improvement of pruritus assessment comprises four levels: “cured” (pruritus disappeared or almost disappeared); “significantly improved” (pruritus improved significantly); “improved” (pruritus is relieved); and “not cured” (pruritus did not decrease or even worsened). Total effectiveness rate (%) is determined as the quotient of the number of cured, significantly improved and improved patients divided by the total number of the patients
(ii) DRKS, Dirk R Kuypers score. Main points: (a) relieving the effect of scratching on pruritus: 1-5points (b) pruritic range: 1-3points (c) frequency of itching: 1–5 points (d) disturbed sleep at night due to itching: 2–14 points. The first three items (a, b, c) are evaluated twice a day, once in the morning and once in the afternoon. Twenty-four-hour maximum score: 40 points. Higher scores indicate worse outcomes

Back to article page

ISSN: 2662-7671

Contact us

Submission enquiries: bmccomplementarymedicineandtherapies@biomedcentral.com
General enquiries: ORSupport@springernature.com