烧伤后瘙痒的机制和治疗研究进展

陈梦佳; 张元文

doi:10.3760/cma.j.cn501225-20221018-00457

烧伤后瘙痒的机制和治疗研究进展

doi: 10.3760/cma.j.cn501225-20221018-00457

陈梦佳¹,
张元文^2, ,

1.
解放军联勤保障部队第926医院神经内科，开远　　661600
2.
解放军联勤保障部队第926医院烧伤整形科，开远　　661600

基金项目:

国家自然科学基金地区科学基金项目 81860338

详细信息

通讯作者:
张元文，Email：xsjl926yy@163.com

计量
- 文章访问数: 351
- HTML全文浏览量: 79
- PDF下载量: 90
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-18
- 网络出版日期: 2023-07-19

Research advances on the mechanism and treatment of post-burn pruritus

Chen Mengjia¹,
Zhang Yuanwen^{2
, ,}

1.
Department of Neurology, No. 926 Hospital, Joint Logistics Support Force of PLA, Kaiyuan 661600, China
2.
Department of Burns and Plastic Surgery, No. 926 Hospital, Joint Logistics Support Force of PLA, Kaiyuan 661600, China

Funds:

Regional Science Foundation of National Natural Science Foundation of China 81860338

More Information

Corresponding author: Zhang Yuanwen, Email: xsjl926yy@163.com

摘要

摘要: 瘙痒是烧伤后的常见症状之一，严重影响着烧伤患者的创面愈合和生活质量，但其诊治常常被忽视。烧伤后瘙痒的病理生理机制尚未被阐明，目前认为主要由神经病源性因素导致；烧伤后瘙痒的标准评估方法和治疗方案尚未形成共识。该文就烧伤后瘙痒的病理生理机制、病情评估、治疗的相关研究进展进行综述。
- 烧伤 /
- 瘙痒症 /
- 机制 /
- 病情评估 /
- 治疗
Abstract: Pruritus is one of the common symptoms after burn injury, which seriously affects the wound healing and quality of life of burn patients, but its diagnosis and treatment are often neglected. The pathophysiological mechanism of post-burn pruritus has not been elucidated, and it is currently believed that post-burn pruritus is caused by the neuropathic factors. In addition, there is no consensus on the standard evaluation methods and treatment protocols for post-burn pruritus. This paper reviewed the research advances on the pathophysiological mechanism, disease evaluation, and treatment of post-burn pruritus.
- Burns /
- Pruritus /
- Mechanism /
- Disease evaluation /
- Treatment
所有作者均声明不存在利益冲突

HTML全文

参考文献(45)

[1]	NedelecB,LaSalleL.Postburn itch: a review of the literature[J].Wounds,2018,30(1):E118-E124.
[2]	ZuccaroJ,BuddD,KellyC,et al.Pruritus in the pediatric burn population[J].J Burn Care Res,2022,43(5):1175-1179.DOI: 10.1093/jbcr/irac006.
[3]	ChungBY,KimHB,JungMJ,et al.Post-burn pruritus[J].Int J Mol Sci,2020,21(11):3880. DOI: 10.3390/ijms21113880.
[4]	DalgardFJ,SvenssonÅ,HalvorsenJA,et al.Itch and mental health in dermatological patients across Europe: a cross-sectional study in 13 countries[J].J Invest Dermatol,2020,140(3):568-573.DOI: 10.1016/j.jid.2019.05.034.
[5]	AnzelcM,BurkhartCG.Pain and pruritus: a study of their similarities and differences[J].Int J Dermatol,2020,59(2):159-164.DOI: 10.1111/ijd.14678.
[6]	YosipovitchG,GreavesMW,SchmelzM.Itch[J].Lancet,2003,361(9358):690-694.DOI: 10.1016/S0140-6736(03)12570-6.
[7]	DongX,DongX.Peripheral and central mechanisms of itch[J].Neuron,2018,98(3):482-494.DOI: 10.1016/j.neuron.2018.03.023.
[8]	StänderS,YosipovitchG.Substance P and neurokinin 1 receptor are new targets for the treatment of chronic pruritus[J].Br J Dermatol,2019,181(5):932-938.DOI: 10.1111/bjd.18025.
[9]	ChoiYH,KimKM,KimHO,et al.Clinical and histological correlation in post-burn hypertrophic scar for pain and itching sensation[J].Ann Dermatol,2013,25(4):428-433.DOI: 10.5021/ad.2013.25.4.428.
[10]	NedelecB,CarrougherGJ.Pain and pruritus postburn injury[J].J Burn Care Res,2017,38(3):142-145.DOI: 10.1097/BCR.0000000000000534.
[11]	AmtmannD,McMullenK,KimJ,et al.Psychometric properties of the modified 5-D itch scale in a burn model system sample of people with burn injury[J].J Burn Care Res,2017,38(1):e402-e408.DOI: 10.1097/BCR.0000000000000404.
[12]	HaestC,CasaerMP,DaemsA,et al.Measurement of itching: validation of the Leuven Itch Scale[J].Burns,2011,37(6):939-950.DOI: 10.1016/j.burns.2011.04.007.
[13]	Van LoeyNE,HoflandHW,HendrickxH,et al.Validation of the burns itch questionnaire[J].Burns,2016,42(3):526-534.DOI: 10.1016/j.burns.2015.08.001.
[14]	BeecherSM,HillR,KearneyL,et al.The pruritus severity scale-a novel tool to assess itch in burns patients[J].Int J Burns Trauma,2021,11(3):156-162.
[15]	RichardsonC,UptonD,RipponM.Treatment for wound pruritus following burns[J].J Wound Care,2014,23(5):227-228, 230, 232-233.DOI: 10.12968/jowc.2014.23.5.227.
[16]	WisemanJ,WareRS,SimonsM,et al.Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: a randomized controlled trial[J].Clin Rehabil,2020,34(1):120-131.DOI: 10.1177/0269215519877516.
[17]	KopeckyEA,JacobsonS,BchMB,et al.Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: a pilot study[J].J Burn Care Rehabil,2001,22(3):235-242.DOI: 10.1097/00004630-200105000-00010.
[18]	McGovernC,QuasimT,PuxtyK,et al.Neuropathic agents in the management of pruritus in burn injuries: a systematic review and meta-analysis[J].Trauma Surg Acute Care Open,2021,6(1):e000810.DOI: 10.1136/tsaco-2021-000810.
[19]	BanerjeeS, McCormackS.Capsaicin for acute or chronic non-cancer pain: a review of clinical effectiveness, safety, and cost-effectiveness[M].Ottawa (ON):Canadian Agency for Drugs and Technologies in Health,2020.
[20]	MalewiczNM,RattrayZ,OeckS,et al.Topical capsaicin in poly(lactic-co-glycolic) acid (PLGA) nanoparticles decreases acute itch and heat pain[J].Int J Mol Sci,2022,23(9):5275.DOI: 10.3390/ijms23095275.
[21]	KwaK,LegemateCM,PijpeA,et al.Doxepin cream is not effective in reducing itch in burn scar patients: a multicenter triple-blind randomized clinical crossover trial[J].Burns,2020,46(2):340-346.DOI: 10.1016/j.burns.2019.11.006.
[22]	BrooksJP,MalicCC,JudkinsKC.Scratching the surface--managing the itch associated with burns: a review of current knowledge[J].Burns,2008,34(6):751-760.DOI: 10.1016/j.burns.2007.11.015.
[23]	LiL,LiuR,PengC,et al.Pharmacogenomics for the efficacy and side effects of antihistamines[J].Exp Dermatol,2022,31(7):993-1004.DOI: 10.1111/exd.14602.
[24]	KaulI,AminA,RosenbergM,et al.Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: a retrospective chart review[J].Burns,2018,44(2):414-422.DOI: 10.1016/j.burns.2017.07.018.
[25]	MendhamJE.Gabapentin for the treatment of itching produced by burns and wound healing in children: a pilot study[J].Burns,2004,30(8):851-853.DOI: 10.1016/j.burns.2004.05.009.
[26]	AhujaRB,GuptaGK.A four arm, double blind, randomized and placebo controlled study of pregabalin in the management of post-burn pruritus[J].Burns,2013,39(1):24-29.DOI: 10.1016/j.burns.2012.09.016.
[27]	李峥,张兵,李巍,等.加巴喷丁治疗深Ⅱ度烧伤后瘢痕瘙痒的临床效果[J].中华烧伤杂志,2015,31(3):177-180.DOI: 10.3760/cma.j.issn.1009-2587.2015.03.005.
[28]	EkelemC,JuhaszM,KheraP,et al.Utility of naltrexone treatment for chronic inflammatory dermatologic conditions: a systematic review[J].JAMA Dermatol,2019,155(2):229-236.DOI: 10.1001/jamadermatol.2018.4093.
[29]	LaSalleL,RachelskaG,NedelecB.Naltrexone for the management of post-burn pruritus: a preliminary report[J].Burns,2008,34(6):797-802.DOI: 10.1016/j.burns.2007.10.009.
[30]	JungSI,SeoCH,JangK,et al.Efficacy of naltrexone in the treatment of chronic refractory itching in burn patients: preliminary report of an open trial[J].J Burn Care Res,2009,30(2):257-260; discussion 261.DOI: 10.1097/BCR.0b013e318198a282.
[31]	KaurR,SinhaVR.Antidepressants as antipruritic agents: a review[J].Eur Neuropsychopharmacol,2018,28(3):341-352.DOI: 10.1016/j.euroneuro.2018.01.007.
[32]	WisemanJ,SimonsM,KimbleR,et al.Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: study protocol for a randomised controlled trial[J].Trials,2017,18(1):72.DOI: 10.1186/s13063-017-1820-z.
[33]	LiP,Li-TsangC,DengX,et al.The recovery of post-burn hypertrophic scar in a monitored pressure therapy intervention programme and the timing of intervention[J].Burns,2018,44(6):1451-1467.DOI: 10.1016/j.burns.2018.01.008.
[34]	JooSY,KimJB,ChoYS,et al.Effect of cold pack therapy for management of burn scar pruritus: a pilot study[J].Burns,2018,44(4):1005-1010.DOI: 10.1016/j.burns.2018.01.011.
[35]	AndersenHH,MelholtC,HilborgSD,et al.Antipruritic effect of cold-induced and transient receptor potential-agonist-induced counter-irritation on histaminergic itch in humans[J].Acta Derm Venereol,2017,97(1):63-67.DOI: 10.2340/00015555-2447.
[36]	JooSY,ChoYS,ChoSR,et al.Effects of pain Scrambler therapy for management of burn scar pruritus: a pilot study[J].Burns,2017,43(3):514-519.DOI: 10.1016/j.burns.2016.09.028.
[37]	党瑞,易南,石梦娜,等.超声波联合手法按摩治疗深度烧伤患者增生性瘢痕瘙痒的效果观察[J].中华烧伤杂志,2016,32(7):426-428.DOI: 10.3760/cma.j.issn.1009-2587.2016.07.009.
[38]	SamhanAF,AbdelhalimNM.Impacts of low-energy extracorporeal shockwave therapy on pain, pruritus, and health-related quality of life in patients with burn: a randomized placebo-controlled study[J].Burns,2019,45(5):1094-1101.DOI: 10.1016/j.burns.2019.02.007.
[39]	JooSY,ChoYS,SeoCH.The clinical utility of extracorporeal shock wave therapy for burn pruritus: a prospective, randomized, single-blind study[J].Burns,2018,44(3):612-619.DOI: 10.1016/j.burns.2017.09.014.
[40]	LvK,LiuH,XuH,et al.Ablative fractional CO2 laser surgery improving sleep quality, pain and pruritus in adult hypertrophic scar patients: a prospective cohort study[J/OL].Burns Trauma,2021,9:tkab023[2022-10-18].https://pubmed.ncbi.nlm.nih.gov/34322556/. DOI: 10.1093/burnst/tkab023.
[41]	张逸秋,董继英,王棽,等.窄谱强脉冲光联合点阵二氧化碳激光治疗增生性瘢痕瘙痒的临床效果[J].中华烧伤杂志,2018,34(9):608-614.DOI: 10.3760/cma.j.issn.1009-2587.2018.09.010.
[42]	GharibK,MostafaA,ElsayedA.Evaluation of botulinum toxin type A injection in the treatment of localized chronic pruritus[J].J Clin Aesthet Dermatol,2020,13(12):12-17.
[43]	AkhtarN,BrooksP.The use of botulinum toxin in the management of burns itching: preliminary results[J].Burns,2012,38(8):1119-1123.DOI: 10.1016/j.burns.2012.05.014.
[44]	ZhuangZ,LiY,WeiX.The safety and efficacy of intralesional triamcinolone acetonide for keloids and hypertrophic scars: a systematic review and meta-analysis[J].Burns,2021,47(5):987-998.DOI: 10.1016/j.burns.2021.02.013.
[45]	HuangSH,WuKW,LoJJ,et al.Synergic effect of botulinum toxin type A and triamcinolone alleviates scar pruritus by modulating epidermal hyperinnervation: a preliminary report[J].Aesthet Surg J,2021,41(11):NP1721-NP1731.DOI: 10.1093/asj/sjab105.