Efficacy of gabapentin combined with hemoperfusion in the treatment of moderate to severe restless legs syndrome in elderly patients undergoing maintenance hemodialysis
Objective To observe the efficacy of gabapentin combined with hemoperfusion in the treatment of moderate to severe restless legs syndrome(RLS)in elderly patients undergoing maintenance hemodialysis.Methods 40 elderly patients with maintenance hemodialysis complicated with moderate to severe RLS were randomly divided into an observation group and a control group,with 20 cases in each group.Both groups were treated with conventional hemodialysis twice a week,and hemodialysis combined with hemoperfusion once a week.The observation group took gabapentin orally every night.The scores of International Restless Leg Syndrome Rating Scale(IRLS),Pittsburgh Sleep Quality Index(PSQI),36-Item Short-Form Health Survey(SF-36)and laboratory examination indicators[intact parathyroidism hormone(iPTH)and β2-microglobulin(β2-MG)]before and after treatment.Results IRLS score of the control group was not improved after 1 week of treatment compared with that before treatment in this group(P>0.05).IRLS scores in the control group after 4 and 8 weeks of treatment were lower than those before treatment in this group,and the difference was statistically significant(P<0.05).After 1,4 and 8 weeks of treatment,IRLS scores in the observation group were lower than those before treatment in this group;IRLS scores in the observation group were(13.40±3.17),(6.40±2.46)and(4.60±0.84)points,which were lower than(20.10±5.55),(16.60±5.02)and(12.20±4.76)points in the control group;the difference was statistically significant(P<0.05).After treatment,PSQI scores in both groups decreased compared with those before treatment in this group,and the observation group had lower PSQI score of(5.20±1.75)points than(7.00±1.15)points in the control group.The difference was statistically significant(P<0.05).Before treatment,there was no significant difference between the two groups in the scores of physical functioning(PF),role-physical(RP),role-emotional(RE),social functioning(SF),bodily pain(BP),vitality(VT),mental health(MH),general health(GH)and health transition(HT)and total scores(P>0.05).After treatment,RE and VT scores and total scores in the control group were higher than those before treatment in this group,and the difference was statistically significant(P<0.05).RP,RE,SF,VT,MH,GH,HT scores and total scores in the observation group were higher than those before treatment in this group,and the difference was statistically significant(P<0.05).After treatment,the RE,SF,VT and MH scores and total scores in the observation group were(80.00±17.21),(50.00±10.21),(37.50±9.20),(80.80±7.25)and(528.90±33.01)points,which were higher than(60.00±21.08),(38.75±12.43),(29.00±7.38),(72.20±10.17)and(437.65±36.73)points in the control group.The difference was statistically significant(P<0.05).Before and after treatment,there was no significant difference in iPTH and β2-MG levels between and within the two groups(P>0.05).There were no adverse reactions in the control group after treatment.In the observation group,there were 2 cases of drowsiness and 1 case of dizziness occurred after 1 week of oral gabapentin treatment,and the symptoms were mild and tolerable.1 case showed drowsiness accompanied by weakness of both lower limbs and ataxia.Brain CT examination was performed to rule out cerebrovascular disease,gabapentine gradually decreased,and the patient's symptoms were relieved and treatment continued.After 4 weeks of treatment,1 patient in the observation group had drowsiness,dizziness and nausea after adjusting the dosage of gabapentin to 300 mg/time,q.d,and the symptoms were tolerable.Conclusion Gabapentin combined with hemoperfusion can quickly and effectively relieve the RLS symptoms in elderly patients undergoing maintenance hemodialysis,and improve their sleep and quality of life,and it is well tolerated.
Restless legs syndromeGabapentinHemoperfusionHemodialysisOld age
万方数据
维普
