Systemic pruritus is a common clinical manifestation in patients with obstructive jaundice. Although it is not a direct threat to the patient’s life, it is unbearable and seriously affects the patient’s quality of life. When itching is intense, the skin needs to be brushed with an iron brush or washed with hot water until the skin bleeds and feels painful and burning, and the itching is only temporarily relieved. Due to intense itching and constant scratching, secondary skin lesions such as scratches and blood scabs appear all over the body, and sometimes there can be eczema-like changes or pigmentation, and scratching of the skin secondary to bacterial infection.
Especially at night, because of the intense itching, it seriously affects the patient’s sleep and can cause dizziness, depression, loss of appetite and other symptoms of neurasthenia. Therefore, itchy skin due to obstructive jaundice has been a difficult clinical problem to be solved. The clinical use of different methods against anti-itch, now fresh aloe vera is used for the treatment of generalized skin itching, it has the effect of anti-itch and anti-bacterial to promote tissue recovery and growth, our department after 2 years of clinical research application of fresh aloe vera juice external application, anti-itch effect is remarkable, the results are reported as follows.
I. Subjects and methods
1. Subjects and grouping
From August 2006 to July 2008, 63 cases of generalized pruritus caused by obstructive jaundice were admitted to our department, of which 34 were male and 29 were female, with an average age of 48.7 years. At present, the conventional methods used clinically to treat generalized pruritus caused by obstructive jaundice are: oral treatment with anti-cholestatic amines, deoxycholic acid, etc., and topical application of anti-itch ground cream.
According to some U.S. drug research and other authorities have done in-depth research on the active ingredients of aloe vera, and have developed a series of mucilage, liquid, etc. applied to skin disorders. Now the test group was given fresh aloe vera to apply on the whole body skin, and the control group was given topical anti-itch cream according to the routine. Both were applied topically to stop itching.
2.Inclusion criteria
63 patients with generalized skin pruritus caused by obstructive jaundice, jaundice refers to all in the range of 288 to 402 mmol/L; skin pruritus degree score are in the range of 2 to 3; now randomly divided into test group and control group, the treatment time is 3 days.
3.Methods
Treatment method of the control group: patients with obstructive jaundice causing generalized pruritus of the skin were given antipruritic ground cream applied 3 times/24h for 3 days of treatment. Experimental group treatment method: patients with obstructive jaundice caused by generalized itchy skin were given fresh aloe vera applied 3 times/24h all over the body for 3 days of treatment.
4, fresh aloe vera applied whole body for the treatment of obstructive jaundice caused by pruritus of the skin care
(1)Cut an aloe vera leaf under the aloe vera plant, a fat and thick leaf should be selected, the epidermis torn off, and gently apply the aloe vera juice to the whole body, every once in a while, the aloe vera juice has good permeability.
(2)Prevent the surface of the aloe vera leaves from drying out should be taken as it is used to ensure that the aloe vera is fresh and free from pollution.
(3) Precautions in use: generally fresh aloe vera leaf juice for external use are relatively safe, but because aloe vera fresh leaf juice contains a certain amount of calcium oxalate and plant proteins, allergy test before use for allergic people. Before use, take a small piece (2cm×2cm) of aloe vera leaves and put it on the skin of the inner forearm of the upper limb. 15-20min later, observe whether the skin has redness, itchiness, rash and other allergic reactions, if there is no reaction, it can be applied, and no allergy was seen in this group.
5. Method of skin pruritus assessment
According to the degree of skin itching scoring criteria are as follows: no itching 0 points, mild itching 1 point, obvious itching makes people irritable 2 points, intense itching that affects sleep 3 points.
6.Evaluation index is effective
The itching was reduced to 0-1 point within three days, and the skin damage was significantly improved; invalid: the itching symptoms were not significantly improved or the clinical symptoms were aggravated within 3 days, and the score was ≥2 points.
II. Results
The effective rate of the test group was significantly higher than that of the control group (P<0.05). Table 1 Comparison of treatment efficiency between the two groups Note: χ2=3.9375, P<0.05.
III. Discussion
The cause of skin pruritus caused by obstructive jaundice: due to biliary obstruction causing an increase in bilirubin in the blood, some bilirubin bile salts in the blood stimulate skin sensory nerve endings and cause skin pruritus. Characteristics of itchy skin caused by obstructive jaundice: itchy type of generalized itching, recurrent, over time can affect the mood, so that people are badly stimulated, resulting in shallow sleep and even change the person’s character easy to irritability, constant scratching, which destroys the protective layer of the skin, can be secondary to infection to produce abscesses, folliculitis, dermatitis, etc.
The superior efficacy of fresh aloe vera applied externally to the whole body.
(1) Aloe vera contains about 30 kinds of ingredients, including a variety of aloe polysaccharides, a variety of vitamins, amino acids, fatty acids, sugar minerals, slow basal state enzymes, active enzymes, choline, etc.
(2) The juice contains Anthraquinonecomplex which has the obvious effect of disinfection and antiseptic to relieve itching, as well as the slow basal state enzymes of Aloe vera and angiotensin to jointly resist inflammation.
(3) aloe vera polysaccharide on the role of the nervous system: has a sedative and tranquilizing effect, can strengthen the inhibitory process of the cerebral cortex to weaken excitability, reduce smooth muscle spasm, used for insomnia, available for the treatment of obstructive jaundice caused by itching resulting in shallow sleep or insomnia.
(4) Aloe vera leaves are rich in mucilaginous liquid, this liquid has anti-ulcer, promote wound healing, stimulate cell growth and hemostatic effect, is also a natural moistening agent, aloe vera also contains aloe arbutin, can promote tissue repair, aloe vera contains choline helps tissue growth, can be used to treat skin breakage caused by scratching.
The use of fresh aloe vera to treat itchy skin caused by obstructive jaundice reduces the patient’s pain and economic burden while also reducing the labor intensity of caregivers and family members, and also avoids infection caused by scratching the skin.
Aloe vera is easy to apply to a large area all over the body, and the topical application method is relatively safe and simple to use. It is applied to the clinic to solve the pain for patients, and the low cost of aloe vera, natural products without side effects has clinical application significance.
The use of fresh aloe vera topical application of systemic pruritus caused by obstructive jaundice can significantly improve the pruritus symptoms and promote the healing of skin breaks, the therapeutic effect is obvious and has clinical practical value.