卡介菌多糖核酸联合氯雷他定治疗慢性荨麻疹96例

目的：观察卡介菌多糖核酸注射液联合氯雷他定治疗慢性荨麻疹的疗效。方法：将96例慢性荨麻疹患者随机分为两组，治疗组每次给予卡介菌多糖核酸注射液0.5mg，im，隔日1次，18次为1疗程，同时给予氯雷他定10mg，qd，po；对照组仅给予氯雷他定口服，剂量及疗程同治疗组。根据患者的瘙痒程度、风团数量及大小等进行临床疗效评价。结果：治疗组总有效率90.4％，痊愈率59.6％，对照组分别为65．9％和34.1％。结论：卡介菌多糖核酸联合氢雷他定治疗惺性荨麻疹取得今人满意的疗效．     

Efficacy and safety of loratadine plus pseudoephedrine in patients with seasonal allergic rhinitis and mild asthma

Background: Antihistamines have been shown to have a variety of therapeutic effects in asthma. Although nasal obstruction may play an important role in modulating lower airway function, no prior trial has used a decongestant in combination with an antihistamine in patients with allergic rhinitis and concomitant asthma.Objective: We sought to determine the efficacy and safety of loratadine (5 mg) plus pseudoephedrine (120 mg) (L/P) twice daily in patients with seasonal allergic rhinitis and mild asthma.Methods: We conducted a randomized, double-blind, placebo-controlled trial of L/P in 193 subjects during the fall allergy season. Nasal and chest symptoms, albuterol use, and peak expiratory flow rates were recorded daily for 6 weeks. Spirometry was measured at baseline and after 1, 2, 4, and 6 weeks of therapy, and health-related quality of life was rated at the beginning and end of the study.Results: Total rhinitis and asthma symptom severity scores were significantly reduced in patients receiving active therapy compared with those receiving placebo throughout the 6-week study. Peak expiratory flow rates improved significantly in patients treated with L/P during weeks 2 through 6 (peak effect [mean ± SEM]: L/P, 26.23 ± 4.64 L/min vs placebo, 8.52 ± 3.53 L/min, p = 0.002) as did FEV₁ (peak effect [mean ± SEM]: L/P, 170 ± 53 ml vs placebo, 20 ± 40 ml, p = 0.01) at all clinic visits. In addition, select measures of asthma-specific quality of life improved significantly relative to placebo.Conclusions: L/P significantly improved nasal and asthma symptoms, pulmonary function, and quality of life in patients with seasonal allergic rhinitis and concomitant mild asthma. (J Allergy Clin Immunol 1997;100:781-8)     

吸入布地奈德联用氯雷他定对支气管哮喘并变应性鼻炎的防治作用

目的观察低剂量吸入布地奈德的基础上联用氯雷他定对支气管哮喘并变应性鼻炎的防治作用。方法采用随机、双盲、安慰剂对照方法，50例轻中度哮喘伴变应性鼻炎患者分为氯他定组（25例）和对照组（25例）进行3个月的治疗，观察吸入布地奈德200μg（每天两次）并联合应用开瑞坦（氯雷他定）10mg或安慰剂（每天一次）。记录哮喘者症状的评分、鼻炎发作天数、感冒次数，按需吸入B：激动剂的次数和气道反应性的变化。结果对照组治疗前、后每周哮喘症状记分为（4．4±0．6）分、（3．0±0．5）分，氯雷他定组为（4．5±0．7）分、（2．2±0．6）分，两组比较有显著性差异（P〈0．01）；两组患者鼻炎发作天数治疗前、后分别为（4．9±1．0）d、（4．4±1．3）d；（5．1±1．0）d、（2．9±1．4）d，两组比较有显著性差异（P〈0．01）；对照组患者每月感冒样症状的发生次数为（1．3±0．4）次，氯雷他定组为（0．7±0．3）次，两组比较有显著性差异（P〈0．01）；按吸入的β2激动剂的平均次数减少（P〈0．01）；治疗后气道反应改善明显（P〈0．05）。结论在低剂量吸入布地奈德的基础上联用氯雷他定可显著提高变应性鼻炎并哮喘的疗效。     

LC-MS法测定人血浆中氯雷他定浓度

目的:建立以液-质联用法测定人血浆中氯雷他定的方法。方法:血浆样品中加入内标地西泮,用液相萃取法处理后测定,色谱柱为AgilentTC-C18,流动相为乙腈(含1%甲酸)-0.02mol·L-1甲酸铵水溶液(90∶10),流速为0.8mL·min-1,柱温为40℃。通过电喷雾电离源(ESI),质谱在正离子多反应监测模式(MRM)下行特征母-子离子对信号采集,以m/z383.2→337.0(氯雷他定)和m/z285.1→154.0(地西泮)进行定量分析。结果:氯雷他定检测浓度在0.5~100μg·L-1范围内线性关系良好(r=0.9960),定量下限为0.5μg·L-1;提取回收率在61.15%~67.11%之间,日内、日间RSD均≤16.54%。结论:本方法简便、灵敏,适用于人体内氯雷他定血药浓度测定及临床药动学研究。     

止痒外洗方联合氯雷他定治疗维持性血液透析患者皮肤瘙痒的疗效研究

目的 探讨止痒外洗方联合氯雷他定治疗维持性血液透析（MHD）患者皮肤瘙痒的疗效及安全 性。方法 选取2013 年6 月-2015 年12 月青海省人民医院收治的156 例合并皮肤瘙痒的MHD 患者为研究 对象。MHD 持续时间≥ 3 个月,2 ～ 3 次/ 周,且符合顽固性皮肤瘙痒的诊断标准。排除合并严重的心、肺、 肾等脏器疾病以及恶性肿瘤、皮肤疾病或其他导致皮肤瘙痒的代谢性疾病等。随机分为观察组和对照组,两 组各78 例,对照组患者给予氯雷他定,观察组给予止痒外洗方联合氯雷他定。比较两组治疗前后的视觉模拟 评分（VAS）评分、改良Duo 评分、匹兹堡睡眠质量指数问卷（PSQI）总分。结果 两组治疗前的基线资料、 VAS 评分、改良Duo 评分、PSQI 总分比较,差异无统计学意义（P >0.05）。观察组治疗后6 周的VAS 评分、 改良Duo 评分、PSQI 总分均低于同期的对照组（P <0.05）。在治疗期间,全部患者均未发生不良反应。结论 止痒外洗方联合氯雷他定能显著缓解MHD 患者的皮肤瘙痒症状,提高其睡眠质量,安全可靠,值得临床推广 应用。     

孟鲁司特联合氯雷他定对小儿咳嗽变异型哮喘血清干扰素γ和白细胞介素4的影响

目的 研究小儿咳嗽变异型哮喘应用孟鲁司特联合氯雷他定治疗时血清干扰素γ(IFN-γ)和白细胞介素4(IL-4)水平的变化.方法 收集46例确诊为咳嗽变异型哮喘患儿,予孟鲁司特联合氯雷他定治疗8周,比较治疗前后血清IFN-γ和IL-4水平的变化.结果 46例患儿治疗前后血清IFN-γ水平分别为(59.94±9.43)、(39.94±9.07) ng/L,IL-4水平分别为(48.78±22.23)、(60.78±16.48) ng/L.治疗前后两种细胞因子水平比较差异均有统计学意义(P＜0.05).结论 孟鲁司特联合氯雷他定治疗小儿咳嗽变异型哮喘,能够调节IFN-γ、IL-4水平失衡,值得进一步研究.     

孟鲁司特联合氯雷他定治疗儿童咳嗽变异性哮喘的临床疗效观察

目的 观察孟鲁司特联合氯雷他定治疗儿童咳嗽变异性哮喘的临床疗效.方法 对照组32例给予硫酸特布他林加酮替芬口服.治疗组32例给予孟鲁司特联合氯雷他定口服.2组总疗程达8周后停药,停药随访6个月,观察复发情况.结果 治疗组疗效明显优于对照组,差异有显著性(P<0.05),有显著的临床意义.结论 孟鲁司特联合氯雷他定治疗儿童咳嗽变异性哮喘临床疗效好、安全、高效、副作用少,值得临床应用.     

HPLC法同时测定氯雷他定糖浆中氯雷他定和苯甲酸钠的含量

目的采用高效液相色谱法同时测定氯雷他定糖浆中氯雷他定和苯甲酸钠的含量。方法采用Agilent Zorbax Eclipse XDB-pheny(4.6 mm×150 mm,3.5μm)色谱柱,以甲醇-乙腈-0.05 mol·L-1磷酸二氢钾溶液(用磷酸调节pH值至3.5)(15∶10∶75)为流动相;流速:1 mL·min-1,检测波长:254 nm,柱温:30℃。结果氯雷他定在40.18¹40.62μg·mL-1范围内线性关系良好(r=0.999 9),苯甲酸钠在39.94140.62μg·mL-1范围内线性关系良好(r=0.999 9),苯甲酸钠在39.94¹39.78μg·mL-1范围内线性关系良好(r=0.999 9),平均回收率分别为100.05%(RSD=0.52%,n=6)、100.18%(RSD=0.36%,n=6)。结论本方法简便、快速、准确,重复性好,可用于氯雷他定糖浆中氯雷他定和苯甲酸钠的含量测定。     

Stability indicating methods for the determination of loratadine in the presence of its degradation product

Four stability-indicating procedures have been suggested for determination of the non sedating antihistaminic agent loratadine. Loratadine being an ester undergoes alkaline hydrolysis and the corresponding acid derivative is produced as a degradation product. Its identity was confirmed using IR and MS. The first procedure is based on determination of loratadine by HPLC with detection at wavelength, 250 nm. Mobile phase is acetonitrile:orthophosphoric acid (35:65) using benzophenone as an internal standard. Sensitivity range is 5.00–50.00 μg/ml. Second determination is a densitometric procedure based on determination of loratadine in the presence of its degradate at λ 246 nm using the mobile phase; methanol:ammonia (10:0.15). Sensitivity range is 1.25–7.50 μg per spot. The third procedure is a spectrophotometric one where a mixture of loratadine and its degradate are resolved by first derivative ratio spectra. Sensitivity range is found to be 3.00–22.00 μg/ml, upon carrying out the measurements at wavelengths 236, 262.4 and 293.2 nm. The fourth procedure is based on second derivative spectrophotometry, where D₂ measurements are carried out at λ 266 nm. The sensitivity range is 3.00–22.00 μg/ml. The validity of the described procedures was assessed by applying the standard addition technique. Statistical analysis of the results have been carried out revealing high accuracy and good precision. The suggested procedures could be used for determination of loratadine both in pure and dosage forms, as well as in the presence of its degradate.     

地洛他定和氯雷他定治疗慢性特发性荨麻疹多中心双盲对照临床试验

目的　观察地洛他定治疗慢性特发性荨麻疹效果及安全性。方法　采用多中心、双盲、双模拟阳性对照研究 ,随机分为试验组和对照组。地洛他定 5mg/次 ,氯雷他定 10mg/次 ,均 1次 /d ,连续服用 2 8天 ,分别于用药后第 1、2、4周随访 ,观察疗效和不良反应。结果　入组例数 2 17例 ,可评价疗效及安全性例数分别为 2 11例和 2 12例。试验组和对照组服药后第 1周疗效分别为 2 3 .81%和 3 2 .0 8% ,第 2周分别为 62 .86%和 5 9.43 % ,第 4周疗效分别为 88.78%和83 .0 2 %。两组不良反应发生率分别为 11.3 2 %和 13 .2 1% ,主要有口干、嗜睡、头痛等。结论　地洛他定治疗慢性特发性荨麻疹安全有效。