抗组胺药物及其新药研究进展

组胺与组胺受体结合后引发以组胺为主的炎性介质释放,导致变态反应性疾病的发生.H1受体拮抗剂是抗组胺药物之一,可阻断组胺与Hl受体结合,从而抑制组胺发挥其生物学效应.Hl受体拮抗剂主要用于治疗由组胺释放诱发的变态反应性疾病.第一代抗组胺药作用时间短,有明显的镇静作用.第二代抗组胺药药效与第一代相近或强于第一代,作用时间长,无明显的中枢镇静作用,但有心脏毒性,故新药的研究成为热点.     

H1抗组胺药物研究进展

人体内组胺受体主要有H1、H2、H3和H4四种受体类型,组胺主要通过受体发挥生物学作用。目前H1抗组胺药物主要用于治疗荨麻疹及其他过敏性疾病,中枢神经系统疾病和前庭疾病。第一代H1抗组胺药物用于治疗过敏性疾病并无规范的研究,多数临床试验不符合当前随机双盲对照试验的标准。与之相比,第二代H1抗组胺药物均有大量充分的试验支持。临床上大部分H1抗组胺药物安全有效,但其中枢神经系统及心脏的不良反应不容忽视。     

正确认识皮炎湿疹

皮炎湿疹临床十分常见。由于对皮炎湿疹概念上的认识很难把握,有众多的学术观点至今仍在不断的争论中,因此给指导临床规范诊断和治疗带来很大的挑战。本文就皮炎湿疹分类、特应性涵义、病因诊断中的接触性变应原分析以及微生物皮损中定植等临床关注的问题进行粗浅的探讨。     

皮炎湿疹类皮肤病致病因素研究

皮炎湿疹类皮肤病是皮肤科的常见病、多发病,因其发病原因复杂,病因往往不易确定。为此,我们对皮炎湿疹类皮肤病患者进行了致病因素的初步研究,现报告如下。材料和方法病例来源　诊断为皮炎湿疹类皮肤病患者３２８例,　兰州医学院第二附属医院皮肤科,７３００３０男１０４例,女２２４例,年龄７～６８岁。其中接触性皮炎１６４例,湿疹１１９例,异位性皮炎（ＡＤ）４５例。所有患者在实验前２周及实验过程中,均无服用皮质类固醇激素及抗组胺药史。健康对照组１２０例,男４５例,女７５例,年龄２０～３８岁,无皮炎湿疹病史及其它…     

皮炎湿疹类疾病规范化诊断术语专家共识

【摘要】 针对皮炎湿疹类疾病在概念、分类和诊断术语等方面的混乱现状,中华医学会皮肤性病学分会免疫学组、中国医师协会皮肤科医师分会指南制定与规范委员会组织专家按照德尔菲法原则对皮炎湿疹类疾病的诊断现状及存在问题进行讨论,提出7条规范化诊断建议,主要包括：①“皮炎”和“湿疹” 是疾病的类别名称而非具体诊断术语;②临床遇到湿疹性皮损时,应积极寻找其临床特征和/或实验室特点,按照特应性皮炎、接触性皮炎和其他皮炎进行分类诊断;③建议暂时保留“湿疹”这一术语,并只用作以湿疹性皮损为表现但尚不能给出确定诊断的、暂时性和描述性诊断用词。本共识旨在推动皮炎湿疹类疾病诊断术语的规范化、同质化,为更好地进行疾病管理、流行病学研究和开展个体化治疗和预防奠定基础。     

冰黄肤乐软膏治疗小儿皮炎湿疹类疾病疗效观察

为观察冰黄肤乐软膏治疗小儿皮炎、湿疹类皮肤病的疗效、安全性及不良反应,我科于2005年8月—2006年1月用冰黄肤乐软膏治疗68例小儿皮炎、湿疹类皮肤病,并进行临床观察,现总结报告如下。1病例与方法1.1病例共选择皮炎、湿疹类患儿68例,男35例,女33例,平均年龄(3.34±3.20)岁,病程10d～10年。68例患儿中,亚急性湿疹11例,慢性湿疹19例,脂溢性皮炎25例,特应性皮炎13例。所有入选患儿在1个月内未系统使用、7d内未局部使用过糖皮质激素制剂。1.2方法1.2.1治疗方法每日早、晚局部各外用1次冰黄肤乐软膏,总疗程为2周。治疗期间停用其他外用制剂和口…     

艾洛松霜剂治疗皮炎湿疹类皮肤病疗效观察

我科于１９９７年１０月～１２月用美国先灵葆雅公司生产的艾洛松霜剂对６０例神经性皮炎、湿疹、异位性皮炎患者进行治疗，取得了良好的疗效，现将结果报告如下。１临床资料１．１病例选择：６０例患者，男３３例，女２７例，年龄最小１８岁，最大６５岁，平均３６岁。病...     

派瑞松霜治疗皮炎湿疹类疾病疗效观察

我们于2000年7月～2001年9月用派瑞松(西安杨森制药有限公司生产)治疗皮炎湿疹类疾病95例,取得了满意疗效。现将结果报告如下。     

重庆地区470例皮炎湿疹类疾病患者斑贴试验结果分析

目的了解重庆地区皮炎湿疹的常见变应原。方法收集我科门诊自2006年1～12月确诊的470例皮炎、湿疹类患者进行斑贴试验,记录试验结果并进行统计分析。结果470例患者中变应原呈阳性反应者381例(80.13%),主要致病因素为硫酸镍、香料、橡胶和对苯二胺。结论斑贴试验可帮助皮炎、湿疹患者明确病因,为预防和治疗该类疾病提供理论依据。     

经典代表方剂及经验方剂在湿疹皮炎类疾患中的临床运用体会

近年来,中医中药在国际上逐渐受到重视。中西医结合治疗皮肤病,已得到广大医患人员的认可。赵炳南和朱仁康老先生为我国北京地区著名中医皮科专家,在我国近代中医发展史上占有重要地位。本文将简要介绍湿疹、皮炎类皮肤病的临床表现、辨证施治原则、经典代表方剂及临床运用体会。     

Correlation of nipple eczema in pregnancy with atopic dermatitis in Northern India: a study of 100 cases

BackgroundNipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis.ObjectiveTo evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis.MethodsThis was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis.ResultsOut of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant.Study limitationsLack of long term follow-up and no large studies in literature to compare results.ConclusionNipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.     

Present status of eczema and its treatment

An overview of the salient developments in definition, classification, etiology and pathogenesis, and treatment of the eczemas in recent years is given. On the basis of the pathogenesis of allergic contact eczema and atopic dermatitis, possible future therapeutic approaches are discussed. The indispensability of the use of topical corticosteroids in eczema treatment at the present time, and the demand for preparations with high potency and absent or low systemic and local side effects is stressed.     

Morbidity and cost of atopic eczema in Australia

The severity, morbidity and financial costs of atopic eczema (AE) were assessed during a 1-year prospective study of a cohort of 85 people aged 14-63 years (mean 36 years) with the disease. A dermatologist examined each participant using the Six Area Six Sign Atopic Dermatitis severity scoring system to classify severity. Participants completed a Dermatology Life Quality Index (DLQI), a Nottingham Eczema Severity Score (NESS) and an ongoing diary of health-care consultations and treatment costs. Follow up by mail to each participant was conducted every 2 months and participants completed a NESS, a DLQI and a diary of costs incurred. The DLQI data revealed that 36% spent over 10 min per day applying treatments, 28% indicated that AE influenced the clothes they wore, 21% felt embarrassed by their skin and 15% reported problems with treatments. There appeared to be a relationship between increased morbidity and increased severity. The average annual out-of-pocket cost for products used for treatment was A$425, ranging from A$13.50 to over A$2000 per individual. The average out-of-pocket cost for medical consultations was A$120, ranging from zero to over A$800 per individual. Although there were concerns about the reproducibility of the severity and morbidity measures, the data showed that AE can have substantial effects both financially and from a personal perspective for those affected.     

活性氧簇在皮炎湿疹发病中的作用

活性氧簇是重要的氧的衍生物,氧化还原反应状态的平衡对维持机体的内环境起着重要的作用.皮肤是氧应激损害的主要靶器官,过多活性氧造成组织损伤,其主要通过影响核因子-κB、NO、蛋白激酶介导的磷酸化和基因异常表达发挥作用.多种炎症性皮肤疾病与活性氧簇相关,活性氧簇在皮炎、湿疹的发病中起着重要作用,抗氧化剂有望成为治疗这类疾病的新途径.     

New and developing therapies for atopic dermatitis

Atopic dermatitis is a common inflammatory skin disease. New understanding in disease pathogenesis has led to a considerable number of promising new drugs in development. New topical agents can be especially helpful for children, providing an alternative to the need for chronic topical corticosteroid use. While many patients with mild or moderate disease can be managed with topical treatments, there are unmet needs for recalcitrant and severe cases. New and developing therapies hold promise for real advances in management of this complex disease.     

过敏专科门诊3 051例湿疹皮炎患者血清特异性IgE检测结果分析

目的分析湿疹皮炎患者血清特异性IgE检测结果。方法回顾2021年4月1日至2022年3月31日于华山医院过敏专科门诊就诊的3 051例湿疹皮炎患者, 利用Phadia过敏原检测系统检测患者的血清特异性IgE水平, 计算各项过敏原的检测阳性率, 分析湿疹皮炎患者的常见吸入性过敏原和食物过敏原。计数资料组间比较采用χ2检验。结果 3 051例湿疹皮炎患者中, 特应性皮炎1 412例, 其他湿疹/皮炎1 639例。1 629例(53%)过敏原阳性, 阳性过敏原数为(3.0 ± 1.6)个。最常见的3种吸入性过敏原分别是粉尘螨(904/1 522例, 59%)、户尘螨(891/1 513例, 59%)和链格孢霉(206/1 068例, 19%);最常见的3种食物过敏原分别是虾(251/1 432例, 18%)、鸡蛋白(165/992例, 17%)和牛奶(149/994例, 15%)。3 051例中, 25例(1%)年龄< 2岁, 571例(19%)2 ～ 12岁, 285例(9%)12 ～ 18岁, 2 170例(71%) > 18岁。在< 2岁、2 ～ 12岁患者组中, 最...     

Bath psoralen-ultraviolet A therapy in atopic eczema

AIMS: To evaluate the efficacy of bath psoralen-ultraviolet A (PUVA) therapy in severe cases of atopic dermatitis (AD) in adults using the extended Six Area, Six Sign Atopic Dermatitis (SASSAD) score. METHODS: Thirty-five adult subjects with severe AD underwent bath PUVA therapy for a maximum of 30 sessions ranging from one to three times a week. The only other treatment allowed during the study was topical application of hydrocortisone. RESULTS: There were a total of six drop-outs, three due to aggravation of symptoms. After the maximum 30 sessions the remaining 29 subjects showed 82.1% improvement in the severity of lesions, 75.2% reduction in extension of lesions, 74% improvement in itching and 79% improvement in night-time rest. Patient evaluations gave an overall score of 8.8 on a scale of 0-10.     

Eczema workshops reduce severity of childhood atopic eczema

An intervention study was conducted to assess the effectiveness of a nurse-led eczema workshop in reducing the severity of atopic eczema in infants, children and adolescents. Ninety-nine new patients referred to the Dermatology Department of The Royal Children's Hospital in Melbourne, Australia, for the management of atopic eczema were randomized to receive care from an eczema workshop or a dermatologist-led clinic. Patients were followed-up 4 weeks after the intervention. The primary outcome was the severity of eczema as determined by scores obtained using the Scoring of Atopic Dermatitis (SCORAD) index at a 4-week follow-up visit. The secondary outcome was a comparison of treatments used in both clinics. At the 4-week review the mean improvement in SCORAD was significantly greater in those patients attending the eczema workshop than those attending the dermatologist-led clinic (−9.93, 95% confidence interval −14.57 to −5.29, P  < 0.001). Significantly more patients from the eczema workshop improved from moderate severity eczema at baseline to mild at review. There was greater adherence to eczema management in the eczema workshop compared with the dermatologist-led clinic. In this study, patients attending the eczema workshop had a greater improvement in eczema severity thanpatients attending a dermatologist-led clinic, supporting collaborative models of service provision.     

抗组胺药在特殊人群中的应用

抗组胺药物是皮肤科治疗过敏性疾病最常见的药物之一,在大部分人群中有着较好的疗效及耐受性。由于其适用范围广泛,安全性显得尤为重要。对于儿童、孕妇、哺乳期妇女、老年人以及肝、肾功能不全的过敏性疾病患者,应用抗组胺药时应充分考虑每一种药物的药效学、代谢特点以及药物之间的相互作用,权衡用药收益和可能带来的不良反应,选择相应的安全性高的抗组胺药物,或者通过减少常规用药剂量、延长用药间隔时间等方法使安全性达到最大。