玉屏风散加味联合抗组胺药治疗慢性荨麻疹疗效与安全性Meta分析

目的： 评价玉屏风散联合抗组胺药治疗慢性荨麻疹的临床疗效及 安全性。方法： 检索中国知网、万方、维普、PubMed、EMbase 及 Cochrane library 等数据库建库至2017年11月期间发表的使用玉屏风散加味联合抗组胺药治疗慢性荨麻疹的随机对照试验（RCTs）。由两名研究者独立筛选文献并提取数据,根据Cochrane 偏倚风险评估工具对纳入研究进行方法学质量评估,用Rev Man 5.3软件进行Meta分析。结果：共纳入15篇文献, 133 6例患者。Meta分析结果显示,玉屏风散联合抗组胺药组与单用抗组胺药组比较,有效率高（P<0.00001）,复发率低（P<0.00001）,不良反应发生率低（P=0.003）。结论：玉屏风散加味联合抗组胺药治疗慢性荨麻疹疗效优于单用抗组胺药,且更安全。     

抗组胺药联合转移因子治疗慢性荨麻疹疗效观察

目的　观察抗组胺药联合转移因子治疗慢性荨麻疹的疗效。方法　分别采用组胺H1和H2 受体拮抗剂、转移因子及三者联合治疗。结果　抗组胺药组与转移因子组疗效相近 (P >0 .0 5 ) ,联合治疗组疗效与其它两组相比 ,疗效有极其显著性差异 (P <0 .0 1)。结论　联合治疗组治疗慢性荨麻疹疗效显著。     

六种新型抗组胺药治疗慢性荨麻疹的疗效比较

1　临床资料　均为门诊病例,共180例,其中男118例,女62例;年龄20～40岁者98例,占54%;病程3个月～1年者102例,占57%;经过各种方法无效者117例,占65%。2　治疗方法　随机分为六组:Ⅰ组:息斯敏片剂,口服,10ｍｇ/次,2次/日;Ⅱ组:比斯妥片剂,口服,60ｍｇ/次,2次/日;Ⅲ组:仙特敏片剂,口服,10ｍｇ/次,1次/日,晚上服用;Ⅳ组:克敏能片剂,口服10ｍｇ/次,1次/日;Ⅴ组:玻丽玛朗片剂,口服,5ｍｇ/次,2次/日;Ⅵ赛庚啶片剂,2ｍｇ/次,3次/日。以上六组均服用1个月,3个月后复查。3　疗效结果及副作用结果见表Ⅰ。表Ⅰ六种抗组胺药物疗效比较组　别例数平均有效…     

关注抗组胺药治疗慢性荨麻疹应用的策略

抗组胺药通过拮抗H1受体来阻断组胺与受体的结合,从而影响变态反应发生的过程,是治疗慢性荨麻疹的基本药物。最新研究表明,抗组胺药还可通过其他机制发挥更广泛的药理作用。本文就目前临床抗组胺药物选择及使用的策略进行探讨。     

从抗组胺药的作用机制谈其治疗慢性荨麻疹的应用策略

抗组胺药物通常通过拮抗H1受体来阻断组胺与受体结合,从而影响变态反应发生的过程.近年来研究发现,抗组胺药可以通过H1受体依赖和非依赖途径起更广泛的抗炎作用,并可以成为反激动剂在组胺缺乏的情况下实施对组胺受体活性的抑制.这些机制促进抗组胺药临床治疗慢性荨麻疹产生新的理念.     

粉尘螨脱敏注射液与抗组胺药联合治疗慢性荨麻疹疗效观察

目的研究粉尘螨脱敏与抗组胺药物联合治疗粉尘螨点刺试验阳性的慢性特发性荨麻疹临床疗效。方法变应原皮肤点刺试验粉尘螨阳性的慢性特发性荨麻疹患者96例,治疗组51例,对照组45例,两组同时服用地氯雷他定5mg,1次/d,西咪替丁0.2g,3次/d,连服4周,其中治疗组同时采用粉尘螨脱敏治疗20周。结果治疗4周时,两组症状、体征均较治疗前明显好转,治疗组有效率为90.2%,对照组有效率为80.0%,两组比较差异无显著性意义(P>0.05);停服药物1周后,治疗组痊愈患者的复发率为38.89%,对照组基本痊愈患者复发率为71.43%,两组比较差异有显著性意义(P<0.01);治疗组脱敏治疗20周,基本痊愈率和有效率分别为56.86%和72.55%。两组均未发现严重不良反应。结论采用抗组胺药联合粉尘螨脱敏是治疗粉尘螨阳性的慢性特发性荨麻疹安全、有效的方法,且远期疗效满意。     

三种抗组胺药联合复方甘草酸苷治疗慢性荨麻疹54例疗效分析

目的:比较观察三种抗组胺药物联合复方甘草酸苷治疗慢性荨麻疹的疗效.方法:共选用门诊慢性荨麻疹100例,其中治疗组54例,对照组46例,治疗组采用左西替利嗪、脑益嗪、雷尼替丁、复方甘草酸苷治疗,对照组采用前三种药物治疗,于治疗2周及4周时进行疗效评价.结果:治疗2周时总有效率治疗组为75.9%,对照组60.9%,两组差异无统计学意义(χ2=2.63,P＞0.05);治疗4周时总有效率治疗组为92.6%,对照组为67.4%,两组差异有统计学意义(χ2=4.5,P＜0.05).两组治疗过程中未见明显不良反应.结论:应用复方甘草酸苷联合抗组胺药物治疗慢性荨麻疹4周时疗效确切、安全.     

卡介菌多糖核酸联合抗组胺药治疗慢性荨麻疹疗效观察

2004年2月-2005年10月，笔者采用免疫调节剂卡介菌多糖核酸联合抗组胺药H1、H2受体拮抗剂左西替利嗪、雷尼替丁治疗慢性荨麻疹180例，疗效显著。并与单用卡介菌多糖核酸及单用盐酸左西替利嗪、雷尼替丁作对照，现报道如下。     

加倍使用第二代抗组胺药剂量治疗慢性荨麻疹疗效及安全性分析

目的 观察第二代抗组胺药剂量加倍治疗慢性荨麻疹的临床疗效和安全性.方法 选取2018年7月至2020年2月某医院治疗的162例慢性荨麻疹患者,随机分为两组,治疗组82例,给予氯雷他定常规剂量2倍治疗;对照组80例,给予氯雷他定联合西替利嗪常规剂量治疗.治疗期间对患者进行症状积分评价及记录不良反应.结果 2周后,对照组的...     

复方甘草酸苷联合抗组胺药治疗慢性荨麻疹疗效观察

慢性荨麻疹是临床常见的顽固性皮肤病,具有反复发作的瘙痒、风团等症状。由于其病因复杂,大多数患者不能找到确切的病因,缺乏特异性治疗药物。目前认为患者免疫机能存在异常[1]。我科采用复方甘草酸苷联合抗组胺药H1、H2受体拮抗剂司他斯汀、雷尼替丁治疗慢性荨麻疹90例,疗效显著。并与单用复方甘草酸苷及单用司他斯汀、雷尼替丁作对照,现报道如下:1病例与方法1.1病例选择90例患者均为本所门诊确诊慢性荨麻疹病例,诊断标准参照《皮肤性病学》[2]中有关慢性荨麻疹的标准拟定。纳入标准:符合上述诊断标准,在1m内未全身应用糖皮质激素和抗组胺…     

Second- and third-generation antihistamines in the treatment of urticaria

ABSTRACT: Chronic urticaria is mainly idiopathic in nature and can be difficult to treat. While less responsive to antihistamine therapy than acute urticaria, antihistamines still play a key role in the management of symptomatology. While many of the antihistamines still commonly used to treat urticaria are first generation H₁ antagonists (e.g., diphenhydramine, hydroxyzine), the more recently developed second-generation agents (e.g., loratadine, cetirizine) and their metabolites—the third-generation antihistamines (e.g., fexofenadine, norastemizole, descarboxyloratadine)—possess many of the desirable clinical effects of the first-generation agents with a more tolerable side effect profile. This review discusses the advantages and disadvantages of each of the various second- and third-generation agents available, and presents some of the data showing the differences among these agents in the treatment of chronic urticaria.     

窄谱中波紫外线联合抗组胺药治疗慢性自发性荨麻疹的疗效观察

目的观察窄谱中波紫外线(NB-UVB)联合抗组胺药治疗慢性自发性荨麻疹的疗效。方法 80例慢性荨麻疹患者,随机分为试验组和对照组,每组各40例。试验组采用NB-UVB光疗,每周2次,共24次,同时口服抗组胺药;对照组仅口服抗组胺药。比较两组治疗后的临床疗效以及随访12周内的复发情况。结果两组患者的症状和体征评分明显下降,且试验组下降更为明显(t=46.37,P0.05)。试验组的临床疗效明显优于对照组(χ~2=6.76,P0.05);且复发率明显低于对照组(χ~2=9.83,P0.01)。结论 NB-UVB安全有效,可作为慢性自发性荨麻疹的辅助治疗手段。     

Effectiveness of as‐needed antihistamines in chronic spontaneous urticaria patients under omalizumab treatment

The question how second‐generation antihistamines (sgAHs) should be used when chronic spontaneous urticaria (CSU) is under control with omalizumab is still unanswered. This study aimed to investigate the effectiveness of as‐needed sgAHs in patients with well‐controlled urticaria under omalizumab treatment. Patients from four different urticaria centers who were treated with omalizumab 300 mg/4 weeks for at least 3 months, had well‐controlled urticaria (Urticaria Control Test: 16 > UCT≥12) and were using sgAHs only if needed, were included in this study. In order to assess effectiveness of sgAHs, change in the itch, hives, and total itch‐hives scores before and after sgAHs were evaluated using modified urticaria activity score‐twice daily. Fifty‐three patients [38 female (71.7%)] with mean age 41.1 ± 11.4 years were included in this study. Median sgAH intake per patient throughout the 4 week‐intervals was 3 (2–5) tablets. sgAH intake decreased itch, hives and total itch‐hives scores 45.7% ± 52.9, 42.4% ± 39.1, and 50.2% ± 51.1, respectively (P < .001 for all). This decrease was similar in both isolated‐urticaria and urticaria‐and‐angioedema phenotypes. Baseline IgE levels were positively correlated with the decrease of three symptom scores (r = 0.31, P = .05; r = 0.375, P = .017; r = 0.31, P = .05, respectively) that showed in patients with higher baseline total IgE levels, as needed sgAH intake decreased the symptom scores less. Our study showed that sgAHs may still be an effective option for the treatment of the intermittent symptoms in patients with well‐controlled urticaria under omalizumab treatment. Baseline total IgE levels may be used as a potential biomarker for sgAH effectiveness in these patients.     

230例慢性荨麻疹患者皮肤变应原点刺试验结果分析

目的:明确武汉地区慢性荨麻疹患者变应原种类。方法:采用标准化皮肤点刺试验方法对230例慢性荨麻疹患者进行10种变应原检测。结果:受试者变应原粉尘螨阳性率最高占80%;其次是海蟹、海虾、花粉、花生、狗毛上皮,分别占44.35%、36.52%、28.26%、26.96%和21.30%。结论:本地区变应原以粉尘螨最常见,慢性荨麻疹患者应尽可能避免接触含尘螨较多的环境。     

依巴斯汀联合卡介菌多糖核酸针治疗慢性荨麻疹56例疗效评价

目的:评价依巴斯汀联合卡介菌多糖核酸针(BCG-PSN)治疗慢性荨麻疹的临床疗效。方法:将112例慢性荨麻疹患者随机分为治疗组(56例)和对照组(56例),两组均给予依巴斯汀片10mg口服,每日1次,治疗组同时给予卡介菌多糖核酸针1 mL肌肉注射,隔日1次;8周后评价疗效。随访1个月,评价复发。结果:治疗8周后,治疗组和对照组总有效率分别为91.08%和75.00%,两组比较有显著性差异(P0.05)。随访1个月后,治疗组和对照组复发率分别为1.79%和14.29%,两组比较有显著性差异(P0.05)。结论:依巴斯汀联合卡介菌多糖核酸针治疗慢性荨麻疹较单独应用依巴斯汀疗效好,复发率低。     

3种抗组胺药治疗慢性特发性荨麻疹的临床研究

目的:评价第2代抗组胺药咪唑斯汀、西替利嗪、氯雷他定治疗慢性特发性荨麻疹的疗效和安全性。方法:采用随机开放平行对照的方法,对96例慢性特发性荨麻疹患者进行随机分组,分别予以咪唑斯汀10mg、西替利嗪10mg、氯雷他定10mg,均每日1次口服,观察治疗第14天、第28天的临床疗效及停药1周后的复发率。结果:三者治疗慢性特发性荨麻疹第14天和第28天的有效率分别为:咪唑斯汀组90.0%和96.7%,西替利嗪组85.3%和94.2%,氯雷他定组90.6%和93.8%,三者之间差异无显著性(P>0.05)。停药1周后的复发率,咪唑斯汀组为40.0%,西替利嗪组为35.3%,氯雷他定组为28.1%。整个试验过程中均无明显严重不良反应出现。结论:咪唑斯汀、西替利嗪和氯雷他定治疗慢性特发性荨麻疹临床疗效好,安全性高,在改善临床症状及控制复发方面各有所长。     

卡介菌多糖核酸联合西替利嗪治疗慢性荨麻疹疗效观察

目的:观察西替利嗪联合卡介菌多糖核酸治疗慢性荨麻疹的临床疗效和安全性。方法:将86例患者随机分为2组,治疗组44例给予口服西替利嗪10 mg每日1次,肌内注射卡介菌多糖核酸注射液1 mL隔日1次;对照组42例仅口服西替利嗪10 mg每日1次,疗程均为6周。结果:治疗组患者有效率为81.82%,对照组患者有效率为54.76%,治疗组有效率明显优于对照组(P0.01),差异有统计学意义。两组患者的不良反应均比较轻。结论:卡介菌多糖核酸联合西替利嗪能有效地控制慢性荨麻疹的症状,提高治愈率,明显降低复发率,疗效好,且安全性高。     

Stanozolol in chronic urticaria: a double blind, placebo controlled trial

H1-type antihistamine drugs are mainstays in the management of chronic urticaria. For patients with refractory, chronic, idiopathic urticaria who have failed to benefit from conventional therapy, other safe therapeutic modalities are required. To evaluate the role of stanozolol as an adjunctive therapeutic agent with H1-antihistamine in refractory chronic idiopathic urticaria, we conducted this study. Fifty-eight patients with chronic refractory urticaria were enrolled in this trial and were randomly assigned to two groups (A and B). Patients in group A received 2 mg stanozolol twice daily along with cetrizine 10 mg daily. Patients in group B received cetrizine 10 mg daily and placebo tablets twice daily. The improvement was monitored by estimation of severity score. Of the 58 patients, 26 in group A and 24 in group B could be evaluated. At the end of 12 weeks, 17 patients in group A showed marked to complete resolution as compared to 7 patients in group B (chi-square p<0.01). The intention to treat analysis p value was a found to be <0.007. There was a highly significant decrease in mean severity score at 12 weeks (p<0.001) in group A patients. The present study demonstrated that stanozolol is an effective and safe adjuvant therapy for treatment of chronic refractory urticaria.     

阿伐斯汀联合玉屏风颗粒治疗慢性荨麻疹临床研究

目的:评价阿伐斯汀胶囊联合玉屏风颗粒治疗慢性荨麻疹的疗效及安全性。方法:将入选的63例慢性荨麻疹患者分为治疗组(34例)和对照组(29例)。治疗组患者口服阿伐斯汀胶囊联合玉屏风颗粒,对照组口服阿伐斯汀胶囊。结果:治疗4周后,治疗组症状体征评分为2.2±1.6,明显低于对照组的3.9±2.1,差异有统计学意义(P0.05)。治疗组有效率为70.58%,高于对照组的48.27%,差异有统计学意义(P0.05)。两组患者均未见明显不良反应。结论:阿伐斯汀胶囊联合玉屏风颗粒治疗慢性荨麻疹疗效优于单用阿伐斯汀胶囊。