幽门螺杆菌感染与慢性荨麻疹间关系的临床观察

目的探讨慢性荨麻疹(CU)与幽门螺杆菌(Hp)感染的相关性及临床治疗方案的选择。方法选取确诊CU患者95例与健康体检者35例,行14C-尿素呼气试验(14C-UBT)明确Hp感染情况。对存在Hp感染的CU患者进行随机分组,A组(对照组)给予基础抗组胺药物(口服盐酸西替利嗪片10mg,1次/d),疗程4周;B组(治疗组):给予基础抗组胺药物,疗程4周同时予根除Hp三联疗法(口服埃索美拉唑镁片20mg,2次/d;阿莫西林胶囊1.0g,2次/d;克拉霉素胶囊0.5g,2次/d),疗程1周,观察药物应用后反应情况及停药后疗效。结果健康体检者中Hp阳性率为31.43%,CU患者为64.21%,两组比较差异有统计学意义(P<0.05)。证实有Hp感染的CU患者对照组治愈率为27.59%,有效率为55.17%;治疗组分别为58.62%和75.86%;两组治愈率比较差异有统计学意义(P<0.05)。治疗组Hp根除率为93.10%,对照组为3.45%,两组比较差异有统计学意义(P<0.05)。结论 Hp感染与CU间存在一定的相关性。对有Hp感染的CU患者可采用基础抗组胺药物加根除Hp三联疗法药物进行治疗。     

幽门螺杆菌与慢性荨麻疹关系的探讨

1998年6月～2001年10月笔者采用14C尿素酶呼气试验(14C-UBT)检测了62例慢性荨麻疹患者,并对幽门螺杆菌(HP)阳性患者进行了治疗,现报告如下。临床资料:慢性荨麻疹患者62例,男27例,女35例;平均年龄37.6岁(18～69岁),病程3个月～18年。对照组25名,为健康志愿者,男16名,女9名,平均年龄22.4岁。两组均作14C-UBT试验。操作过程按说明书进行。样品每分钟衰变数(DPM)≥200为阳性。对14C-UBT阳性患者用下列方案进行HP根除治疗:奥美拉唑40mg/d、阿莫西林2g/d和克拉霉素1g/d,疗程1周。疗效评定标准:治疗后2周内症状和体征消失为痊愈,治疗4周后…     

幽门螺杆菌与慢性荨麻疹

为探讨幽门螺杆菌（HP）感染在慢性荨麻疹中的作用，采用^13尿素呼吸试验对28例慢性荨麻疹患者及25名健康对照进行HP检测。结果显示：28例荨麻疹患者中19例HP阳性（68％）；25名健康对照中15例HP阳性（60％）。分别对慢性荨麻疹组及健康对照组中的HP阳性者应用根除HP感染治疗方案，停药6周后，慢性荨麻疹组有17例HP转阴，3例荨麻疹有好转，其余症状和体征均未改善。提示HP感染与慢性荨麻疹发生无明显关系。     

幽门螺杆菌感染与慢性荨麻疹的关系

目的:探讨幽门螺杆菌(HP)感染与慢性荨麻疹发病之间的关系。方法:抽静脉血通过酶联免疫吸附试验(ELISA)对60例慢性荨麻疹患者及35例健康对照者检测比HP阳性率;把慢性荨麻疹HP阳性者随机分为二组:A组用治疗HP的三联方法,B组单用地氯雷他定,分别对比A组与健康对照HP阳性者经三联疗法后HP的阴转率及A组与B组6周后荨麻疹变化情况,同时观察3个月后A组HP感染率与荨麻疹转归情况。结果:慢性荨麻疹与健康对照组之间HP感染有明显差异;慢性荨麻疹组与健康对照组经三联疗法治疗HP后其阴转率无明显差异;同为慢性荨麻疹HP阳性患者,用三联疗法与单用地氯雷他定治疗1周后,荨麻疹皮疹变化无明显差异;用三联疗法治疗慢性荨麻疹HP阳性患者对比6周与3个月后,HP感染有明显差异,荨麻疹皮疹变化有明显差异。结论:慢性荨麻疹的发病与HP感染有关系,但对HP进行根除治疗后,慢性荨麻疹病情转归无改变。     

幽门螺杆菌感染与慢性荨麻疹相关关系的研究进展

慢性荨麻疹是皮肤科的一种常见病、多发病，其病因复杂、诱发因素较多，治疗也较为棘手。有学者认为机体内存在慢性感染病灶是荨麻疹反复发作、久治不愈的原因。近年来幽门螺杆菌感染与慢性荨麻疹的发病关系引起皮肤界的重视，但结果尚有争议。本文主要就两者之间的研究进展作一简要综述。     

幽门螺杆菌感染与慢性荨麻疹相关关系的临床观察

慢性荨麻疹（chronic urticaria,CU）病因复杂,近年来研究发现消化道幽门螺杆菌（Helieobacter pylori,IIP）感染可能与慢性荨麻疹的发生有一定的关系,但研究结果尚存争议[㈦]。本研究通过检测患者及健康体检者血清中HP-IgG抗体并比较两组阳性率,以探讨HP感染与慢性荨麻疹的关系,以及感染HP慢性荨麻疹的治疗方法。本文采用抗组胺药联合抗HP药物治疗感染HP的慢性荨麻疹患者,取得一定疗效,现报告如下。     

幽门螺杆菌感染与酒渣鼻、慢性荨麻疹

近年来幽门螺杆菌helieoharter pylori，HP)感染与皮肤病的关系已越来越引起临床重视，现有研究主要集中住HP感染与酒渣鼻、慢性特发性荨麻疹的相关性方面，但结果尚有争议。为进一步探讨HP感染在酒渣鼻、慢性荨麻疹中的作用，我们采用^14C尿素呼吸试验（^14C-UBT)对38例酒渣鼻、32例慢性荨麻疹患者进行HP检测，并对HP阳性者采用根除治疗方案，观察其症状改善程度，现将结果报告如下。     

儿童慢性荨麻疹与幽门螺杆菌关系的探讨

目的探讨儿童慢性荨麻疹与幽门螺杆菌的关系，幽门螺杆菌抗体检测在治疗慢性荨麻疹中的意义。方法对随机抽取的门诊慢性荨麻疹的患儿检测幽门螺杆菌抗体。结果试验组的阳性率高于健康对照组，P〈0．01；Hp（＋）的患者给予三联疗法配合抗组胺药物治疗，效果较显著。结论慢性荨麻疹患者应考虑幽门螺杆菌感染的可能，并给予抗幽门螺杆菌的正规治疗，这对慢性荨麻疹的治疗有一定参考。     

中药对有幽门螺杆菌感染的慢性荨麻疹的辨证治疗

目的 探讨治疗有幽门螺杆菌(Hp)感染的慢性荨麻疹的安全有效、可长期服用的方法。方法 将29例经C^13尿素呼吸试验证实有Hp感染的慢性荨麻疹患者，随机分为中药 抗组胺药组(治疗组)和单纯抗组胺药组(对照组)。治疗组中医辨证分为两型：湿热蕴阻、气滞血瘀型和寒湿内阻、脾胃气虚型。以中医辨证和辨病相结合的方法组方用药，方中加入经现代药理研究证实有抗Hp感染的中药，如黄连、黄芩、大黄等。结果 治疗组17例慢性荨麻疹思者，经治疗4周后，治愈7例，显效5例；而对照组12例中，1例治愈，显效2例。两组对比有明显差异。结论 慢性荨麻疹患者可能有Hp感染，采用中药加抗组胺药治疗可能是一个较好的方法。     

慢性荨麻疹患者幽门螺杆菌的检测及其意义

近年来有报道认为部分慢性荨麻疹的发生与幽门螺杆菌 (Ｈｅｌｉｃｏｂａｃｔｅｒｉｕｍｐｙｌｏ ｒｉ,Ｈｐ)感染有关 ,我们对 76例慢性荨麻疹患者进行了1 4 碳 尿素呼气试验 (1 4 Ｃ ｕｒｅａｂｒｅａｔｈｔｅｓｔ,1 4 Ｃ ＵＢＴ)检测Ｈｐ的感染 ,并对ＨＰ阳性的慢性荨麻疹患者采用三联疗法进行了治疗。现报道如下。资料和方法　临床资料 :慢性荨麻疹患者 76例 ,男 35例 ,女 41例 ;年龄 12～ 6 3岁 ,平均 2 9.6± 7.3岁 ,病程 3个月至 8年。其中伴恶心、腹痛、呕吐等胃肠症状者 2 6例。检查时均有皮肤风团存在。所有病例均曾用过多种抗组胺…     

梅州城区幽门螺杆菌感染与慢性荨麻疹的关系探讨

目的探究梅州城区幽门螺杆菌感染与慢性荨麻疹的关系。方法选取我院在2016年1月—2017年1月期间收治的常住或工作在梅州城区的慢性荨麻疹患者共90例,设为试验组,同期选取在我院进行健康检查者90例,设为正常组。将试验组中幽门螺杆菌阳性的患者随机分为对照组和观察组,对照组患者给予氯雷他定分散片治疗,观察组患者在上述治疗的基础上同时给予克拉霉素缓释胶囊、兰索拉唑肠溶胶囊和阿莫西林分散片,分析幽门螺杆菌的感染与慢性荨麻疹的关系。结果试验组患者幽门螺杆菌感染阳性率显著高于正常组,差异有统计学意义(P0.05);观察组患者治疗效果显著优于对照组,差异有统计学意义(P0.05)。通过临床随访3个月还发现,对照组复发率为28.95%,高于观察组的13.33%。结论梅州城区幽门螺杆菌感染与慢性荨麻疹存在一定的相关性,且抗幽门螺杆菌药物对于治疗慢性荨麻疹有一定的作用,临床上值得进一步推广应用。     

雷公藤多甙片联合地氯雷他定治疗慢性特发性荨麻疹疗效观察

目的观察雷公藤多甙片联合地氯雷他定治疗慢性特发性荨麻疹的临床疗效和安全性。方法共入选180例患者,将其随机分成两组,每组各90例,治疗组予雷公藤多甙片10mg口服,3次/d,地氯雷他定5mg口服,1次/d,均连用28天;对照组仅予地氯雷他定5mg口服,1次/d,连用28天。结果治疗第7天时治疗组有效率为69.77%,对照组为54.02%;第14天时治疗组有效率82.56%,对照组59.77%;第28天时治疗组有效率93.02%,对照组67.82%。两组患者在治疗第7,14和28天时有效率比较,差异均有统计学意义(P均<0.05)。患者主观生活质量评估在治疗14天后DLQI和睡眠情况改善明显好于对照组,28天后DLQI、睡眠情况和日常活动评分也明显好于对照组(P均<0.05)。不良反应:治疗组发生率为8.14%,对照组为6.90%,两组差异无统计学意义。停药6周后进行随访和复诊,试验组复发率低于对照组,差异有统计学意义(P<0.05)。结论雷公藤多甙片联合地氯雷他定治疗慢性特发性荨麻疹的临床疗效比单纯应用地氯雷他定治疗的疗效好,停药后复发率低。     

Usefulness of the Autologous Serum Test for the Diagnosis of Chronic Idiopathic Urticaria

Background

The majority of chronic urticaria cases are chronic idiopathic urticaria (CIU) with no specific identifiable etiology. The role of autoantibodies in such cases remains controversial.

Objective

This study determined the positivity rate of autologous serum tests in CIU patients.

Methods

This study was performed on 30 patients with CIU and 30 individuals without any systemic or dermatologic disease. After the volar parts of right and left forearms were cleansed, 0.05 ml serum physiologic and 0.05 ml autologous serum were injected intradermally on the right forearm 5 cm apart from each other, resulting in the formation of small papules; meanwhile, 0.05 ml histamine alone was injected to the left forearm. The test results were evaluated after 30 minutes as positive in positive cases.

Results

The autologous serum test produced significant and non-significant results in patients with CIU and controls, respectively. The positivity rates of the autologous serum test in the CIU and control groups were 53.3% and 26.6%, respectively. There was no relationship between autologous serum test positivity and sex in either group. In male patients with CIU, positive results ranged widely with age, while in female patients, positive results were mainly observed at younger ages with a narrow age range.

Conclusion

The autologous serum test is a useful test in the diagnosis and treatment of CIU as well as the selection of immunotherapy, especially in patients refractory to classic therapy.     

Psychosomatic Treatment of a Case of Chronic Urticaria

A 35-year-old Japanese woman presented with urticaria in January of 1992. As her symptoms gradually became worse, she came to our hospital in March of that year. I treated her with various combinations of antihistaminics and antiallergics. However, her symptoms did not respond and continued to deteriorate. Although her blood was analyzed in an attempt to identify antigenic or physical factors, no positive data were obtained. Because three kinds of psychological tests showed that the patient was highly anxious and depressive, I additionally treated her with psychotropics and psychotherapy in May of 1994. After a month, the symptoms began to disappear. She has since been free from the symptoms while taking medicine only twice a week. Our group recently presented the efficacy of psychotropics in patients with chronic urticaria. This case suggests that highly anxious or depressive cases with chronic urticaria should be treated not only dermatologically, but also psychologically.     

卡介菌多糖核酸联合咪唑斯汀治疗慢性特发性荨麻疹疗效及安全性研究

目的探讨卡介菌多糖核酸联合咪唑斯汀治疗慢性特发性荨麻疹的治疗效果及安全性。方法纳入我院2013年1月—2014年11月确诊为慢性特发性荨麻疹的患者150例,随机平均分为2组,其中观察组75例,予隔天臀部肌内注射卡介菌多糖酸2 m L并联合每天口服咪唑斯汀10 mg;对照组75例,予每天咪唑斯汀10 mg口服,2组均连续治疗4周。分别于治疗前、治疗后2周、4周及3个月共4个时间点观察2组患者的症状积分的变化情况及有效率,并对2组的不良反应等安全性情况进行分析。结果治疗后2周、4周和3个月2组患者的症状积分和有效率与治疗前比较差异有统计学意义(P<0.05);治疗后2周观察者与对照组症状积分和有效率2组比较差异无统计学意义(P>0.05),而治疗后4周和3个月2组的症状积分和有效率比较差异有统计学意义(P<0.05);2组均未发现严重的不良反应,其中观察组有10例患者、对照组有8例患者出现了轻度的嗜睡现象,观察组、对照组各有2例出现了头痛现象,均未做任何特殊处理,停药后症状消失。所有患者的肝肾功能等实验室检查均无异常表现。结论卡介菌多糖核酸联合咪唑斯汀治疗慢性特发性荨麻疹疗效确切且安全性高。     

Correlations between Anti-Mast Cell Autoantibodies and Chronic Idiopathic Urticaria

Background

The etiology of chronic idiopathic urticaria (CIU) is not completely clear. There are a few antibodies were reported to correlate with CIU.

Objective

To investigate the correlation these antibodies and CIU.

Methods

The autologous serum skin test (ASST) and allergens were performed. Serum levels of immunoglobulin E (IgE), anti-FcεRI and anti-IgE, anti-Helicobacter pylori (HP) antibodies and anti-thyroglobulin antibody (TGAb) were measured in 100 patients with CIU, acute urticaria (AU) and normal controls respectively.

Results

Eighty-six percent food or inhalant allergens were detected in AU patients, but no allergens were detected in CIU patients and normal controls. Serum anti-FcεRI antibody and anti-IgE antibody levels were higher in the CIU than that in the AU patients and normal controls (p<0.05, respectively). IgE level was lower in the CIU patients (T=190.00, p< 0.05), but increased in the AU patients (T=226.00, p<0.05) compared with the normal controls. The ASST positive rates in the CIU and the AU patients were 53.4% and 12.6% respectively, but all normal controls were negative. The anti-FcεRI antibody level was higher in the ASST-positive CIU patients than those negative ones (T=101.73, p<0.05). In anti-HP antibody positive and TGAb positive CIU patients, anti-FcεRI antibody positive rate was higher than AU patients (p<0.01) and normal controls (p<0.01).

Conclusion

The anti-FcεRI and anti-IgE antibodies play a key role in CIU, but anti-HP antibody and TGAb have an indirect correlation with CIU.     

复方甘草酸苷注射液治疗对慢性特发性荨麻疹外周血T细胞细胞因子水平的影响

目的检测复方甘草酸苷注射液(商品名美能)治疗慢性特发性荨麻疹前后患者外周血CD3 T细胞细胞因子水平,探讨美能治疗慢性荨麻疹的可能免疫学机制。方法分离外周血淋巴细胞,刺激物刺激细胞,增加细胞内细胞因子的表达,然后应用流式细胞仪定量测定Th1/Th2细胞因子的水平,观察美能治疗慢性特发性荨麻疹前后Th1/Th2细胞因子水平的变化并作疗效评估,进一步作Th1/Th2细胞因子水平和疗效水平相关性分析。结果慢性特发性荨麻疹患者外周血Th1细胞因子明显低于正常人,而Th2细胞因子水平升高,美能治疗后,患者Th1细胞因子水平较治疗前升高,Th2细胞因子水平下降。Th1细胞因子水平和疗效水平呈正相关,Th2细胞因子水平和疗效水平呈负相关。结论美能通过逆转慢性荨麻疹患者失衡的Th1/Th2免疫反应是其达到临床疗效的可能机制之一。