加倍剂量抗组胺药物治疗顽固性慢性自发性荨麻疹40例疗效观察

目的探讨加倍抗组胺药治疗慢性荨麻疹临床疗效和安全性。方法将入选的80例慢性荨麻疹患者随机分为2组,各40例。治疗组予抗组胺药3倍剂量,每晚1次口服,对照组予抗组胺药常规剂量1次/d口服,疗程8周。结果治疗结束时,治疗组治愈率40.00%,有效率57.50%;对照组治愈率10.00%,有效率25.00%,治疗组疗效明显优于对照组,差异有统计学意义(P0.01)。且两组均无明显不良反应。结论加倍抗组胺药治疗慢性荨麻疹安全有效,治愈率高,复发率低。     

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.     

苦参素联合抗组胺药治疗慢性荨麻疹疗效的Meta分析

目的:评价苦参素联合抗组胺药治疗慢性荨麻疹的疗效及不良反应。方法:检索中国知网、万方、维普、Pubmed、EMbase及Cochrane library等数据库,筛选符合标准的文献,采用RevM an 4.2进行Meta分析。结果:共纳入14篇文献,入选文献发表偏倚较小,无明显异质性(P=0.34)。Meta分析结果显示,苦参素联合抗组胺药组与单用抗组胺药组比较,有效率高[P0.00001,RR=1.40,95%CI(1.30~1.51)],复发率低[P0.00001,RR=0.19,95%CI(0.10-0.37)]。结论:苦参素联合抗组胺药治疗慢性荨麻疹疗效优于单用抗组胺药。     

卡介菌多糖核酸注射液联合地氯雷他定分散片治疗慢性荨麻疹106例疗效观察

目的观察卡介菌多糖核酸注射液联合地氯雷他定分散片治疗慢性荨麻疹的疗效和安全性。方法按就诊次序收集病例,随机将211例慢性荨麻疹患者分为治疗组106例和对照组105例,两组均予地氯雷他定分散片5mg,1次/d,饭后口服;治疗组在此基础上肌注卡介菌多糖核酸注射液2ml,1次/qod。结果试验组2、4周的疗效均高于对照组。治疗2、4周时,试验组与对照组的总有效率分别为94.34%和80.00%(χ~2=9.70,P0.05),两组比较差异具有显著性意义。不良反应比较差异无统计学意义(χ~2=0.14,P0.05)。结论卡介菌多糖核酸注射液联合地氯雷他定分散片治疗慢性荨麻疹疗效好,安全,起效快,治愈率高。     

卡介菌多糖核酸对慢性荨麻疹、慢性湿疹的疗效观察

目的观察卡介菌多糖核酸配合抗组胺药物治疗慢性荨麻疹、慢性湿疹的疗效。方法 135例患者随机分为两组,治疗组在抗组胺治疗的基础上再加用卡介菌多糖核酸2ml肌注,每周3次,对照组仅用抗组胺药物治疗,两组均治疗6周。结果卡介菌多糖核酸配合抗组胺药物组治疗慢性荨麻疹的有效率为83.4%,高于口服抗过敏药物组(64.1%)(P0.05)。对慢性湿疹的有效率为79.3%,高于口服抗过敏药物组(54.9%)。结论卡介菌多糖核酸配合抗组胺药物治疗慢性荨麻疹、慢性湿疹疗效高、无不良反应。可作为新的治疗方法。     

雷公藤多苷联合抗组胺药治疗慢性荨麻疹临床疗效及生活质量的观察

目的 临床观察雷公藤多苷联合不同的第二代抗组胺药治疗慢性荨麻疹的临床疗效及对患者生活质量的影响.方法 360例慢性荨麻疹患者,随机分为六组.治疗组为雷公藤多苷联合不同的抗组胺药(氯雷他定、西替利嗪、咪唑斯汀)各一组,以及仅使用不同抗组胺药(氯雷他定、西替利嗪、咪唑斯汀)各一组作为对照组的治疗方案.六组于治疗前后记录荨麻疹症状评分以及皮肤病生活质量评分表.结果 治疗4周后,雷公藤多苷和抗组胺药联合应用的治疗组的症状评分均低于仅使用抗组胺药物的对照组(P＜0.001),有效率治疗组也高于对照组(P＜0.05).在生活质量方面,治疗组的DLQI评分在用药2周与4周后均显著低于对照组(P＜0.05,P＜0.001)结论 使用雷公藤多苷联合抗组胺药(尤其是咪唑斯汀)能够更快的减轻患者症状,提高患者的生活质量.     

抗FcεRⅠα自身抗体在慢性自发性荨麻疹中的表达及临床意义

目的研究抗FcεRⅠα自身抗体在慢性自发性荨麻疹(Chronic spontaneous urticaria,CSU)中的表达及临床意义。方法采用酶联免疫吸附法(ELISA)检测CSU患者中抗FcεRⅠα自身抗体的表达,并分析抗FcεRⅠα自身抗体与CSU患者的病程、荨麻疹活动性评分(UAS)评分、风团数目、瘙痒程度、生活质量评分、单一抗组胺药疗效的临床相关性。结果 CSU患者组抗FcεRⅠα抗体水平较正常对照组明显升高(P0.05),抗FcεRⅠα抗体水平与病程、荨麻疹活动性评分(Urticaria activity score,UAS)、风团数目评分、瘙痒程度评分、生活质量评分无明显相关性(P0.05),单一抗组胺药使用有效者其血清抗FcεRⅠα抗体滴度低于单一抗组胺药治疗无效者(P0.05)。结论抗FcεRⅠα抗体在CSU发病中有重要的作用,抗FcεRⅠα抗体滴度较高的CSU患者可能对常规抗组胺药治疗抵抗。     

祛风止痒保健茶辅助治疗慢性荨麻疹临床疗效观察

目的评价一种祛风止痒保健茶组方对慢性荨麻疹的辅助治疗效果与安全性。方法 80例临床确诊的慢性荨麻疹患者随机分为2组,治疗组应用含有黄芪、白术、防风、五味子、乌龙茶的保健茶和左西替利嗪治疗;对照组使用黄芪、白术、防风、五味子配合左西替利嗪治疗。分别于治疗后4周和8周总结荨麻疹活动性评分(Urticaria activity score,UAS)和临床疗效等;并于24周后随访痊愈患者的复发率。结果4周、8周后治疗组和对照组UAS评分均比治疗前有明显下降(P0.05),但2组之间没有明显的差别。治疗8周后治疗组瘙痒程度较对照组减轻(t=2.402,P0.05)。治疗组有效率为95.2%,明显高于对照组88.9%,其结果差异有统计学意义(χ~2=5.011,P0.05)。24周后随访,治愈患者中治疗组2例复发,对照组8例复发。结论包含乌龙茶成分的祛风止痒保健茶能提高慢性荨麻疹的临床治疗效果,有一定的止痒和减少复发的作用。     

五味子汤治疗慢性风寒束表型荨麻疹疗效分析

目的观察五味子汤对慢性风寒束表型荨麻疹的有效性和安全性。方法采用随机、双盲对照法,共治疗86例患者。试验组46例,口服五味子汤,1剂/d分早晚服;对照组40例,口服氯雷他定10 mg,每晚1次,连用4周,两组病例均停药观察12周。结果试验组有效率为82.26%,对照组有效率82.50%,两组疗效无显著性差异(χ2=0.096,P>0.05);停药后随访3个月,试验组复发率16.67%,对照组为76.19%,两组复发率有显著性差异(χ2=18.07,P<0.01);试验组不良反应发生率为10.8%,对照组为7.5%。结论五味子汤对慢性风寒束表型荨麻疹的近期疗效与口服氯雷他定相似,而远期疗效明显优于氯雷他定,复发率较低,耐受性好,无严重不良反应。     

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。     

炎症因子及凝血因子与慢性荨麻疹发病及预后的相关性

目的：分析慢性荨麻疹患者血液学指标与发病及预后的相关性。方法：检测138例慢性荨麻疹患者及100例正常对照的血清总IgE、CRP、补体C3、补体C4、D2聚体、F1+2片段、FVIIa水平,并进行多因素Logist回归分析。结果：慢性荨麻疹患者血清中总IgE值、补体C3、C4、CRP、F1+2片段、FVIIa 及D2聚体与水平显著高于对照组,差异具有统计学意义( P＜0.05);87例慢性荨麻疹患者抗组胺药物治疗3个月后有效,其CRP、FVIIa、D2聚体、疾病严重程度评分明显高于治疗有效组,差异具有统计学意义( P＜0.05)。慢性荨麻疹抗组胺治疗无效组进行多因素Logist回归分析示D2聚体为治疗抵抗的主要影响因素（OR：1．63,95％CI 1.102-1.799,P<0.05）。以D2聚体的中位数（5.41 mg/L）分为两组,A组（≥5.41 mg/L）,B组（＜5.41 mg/L）,治疗后随访2年显示A组的复发率（23.56%）明显高于B组（12.14%）,差异具有统计学意义（P）＜0.001）。结论：多种炎症因子及凝血因子可能参与慢性荨麻疹的发病;D2聚体水平可能与慢性荨麻疹治疗的疗效及复发相关。     

地氯雷他定联合奥马珠单抗治疗慢性自发性荨麻疹的临床观察

目的 观察地氯雷他定联合奥马珠单抗治疗慢性自发性荨麻疹的临床疗效和安全性.方法 将慢性自发性荨麻疹患者60例随机分为观察组和对照组各30例.观察组采用口服地氯雷他定片(5 mg,每日1次)联合皮下注射奥马珠单抗注射液(300 mg,4周1次)治疗,对照组仅口服地氯雷他定片(5 mg,每日1次),12周后观察两组临床疗效...     

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。     

玉屏风散配合腧穴自血疗法治疗慢性荨麻疹临床观察

目的观察玉屏风散配合腧穴自血疗法治疗慢性荨麻疹的临床疗效及复发率。方法将126例患者随机分为两组,对照组单纯口服西替利嗪,治疗组采用玉屏风散配合腧穴自血疗法。观察两组患者的临床疗效、血IgE值及复发率。结果两组患者临床疗效比较差异有统计学意义(P<0.01),治疗组IgE值和复发率明显低于对照组(P<0.05)。结论玉屏风散配合腧穴自血疗法治疗慢性荨麻疹较比单纯应用西药疗效好。     

Efficacy of H, antihistamine, corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria

H, antihistamines relieve urticaria by blocking the action of histamine on the target tissue, while demonstration of autoantibodies in the sera of a proportion of the patients having chronic idiopathic urticaria, use of immunosuppressive drugs for the treatment of these patients has acquired the greater rationality. We evaluated the role of corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria. Twenty-five patients, 13 males and 12 females, between 18-53 years in age, having chronic dermographic urticaria were taken up for this study. The patients were divided into three groups. Group I patients (n=9) were treated with cetirizine hydrochloride 10 mg per day orally, group II patients (n=7) were treated with betamethasone 2 mg along with cyclophosphamide 50 mg along with cetirizine 10 mg per day for a total period of 4 weeks. The patients were evaluated every week to record the therapeutic response and side effects, and then followed up without treatment for a period of 6 months to look for recurrence of the urticaria, if any. Six patients in group I and all the patients in group II and group III had complete remission while the remaining patients in group I had partial relief. The side effects included drowsiness in 4 patients. All the patients in group II had weight gain, 4 patients had acne and 2 patients developed cushingoid features. Majority of the patients relapsed within 3 days after stopping the treatment. Supplementation of the treatment with oral corticosteroids or cyclophosphamide was more effective in controlling the symptoms as compared to cetirizine alone. But a four weeks supplementation was not adequate for preventing the relapses when the drugs were withdrawn.     

氯雷他定联合地氯雷他定治疗儿童慢性自发性荨麻疹的临床观察

目的：探讨氯雷他定联合地氯雷他定治疗儿童慢性自发性荨麻疹的临床疗效及安全性。方法177例儿童自发性慢性荨麻疹患儿分为3组。根据年龄,试验组每日晨服地氯雷他定,同时每晚睡前口服氯雷他定,连用28 d。对照1组每日晨服安慰剂（淀粉压片）半片,每晚睡前口服氯雷他定,连用28 d。对照2组每日晨服安慰剂半片,同时每晚睡前口服地氯雷他定,连用28 d。于用药后随访观察药物的可能不良反应及疗程结束时药物的疗效。结果试验组、对照1组及对照2组有效率分别为90.9%、71.4%和74.5%,试验组有效率优于对照组（χ2值分别为6.865、5.153,均P＜0.05）,3个组不良反应发生率分别为10.9%、8.9%、9.1%,3个组不良反应发生率比较,差异无统计学意义（P＞0.05）。结论氯雷他定联合地氯雷他定治疗儿童慢性自发性荨麻疹优于单用氯雷他定或单用地氯雷他定治疗,3个组不良反应发生率差异无统计学意义。     

光动力疗法联合果酸治疗面部中重度痤疮临床疗效观察

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)联合果酸治疗面部中重度痤疮的有效性及安全性。方法 52例面部中重度痤疮患者随机分为两组,试验组25例,先给予ALA-PDT治疗,每周1次,共2次,2周后行果酸治疗,每2周1次,共2次。对照组27例,仅给予ALA-PDT治疗,每周1次,共2次。在治疗结束后2、4、8周进行疗效判断及不良反应记录。结果治疗后2、4周试验组与对照组疗效相比,差异无统计学意义(P0.05);治疗后8周试验组疗效明显优于对照组(P0.05)。结论 ALA-PDT联合果酸治疗面部中重度痤疮是一种安全、有效的治疗方法。     

生物共振治疗慢性荨麻疹疗效分析

目的探讨生物共振治疗系统治疗慢性荨麻疹的临床疗效及安全性。方法将患者随机分为3组,治疗组61例,采用生物共振治疗系统进行脱敏治疗;对照组59例口服咪唑斯汀(皿治林)10mg,qd,连续用3周;联合治疗组32例,采用生物共振治疗系统脱敏治疗同时加口服咪唑斯汀(皿治林)10mg,qd,连用3周。结果3组治疗有效率比较差异有显著性(P<0.05),其中联合治疗组与治疗组及对照组比较均有显著差异(P<0.05),治疗组与对照组比较无显著性差异(P>0.05)。3组复发率比较差异有显著性(P<0.001)。结论生物共振技术治疗慢性荨麻疹有一定的疗效和安全性,且复发率低,尤其联合治疗可提高疗效。     

Positive effect of using calcipotriol ointment with narrow-band ultraviolet B phototherapy in psoriatic patients

BACKGROUND/PURPOSE: The successful use of narrow-band ultraviolet B (UVB) phototherapy for the management of psoriasis has prompted the examination of various combination treatments with narrow-band UVB. However, there have been contradictory reports on the effect of the calcipotriol-narrow-band UVB combination. This study was performed to compare the clinical efficacy of the calcipotriol-narrow-band UVB combination with narrow-band UVB alone. METHODS: Of the 28 psoriasis patients, 10 were treated with the calcipotriol-narrow-band UVB and 18 with narrow-band UVB alone. Phototherapy was done once daily three times a week and the dose was gradually increased in a stepwise fashion by 0.05 J/cm2. At the end of therapy, overall efficacy was classified according to the chosen grading system. RESULTS: On assessing the therapeutic results using the criteria selected, 90.0% patients (n = 9) in the calcipotriol-narrow-band UVB group and 61.1% patients (n = 11) in the narrow-band UVB group showed grade IV at the end of therapy. The calcipotriol-narrow-band UVB group showed more rapid improvement at the early stage. The final and total UVB dose were slightly lower in the calcipotriol-narrow-band UVB group but no significant difference was observed with respect to the total number of irradiations, duration of treatment, final UVB dose or total cumulative UVB dose required to reach grade IV in both groups (P > 0.05). The pattern of adverse effects was similar in both groups with a slightly higher frequency in the calcipotriol-narrow-band UVB group. CONCLUSION: Our results demonstrated that the total cumulative UVB dose required to reach grade IV was not significantly different in both groups, although it was slightly lower in the calcipotriol-narrow-band UVB group. However, a higher percentage of patients attained grade IV at the end of therapy in the combination group and this therapy was more effective in reducing the Psoriasis Area and Severity Index early in treatment. More studies are warranted to confirm these results.