盐酸非索非那定治疗慢性特发性荨麻疹的疗效及安全性研究

采用多中心、随机、双盲、平行对照法,观察盐酸非索非那定治疗慢性特发性荨麻疹的疗效和安全性,并与盐酸西替利嗪进行比较。结果:共完成病例235例,其中盐酸非索非那定组117例,盐酸西替利嗪组118例。治疗结束时,盐酸非索非那定组痊愈73例(62.39%),总有效率82.91%;盐酸西替利嗪组痊愈74例(62.71%),总有效率87.29%。两组比较差异无统计学意义(P>0.05)。结论:盐酸非索非那定是一种对慢性特发性荨麻疹有良好疗效且安全的药物。     

盐酸非索非那定治疗慢性特发性荨麻疹疗效观察

为了评价盐酸非索非那定片治疗慢性特发性荨麻疹的疗效,我们对183例慢性特发性荨麻疹患者采用随机、开放、平行对照的方法,观察其疗效,并与盐酸西替利嗪进行比较,现将结果总结如下.     

咪唑斯汀治疗慢性特发性荨麻疹38例疗效观察

2004年4月-10月笔者采用咪唑斯汀（商品名：皿治林，西安杨森制药有限公司）治疗38例慢性特发性荨麻疹患者，现将观察结果报告如下。     

盐酸非索非那定治疗126例慢性特发性荨麻疹

为进一步评价盐酸非索非那定和盐酸西替利嗪治疗慢性尊麻疹的疗效和安全性,我们于2009年10月至2010年6月采用随机、平行对照法观察盐酸非索非那定片治疗慢性特发性荨麻疹的疗效和安全性,现报道如下. 一、临床资料 1.人选标准:①年龄18～65岁,男女不限;②风团持续时间≤24 h,皮疹时隐时现;③病程至少在6周以上,就诊的当天见到风团;④病因不明;⑤无相关药物过敏史者.本研究经医院伦理委员会批准,签署知情同意书.     

盐酸非索非那定治疗126例慢性特发性荨麻疹

为进一步评价盐酸非索非那定和盐酸西替利嗪治疗慢性尊麻疹的疗效和安全性,我们于2009年10月至2010年6月采用随机、平行对照法观察盐酸非索非那定片治疗慢性特发性荨麻疹的疗效和安全性,现报道如下. 一、临床资料 1.人选标准:①年龄18～65岁,男女不限;②风团持续时间≤24 h,皮疹时隐时现;③病程至少在6周以上,就诊的当天见到风团;④病因不明;⑤无相关药物过敏史者.本研究经医院伦理委员会批准,签署知情同意书.     

盐酸非索非那定治疗126例慢性特发性荨麻疹

为进一步评价盐酸非索非那定和盐酸西替利嗪治疗慢性尊麻疹的疗效和安全性,我们于2009年10月至2010年6月采用随机、平行对照法观察盐酸非索非那定片治疗慢性特发性荨麻疹的疗效和安全性,现报道如下. 一、临床资料 1.人选标准:①年龄18～65岁,男女不限;②风团持续时间≤24 h,皮疹时隐时现;③病程至少在6周以上,就诊的当天见到风团;④病因不明;⑤无相关药物过敏史者.本研究经医院伦理委员会批准,签署知情同意书.     

慢性特发性荨麻疹的发病机理

慢性特发性荨麻疹发病机理目前尚不清楚，但主要的效应细胞是肥大细胞。大约１／３的患者具有循环功能性组胺释放自身抗体，此抗体与高亲合力ＩｇＥ相结合。该病的治疗主要用抗组胺治疗，血浆去除法等对重症难治患者可能有效。对免疫调节起反应以最近发现与ＨＬＡ－ＤＲ４有关均为某些患者的慢性荨麻疹自身免疫基础提供了一步支持。     

依巴斯汀治疗慢性特发性荨麻疹临床观察

为了观察依巴斯汀(开思亭)治疗慢性特发性荨麻疹的疗效和安全性，2003年2月—2003年8月，上海第一人民医院、上海瑞金医院、上海新华医院及上海华山医院皮肤科联合对开思亭治疗慢性荨麻疹的疗效及安伞性进行了临床观察，现将结果报告如下。     

咪唑斯汀治疗慢性特发性荨麻疹50例临床观察

咪唑斯汀是一种新型的抗组胺药,由法国赛诺菲-圣德拉堡药物研制公司开发合成,于1998年1月最早在瑞士上市,目前已在45个国家陆续上市.     

依巴斯汀治疗慢性特发性荨麻疹32例临床观察

2003年8月—2004年9月,我科采用依巴斯汀[商品名：开思亭,卫材(中国)药业有限公司]治疗32例慢性特发性荨麻疹患者,取得良好疗效,现将结果报告如下。     

Methotrexate-responsive chronic idiopathic urticaria: a report of two cases

Chronic idiopathic urticaria (CIU) may be severe and refractory to standard therapies. We describe two patients with CIU, neither of whom had detectable autoantibodies, in whom control of the disease was achieved with methotrexate.     

Clinical characteristics of pruritus in chronic idiopathic urticaria

BACKGROUND: Although pruritus is a predominant symptom of chronic idiopathic urticaria (CIU) its clinical characteristics have not been explored. OBJECTIVES: To characterize the clinical pattern and sensory and affective dimensions of the itch experience, utilizing a comprehensive itch questionnaire. METHODS: A structured questionnaire based on the McGill pain questionnaire was used in 100 patients suffering from CIU randomly recruited from a tertiary referral centre. RESULTS: All 100 patients recruited with CIU completed the questionnaire. In 68 patients pruritus appeared on a daily basis. Most patients experienced their pruritus at night and in the evening (n = 83), and 62 reported difficulty in falling asleep. Pruritus involved all body areas, but mostly the arms (n = 86), back (n = 78) and legs (n = 75). Accompanying symptoms were a sensation of heat in 45 patients and sweating in 15. Most patients (n = 98) were prescribed antihistamines (mainly sedating), of whom 34 experienced long-term relief. The sensation of itch was reported to be stinging (n = 27), tickling (n = 25) and burning (n = 23). Seventy-six patients found their pruritus bothersome, 66 annoying and 14 complained of depression. The itch intensity at its peak was more than double that felt after a mosquito bite. The worst itch scores of those who felt depressed were significantly higher than of those who did not (P = 0.018). There was a positive correlation between the sensory and affective scores during worst itch (P < 0.001). CONCLUSIONS: This study describes the itch experienced in CIU, highlighting sensory and affective dimensions. The itch questionnaire was found to be a valuable tool for evaluating pruritus in CIU and its unique features.     

非索非那定治疗慢性荨麻疹疗效观察

【摘要】 目的 评估非索非那定治疗慢性荨麻疹的疗效及安全性。方法 采用随机对照的临床研究方法,对89例慢性荨麻疹患者随机分组,治疗组口服非索非那定片60mg,每日2次,对照组口服左旋西替利嗪5mg,每日1次。观察起效时间和治疗第2、4周末疗效和不良反应。结果 在治疗后第2、4周末,2组症状积分值分别为2.49±1.16,2.88±1.21和0.84±1.02,0.92±1.16,与治疗前相比症状积分下降均有显著性差异（t=2.25,P<0.05和t=2.46,P<0.05）;2组间症状积分下降无显著性差异（t=1.26,P>0.05 ）。治疗4周末总体有效率分别为93.48%和86.05%,2组间比较无显著差异（x2 =1.35,P>0.05）。治疗组起效较快于对照组（t=2.68,P<0.01）。治疗组不良反应为4.35%,对照组为9.30%。结论 非索非那定治疗慢性荨麻疹起效迅速、疗效肯定、不良反应发生率低。     

Persistent solar urticaria. A case report

Solar urticaria is an uncommon dermatological disease characterized by wheals developing within a few minutes after sun exposure and lasting a few hours. We describe a man in whom wheals developed on his trunk and arms more than 30 min after sun exposure and lasted more than 24 h. High doses of UVA reproduced lesions with histological features typical of urticaria. After 7 years, urticaria began to develop even in winter and without sun exposure. Our patient is unusual in that his wheals were delayed in onset and longlasting. The later association of idiopathic urticaria is an additional unusual feature.     

Levocetirizine in the treatment of chronic idiopathic urticaria: a randomized, double-blind, placebo-controlled study

BACKGROUND: Chronic urticaria is a common skin condition. It is frequently a disabling disease because of the persistence of clinical symptoms, the unpredictable course and its negative influence on the quality of life. OBJECTIVES: To determine whether levocetirizine is efficacious in the treatment of chronic idiopathic urticaria. METHODS: A randomized, double-blind, placebo-controlled study was conducted in 106 patients with a diagnosis of chronic idiopathic urticaria. A 1-week single blind placebo run-in period (baseline) was followed by a 6-week double blind active treatment period. The patients were randomized to receive one of the following treatments once daily: (a) oral levocetirizine 5 mg, or (b) oral placebo. The study ended after another 1-week single blind placebo washout period. RESULTS: The evaluable population consisted of 100 patients. Levocetirizine administered once daily is effective and well tolerated in the treatment of the symptoms of chronic idiopathic urticaria and in improving the patient's quality of life. Levocetirizine was superior to placebo in reducing the mean total symptoms score as well as individual symptoms, the number of daily episodes and the number of weals, the overall severity of symptoms and the quality of life. The significant beneficial effects of levocetirizine lasted only during the active trial, while at follow-up there was a significant worsening of all the variables evaluated in this study, after the end of the active trial (week 7). CONCLUSIONS: A global assessment indicates that levocetirizine 5 mg once daily is an effective agent in patients with chronic idiopathic urticaria, as its action provides a rapid and satisfactory control of the symptoms and measures of subjective disease, although this is limited to the duration of treatment.     

荨麻疹患者血清特异性IgE过敏原检测及两种氯雷他定的疗效比较

目的:了解322例荨麻疹患者的致病因素及各种因素之间的相互关系,比较2种氯雷他定治疗84例慢性特发性荨麻疹患者的疗效。方法:采用德国“敏筛”定量过敏原检测系统对322例荨麻疹患者进行了特异性IgE及过敏原的检测和分析,应用2种氯雷他定片治疗84例慢性特发性荨麻疹患者,并进行疗效对比和随访观察。结果:322例患者中有159例至少对1项过敏原阳性,阳性率为49.4%。平均阳性过敏原为(1.36±1.70)项;78例患者血清特异性总IgE阳性,阳性率为24.2%。2种氯雷他定片治疗前后患者症状和体征评分指数下降差异无统计学意义。治疗后,治疗组基愈率为37.2%,有效率为72.2%;对照组基愈率为39.0%,有效率为78.0%,两组疗效比较差异无统计学意义。结论:德国“敏筛”定量过敏原检测系统能较简便地检测特异性IgE和过敏原;国产氯雷他定治疗慢性特发性荨麻疹安全有效。     

Markers of antioxidant defence system and lipid peroxidation in peripheral blood of female patients with chronic idiopathic urticaria

Oxidative stress is an important event in lesional skin of patients with chronic idiopathic urticaria (CIU). In the present study, we assessed blood oxidant/antioxidant status of patients suffering from CIU with positive response to autologous serum skin test (ASST) and with negative ASST, to improve our understanding of biological processes and the part of oxidative stress in this disease. Activities of manganese superoxide dismutase (MnSOD), copper–zinc superoxide dismutase (Cu/ZnSOD), glutathione peroxidase (GSH-PX), and catalase (CAT) as indices of enzymatic antioxidant capacity, as well as malondialdehyde (MDA) level as a maker of lipid peroxidation were measured in plasma and erythrocytes from 14 CIU female patients showing positive ASST, 31 CIU female patients with negative ASST and in 19 sex- and age- matched healthy subjects. The antioxidant enzyme activity in plasma and in erythrocytes did not differ significantly among the three groups. Also, the plasma and erythrocytes MDA levels were similar in the three groups. Based on our results, it seems that systemic activity of the enzymatic antioxidants (CuZn/SOD, MnSOD, GSH-Px, and CAT) as well as level of lipid peroxidation determined by MDA may not be increased in the course of immune-inflammatory processes associated with CIU. We also suggest that the systemic oxidant/antioxidant status of CIU patients, showing positive response to ASST, may not be different from that of CIU patients with negative ASST.     

Chronic idiopathic urticaria: prevalence and clinical course

The purpose of our study was to assess the prevalence and clinical course of patients with chronic idiopathic urticaria (CIU), as well as possible causes or associated findings, laboratory findings and the duration of the disease in patients with chronic urticaria (CU). We retrospectively reviewed the 450 case record forms of patients with CU and/or angioedema who attended the Department of Dermatology, Siriraj Hospital, during the period 2000-2004. Of 450 patients with CU, 337 patients (75%) were diagnosed as CIU. Forty-three patients (9.5%) had physical urticaria, while 17 patients (3.8%) had infectious causes. Other possible causes were food, thyroid diseases, atopy, drugs, dyspepsia and collagen vascular diseases. In eighty-nine percent of patients, no abnormalities were detected at the time of physical examination. The most common abnormal laboratory finding was minimal elevation of the erythrocyte sedimentary rate (42%). In 61 patients, autologous serum skin tests had been done. Fifteen patients (24.5%) had positive results i.e. autoimmune urticaria. Anti-thyroglobulin and anti-microsomal antibodies were positive in 16 % and 12% of CIU patients respectively. After 1 year from the onset of the symptoms, 34.5% of CIU patients were free of symptoms and after 1.2 years from the onset of the symptoms, 56.5% of autoimmune urticaria patients were free of symptoms. The median disease duration of CIU and autoimmune urticaria were 390 days and 450 days respectively. Our study provided an overview of CU and CIU in a large series of Thai patients, based on etiological aspects and clinical courses.     

Low-dose and short-term cyclosporine treatment in patients with chronic idiopathic urticaria: a clinical and immunological evaluation

The present study aimed to evaluate the effectiveness of 2.5 mg/kg/day cyclosporin (CsA) treatment in patients with severe chronic idiopathic urticaria (CIU) and the impact of CsA treatment on several cytokines involved in the etiopathogenesis of CIU. Twenty-seven CIU patients and 24 healthy control subjects were included in the study. The autologous serum skin test (ASST) for autoantibodies and urticaria activity scoring (UAS) were measured for the evaluation of the clinical severity and the response to therapy, and the serum levels of interleukin (IL)-6, IL-8, IL-2 receptor, IL-1beta, tumor necrosis factor (TNF)-alpha and IL-5 were measured. The mean UAS score was 32.07 +/- 7.05 and 6.22 +/- 3.84 before and after CsA treatment, respectively. The serum IL-2 receptor, TNF-alpha and IL-5 levels of patients before CsA treatment were statistically higher than those of the control group (P = 0.001), and after 4 weeks of CsA therapy the mean IL-2R, TNF-alpha and IL-5 levels were significantly decreased. The data from this study demonstrate that CsA therapy is efficient and safe for CIU patients. Increase in clinical efficacy and marked decreases in serum cytokine levels suggest that inhibition of cytokine generation is involved in the action of the drug in this clinical setting.     

依巴斯汀治疗慢性特发性荨麻疹的临床试验研究

目的:评估国产依巴斯汀治疗慢性特发性荨麻疹的临床疗效和安全性。方法:采用随机、双盲、平行对照的方法对依巴斯汀治疗慢性荨麻疹进行Ⅱ期临床试验,并与西替利嗪进行对照。结果:共观察患者136例,依巴斯汀组69例,西替利嗪组67例,依巴斯汀组的有效率和显效率分别为91.3%和63.8%,而西替利嗪组分别为87.9%和65.2%,两组间比较差异均无显著性(P>0.05)。依巴斯汀组症状积分下降指数为0.79±0.26,而西替利嗪组为0.76±0.29,两组间比较差异无显著性(P>0.05)。两种药物的不良反应主要为轻至中度困倦和口干。结论:依巴斯汀治疗慢性特发性荨麻疹安全有效,其疗效及不良反应与西替利嗪相似。