中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2012年
7期
470-473
,共4页
陈曙光%翟志芳%宋志强%冯林%黄秀英%周晓芳%游弋%钟华%王欢%程良金%向明明%郝飞
陳曙光%翟誌芳%宋誌彊%馮林%黃秀英%週曉芳%遊弋%鐘華%王歡%程良金%嚮明明%郝飛
진서광%적지방%송지강%풍림%황수영%주효방%유익%종화%왕환%정량금%향명명%학비
荨麻疹%皮肤试验%自体血清%自体全血注射
蕁痳疹%皮膚試驗%自體血清%自體全血註射
담마진%피부시험%자체혈청%자체전혈주사
Urticaria%Skin tests%Autologous serum%Autologous whole blood injection
[目的]评价自体全血注射治疗对自体血清皮肤试验(ASST)阳性的慢性自发性荨麻疹的疗效.[方法]对慢性自发性荨麻疹患者在临床病史评估的基础上进行皮肤点刺试验(SPT)及ASST;选择ASST阳性且常见变应原皮肤点刺试验阴性的100例患者,随机分为治疗组(60例)和对照组(40例).两组均给予规则口服氯雷他定片,并尝试逐渐减量至可控制症状的最小服药量；治疗组同时接受每周1次的自体全血注射治疗,连续治疗12周.在治疗后的第3和6个月评价所有患者荨麻疹疾病活动程度(UAS)、皮肤病生活质量指数(DLQI)和每月抗组胺药物总服用量.采用SPSS13.0统计软件,对治疗前后UAS、DLQI、累计抗组胺药物总量以及治疗前后ASST诱导的风团/红晕直径行t检验,组间疗效比较采用秩和检验.[结果]治疗组在治疗前(基线)和治疗后第3个月、第6个月时的UAS分别为5.73± 0.51、1.57±1.42、0.69±0.92;对照组分别5.32±0.79、3.65±1.53、2.65±1.61,经秩和检验,两组在治疗前UAS评分差异无统计学意义；与基线相比较,治疗后第3和第6个月,两组UAS均有不同程度改善.治疗3个月后,治疗组和对照组UAS改善程度分别为69％和35％；治疗6个月后分别为81％和53％,两组差异均有统计学意义(P＜0.05).治疗组抗组胺药物平均月需量(第3个月平均8.63片,第6个月平均3.83片)均较对照组显著减少(分别为16.85片和15.27片).[结论]自体全血注射联合抗组胺药治疗可有效改善ASST阳性慢性自发性荨麻疹患者的UAS和DLQI,且可显著减少患者对抗组胺药物的总需求量.
[目的]評價自體全血註射治療對自體血清皮膚試驗(ASST)暘性的慢性自髮性蕁痳疹的療效.[方法]對慢性自髮性蕁痳疹患者在臨床病史評估的基礎上進行皮膚點刺試驗(SPT)及ASST;選擇ASST暘性且常見變應原皮膚點刺試驗陰性的100例患者,隨機分為治療組(60例)和對照組(40例).兩組均給予規則口服氯雷他定片,併嘗試逐漸減量至可控製癥狀的最小服藥量；治療組同時接受每週1次的自體全血註射治療,連續治療12週.在治療後的第3和6箇月評價所有患者蕁痳疹疾病活動程度(UAS)、皮膚病生活質量指數(DLQI)和每月抗組胺藥物總服用量.採用SPSS13.0統計軟件,對治療前後UAS、DLQI、纍計抗組胺藥物總量以及治療前後ASST誘導的風糰/紅暈直徑行t檢驗,組間療效比較採用秩和檢驗.[結果]治療組在治療前(基線)和治療後第3箇月、第6箇月時的UAS分彆為5.73± 0.51、1.57±1.42、0.69±0.92;對照組分彆5.32±0.79、3.65±1.53、2.65±1.61,經秩和檢驗,兩組在治療前UAS評分差異無統計學意義；與基線相比較,治療後第3和第6箇月,兩組UAS均有不同程度改善.治療3箇月後,治療組和對照組UAS改善程度分彆為69％和35％；治療6箇月後分彆為81％和53％,兩組差異均有統計學意義(P＜0.05).治療組抗組胺藥物平均月需量(第3箇月平均8.63片,第6箇月平均3.83片)均較對照組顯著減少(分彆為16.85片和15.27片).[結論]自體全血註射聯閤抗組胺藥治療可有效改善ASST暘性慢性自髮性蕁痳疹患者的UAS和DLQI,且可顯著減少患者對抗組胺藥物的總需求量.
[목적]평개자체전혈주사치료대자체혈청피부시험(ASST)양성적만성자발성담마진적료효.[방법]대만성자발성담마진환자재림상병사평고적기출상진행피부점자시험(SPT)급ASST;선택ASST양성차상견변응원피부점자시험음성적100례환자,수궤분위치료조(60례)화대조조(40례).량조균급여규칙구복록뢰타정편,병상시축점감량지가공제증상적최소복약량；치료조동시접수매주1차적자체전혈주사치료,련속치료12주.재치료후적제3화6개월평개소유환자담마진질병활동정도(UAS)、피부병생활질량지수(DLQI)화매월항조알약물총복용량.채용SPSS13.0통계연건,대치료전후UAS、DLQI、루계항조알약물총량이급치료전후ASST유도적풍단/홍훈직경행t검험,조간료효비교채용질화검험.[결과]치료조재치료전(기선)화치료후제3개월、제6개월시적UAS분별위5.73± 0.51、1.57±1.42、0.69±0.92;대조조분별5.32±0.79、3.65±1.53、2.65±1.61,경질화검험,량조재치료전UAS평분차이무통계학의의；여기선상비교,치료후제3화제6개월,량조UAS균유불동정도개선.치료3개월후,치료조화대조조UAS개선정도분별위69％화35％；치료6개월후분별위81％화53％,량조차이균유통계학의의(P＜0.05).치료조항조알약물평균월수량(제3개월평균8.63편,제6개월평균3.83편)균교대조조현저감소(분별위16.85편화15.27편).[결론]자체전혈주사연합항조알약치료가유효개선ASST양성만성자발성담마진환자적UAS화DLQI,차가현저감소환자대항조알약물적총수구량.
[Objective] To evaluate the efficacy of autologous whole blood injections in patients with chronic spontaneous urticaria and positive autologous serum skin test (ASST).[[Methods]] After assessment of clinical history,patients with chronic spontaneous urticaria underwent skin prick test (SPT) and ASST.Then,100 patients with positive ASST but negative SPT for common allergens were randomly classified into treatment group (n =60) and control group (n =40).Oral loratadine was given to all the patients with a gradual tapering to the least maintenance dose.Patients in the treatment group were also injected with autologous whole blood once a week for 12 times.Patients were evaluated by urticaria activity score (UAS) and dermatology life quality index (DLQI) at the baseline,the end of the 3rd and 6th month after the initial treatment.The total amount of antihistamines required for the control of urticaria every month was calculated.The UAS,DLQI,accumulative amount of administrated antihistamines,and the diameter of wheal/flush induced by autologous serum were compared by t test before and after the treatment,and the efficacy was compared by rank sum test between the two groups.[Results] No significant difference was observed between the control and treatment group in UAS at the baseline (5.73 ± 0.51 vs.5.32 ± 0.79,P＞ 0.05).The UAS reached 1.57 ± 1.42 and 0.69± 0.92 with a decrease rate of 69％ and 81％ in the treatment group,and 3.65 ± 1.53 and 2.65 ± 1.61 with a decrease rate of 35％ and 53％ in the control group,respectively at the end of the 3rd and 6th month,and statistical difference was observed for the decrease in both groups at the two time points (all P ＜ 0.05).The total amount of antihistamines required for the control of urticaria per month averaged 8.63 pills and 3.83 pills respectively in the treatment group after 3 and 6 months of treatment,significantly less than that in the control group (16.85 and 15.27 pills,respectively).[Conclusion]s The combination of oral antihistamine and autologous whole blood injections can not only reduce disease activity and improve patients' quality of life,but also decrease the total amount of antihistamines required for the control of urticaria.
