Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or a...Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.展开更多
Objective:To evaluate the effectiveness and safety of acupoint catgut embedding(ACE)in combination with Chinese herbal medicine(CHM)in treating chronic urticaria(CU).Methods:We thoroughly searched Embase,PubMed,Cochra...Objective:To evaluate the effectiveness and safety of acupoint catgut embedding(ACE)in combination with Chinese herbal medicine(CHM)in treating chronic urticaria(CU).Methods:We thoroughly searched Embase,PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wangfang database,Chinese Scientific Journal Database(VIP),and Chinese biomedical literature database(SinoMed)for relevant studies from inception until May 2022.Randomized controlled trials(RCTs)on ACE combined with CHM for CU were included.Literature search,data extraction,and risk of bias assessment were independently conducted by two authors.Results:A total of 15 RCTs with 1065 participants were included in this review.Five trials reported that the combined therapy showed a higher total effective rate,and four trials reported that the combined therapy was associated with a lower level of serum immunoglobulin E.Furthermore,two,four,and four trials reported that the combined therapy was more effective in reducing itching degree,size,and number of wheals,respectively.The combined therapy was reported to be associated with a lower recurrence rate in three trials,and with a fewer adverse reaction rate in two trials.Conclusions:ACE in combination with CHM appears to be a safe and effective therapy for patients with CU.Given the relatively low quality of the included trials,these findings should be interpreted cautiously.Further high-quality RCTs are needed to confirm our findings.展开更多
Background:Based on clinical data mining,we introduce the medication rule and clinical application of Professor Wang Lifen in the treatment of chronic urticaria,as the reference of clinical treatment of chronic urtica...Background:Based on clinical data mining,we introduce the medication rule and clinical application of Professor Wang Lifen in the treatment of chronic urticaria,as the reference of clinical treatment of chronic urticaria.Methods:we collected 110 traditional Chinese medicine prescriptions for the treatment of chronic urticaria,and found out tastes,functions and channel tropism of Chinese medicine.After collecting and sorting,we inputted the data into excel 2010 software and established drug electronic database.We calculated the frequency of tastes,functions and channel tropism using the Spss 20.0 and analyzed the potential relationship between the drugs using Weka 3.8.We used Cytoscape 3.6.1 to draw the related network and combine it into a new prescription.Then the clinical data of prescriptions were statistically analyzed.Results:The statistical analysis showed that the high-frequency drugs for the treatment of the disease were Gancao(Glycyrrhizae radix et rhizoma),Huangqin(Radix scutellariae),Desmopeel,Jingjie(Herba schizonepetae),parsnip,etc.,accounting for more than 69.50%of the total frequency.Moreover,the combination and drug pairs with the strongest and most commonly used high-frequency drugs were found.From the point of medicinal properties of these drugs in the treatment of chronic urticaria,the main drugs are cold,followed by warm and smooth,accounting for 70.75%of the total frequency.From the perspective of the efficacy of these drugs in the treatment of chronic urticaria,heat-clearing drugs are the main ones,followed by relieving drugs and Tonic drugs,accounting for 68.25%of the total frequency.From the perspective of medicine taste,sweet taste is the most important,followed by bitter and pungent taste,accounting for 68.00%of the total frequency.From the perspective of drugs channel tropism,the meridian of spleen is the most important,followed by the meridian of lung,liver,heart,stomach,etc.,accounting for 71.62%of the total frequency.Conclusion:According to the data mining results,traditional Chinese medicine treatment of chronic urticaria is mainly based on dispelling wind,clearing heat and removing dampness,cooling blood and detoxifying,supplemented by nourishing blood and nourishing deficiency.This data mining conforms to the law and principle of traditional Chinese medicine treatment of chronic urticaria,which has certain reference and enlightenment significance for clinical treatment of chronic urticaria.展开更多
Chronic urticaria is a commonly encountered skin illness characterized by protracted course and recurrent episodes. The author had treated 26 cases of chronic urticaria by pricking, cupping and Qu Feng Tiao Ying (... Chronic urticaria is a commonly encountered skin illness characterized by protracted course and recurrent episodes. The author had treated 26 cases of chronic urticaria by pricking, cupping and Qu Feng Tiao Ying (QFTY) decoction (祛风调营汤the Wind-dispelling and Ying system-regulating Decoction) with satisfactory results. A report is as follows.……展开更多
In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase cha...In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.展开更多
Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with anti...Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.展开更多
Background Chronic urticaria(CU)has been shown to impact patients'quality of life negatively and may coexist with psychiatric disorders.We systematically reviewed the published evidence of comorbid psychiatric dis...Background Chronic urticaria(CU)has been shown to impact patients'quality of life negatively and may coexist with psychiatric disorders.We systematically reviewed the published evidence of comorbid psychiatric disorders in children and adolescents with CU.Methods A systematic review of studies published until February 2022 in PubMed,Google Scholar,and Scopus was performed.An a priori set of inclusion criteria was predefined for the studies to be included:(1)clear distinction between urticaria and other allergies;(2)precise distinction between acute and CU;(3)participants younger than 18 years old,exclusively;(4)use of appropriate standardized questionnaires,psychometric tools,and standard diagnostic nomenclature for the mental health and behavioral disorders diagnosis;and(5)manuscripts written or published in the English language.Results Our search identified 582 potentially relevant papers.Only eight of them satisfied the inclusion criteria.Quantita-tive meta-analysis was not deemed appropriate,given the lack of relevant randomized control trials,the small number of relevant shortlisted,the small sample size of the patients included in each study,and the remarkable heterogeneity of the studies'protocols.Conclusions The included studies suggest an increased incidence of psychopathology among children and adolescents with CU as opposed to healthy age-matched individuals,but the data are scarce.Further research is required to clarify whether psychopathology is just a comorbid entity,the cause,or the consequence of CU.Meanwhile an interdisciplinary collaboration between allergists/dermatologists and psychiatrists is expected to substantially minimize CU burden and improve patients'quality of life.展开更多
Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, ...Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.展开更多
Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including sys...Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.展开更多
Objective： To assess the effect and adverse reaction of total glucosides of paeony capsule （TGPC） in combining with citirizine for the treatment of chronic urticaria. Methods： A total of 120 patients were assigned...Objective： To assess the effect and adverse reaction of total glucosides of paeony capsule （TGPC） in combining with citirizine for the treatment of chronic urticaria. Methods： A total of 120 patients were assigned to two groups by lottery, 65 in the treated group and 55 in the control group. They all were orally treated with citirizine tablet 10 mg per day, but to the treated group, additional 0.2 g TGPC was given three times per day, the therapeutic course for both groups was 4 weeks. The effectiveness of treatment was observed, and the changes of total symptom score, serum levels of interleukin-4 （IL-4）, and immunoglobulin E （IgE） were measured before and after treatment. Moreover, a follow- up was carded out one month after ending the treatment. Results： The dropped cases were two in the treated group and seven in the control group; so, the study was accomplished on 63 patients in the treated group and 48 patients in the control group. The total effective rate was assessed at 73.02% （46/63） in the treated group, which was significantly higher than 47.92% （23/48） in the control group （P〈0.01）. After treatment, the total symptom score decreased in both groups, but the decrement in the treated group was more significant （P〈0.05）. Serum levels of IL-4 and IgE in the treated group lowered significantly, while the changes in the control group were insignificant, so statistical significant differences were shown between groups （P〈0.01）. A follow-up study showed that the relapse rate in the treated group was 30.00% （6/20）, while that in the control group was 90.00% （9/10）, and the former was lower than the latter （P〈0.01）. Adverse reactions, revealed as drowsiness, dizziness, and weakness, were seen in eight cases and seven cases in the two groups, respectively. Besides, mild diarrhea occurred in two cases of the treated group. Conclusions： The treatment of TGPC combining citirizine shows definite curative effect in treating chronic urticaria, with low relapse rate and without evident adverse reaction. Its therapeutic effect might be realized by means of regulating patients＇ immune function. Besides, the medication should be continued for a rather long peried to achieve the full effect.展开更多
Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe tr...Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe treatments for CU are still needed.Objective:This review aims to evaluate the effectiveness and safety of cupping therapy in patients with CU.Search strategy:The search strategy looked for the presence of related keywords,such as‘‘chronic urticaria"and‘‘cupping therapy,"in the title and abstract of research articles indexed in major databases.Randomized controlled trials(RCTs)were selected after querying nine electronic databases from their inception to May 2019 with the above search terms.Inclusion criteria:RCTs were included if they recruited patients with CU who were intervened with dry or wet cupping.Publications could be written in Chinese or English.Data extraction and analysis:Data were extracted,and the studies were assessed for the quality of their methodological design and risk of bias.Meta-analyses of the RCT data were conducted to assess the total effective rate of the treatment as the primary outcome.Skin disease quality of life index score,recurrence rate,and adverse events were assessed as secondary outcomes.Subgroup analyses were conducted based on different interventions.Results:Thirteen comparisons from 12 RCTs involving 842 participants were included.There were no significant differences between wet cupping and medications in total effective rate(n=372;risk ratio[RR]=1.10,95%confidence interval[CI]0.97 to 1.25;P=0.14)or recurrence rate(n=240;RR=0.56,95%CI 0.23 to 1.36;P=0.20).Cupping therapy,in combination with antihistamine treatment was more efficacious than antihistamines alone,with a greater total effective rate(n=342;RR=1.18,95%CI 1.01 to1.39;P=0.03)and lower recurrence rate(n=342;RR=0.52,95%CI 0.32 to 0.84;P=0.007).Cupping therapy combined with acupuncture was more effective than acupuncture alone(n=156;RR=1.25,95%CI 1.07 to 1.46;P=0.006).No serious adverse events were reported.Conclusion:Wet cupping may be as effective as treatment with antihistamines.When cupping therapy is used as an adjuvant therapy to antihistamines or acupuncture,it may enhance the efficacy.Results drawn from these studies should be interpreted with caution and applied with care to clinical practice,because of the poor quality among the studies that were reviewed.Systematic review registration:PROSPERO,CRD42019137451.展开更多
Chronic urticaria（CU）is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medic...Chronic urticaria（CU）is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medicine（CM）has been shown to relieve symptoms and prevent recurrence.However,the lack of robust evidence from the evidence-based medicine perspective is hindering acceptance of CM by the Western medicine community.In recent years,more and more evidence-based studies of CU treatment by CM were report in English literatures,including acupuncture,herbs,and food,although some of evidence is still with low quality.These progress in CM treatment of CU will inspire high quality evidences via randomized,controlled trials assessing efficacy and safety of CM treatment of CU.展开更多
Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system...Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.展开更多
Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate ...Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.展开更多
Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is t...Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine展开更多
Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to eval...Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.展开更多
文摘Chronic spontaneous urticaria (CSU) is defined as the spontaneous appearance of wheals, angioedema, or both, for at least 6 weeks, due to known or unknown causes [1]. In some patients who present a CSU with daily or almost daily symptoms a type I allergy could be the underlying cause. We present one adult patient with chronic urticaria who was finally diagnosed as a non-occupational case of IgE-mediated wheat allergy manifested following exposure by 3 different routes: inhalation (rhinitis and bronchial asthma), dermal absorption (contact urticaria) and ingestion (systemic chronic urticaria). We were able to detect the culprit proteins by immunoblotting. Serum IgE binds mainly to alpha-amylase/trypsin inhibitors and, to a lesser extent, to other proteins associated with food allergy to grains (e.g. beta-glucanase, serpin, peroxidase). In our opinion, skin prick tests with a food standard battery could help in the etiological diagnosis of chronic urticaria. The identification of responsible allergens could be difficult because only a few complex in vitro techniques allow detecting the allergy to several proteins.
基金This research was supported by Key Research Program of the Chinese Academy of Sciences(ZDRW-ZS-2021-1-2).
文摘Objective:To evaluate the effectiveness and safety of acupoint catgut embedding(ACE)in combination with Chinese herbal medicine(CHM)in treating chronic urticaria(CU).Methods:We thoroughly searched Embase,PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wangfang database,Chinese Scientific Journal Database(VIP),and Chinese biomedical literature database(SinoMed)for relevant studies from inception until May 2022.Randomized controlled trials(RCTs)on ACE combined with CHM for CU were included.Literature search,data extraction,and risk of bias assessment were independently conducted by two authors.Results:A total of 15 RCTs with 1065 participants were included in this review.Five trials reported that the combined therapy showed a higher total effective rate,and four trials reported that the combined therapy was associated with a lower level of serum immunoglobulin E.Furthermore,two,four,and four trials reported that the combined therapy was more effective in reducing itching degree,size,and number of wheals,respectively.The combined therapy was reported to be associated with a lower recurrence rate in three trials,and with a fewer adverse reaction rate in two trials.Conclusions:ACE in combination with CHM appears to be a safe and effective therapy for patients with CU.Given the relatively low quality of the included trials,these findings should be interpreted cautiously.Further high-quality RCTs are needed to confirm our findings.
文摘Background:Based on clinical data mining,we introduce the medication rule and clinical application of Professor Wang Lifen in the treatment of chronic urticaria,as the reference of clinical treatment of chronic urticaria.Methods:we collected 110 traditional Chinese medicine prescriptions for the treatment of chronic urticaria,and found out tastes,functions and channel tropism of Chinese medicine.After collecting and sorting,we inputted the data into excel 2010 software and established drug electronic database.We calculated the frequency of tastes,functions and channel tropism using the Spss 20.0 and analyzed the potential relationship between the drugs using Weka 3.8.We used Cytoscape 3.6.1 to draw the related network and combine it into a new prescription.Then the clinical data of prescriptions were statistically analyzed.Results:The statistical analysis showed that the high-frequency drugs for the treatment of the disease were Gancao(Glycyrrhizae radix et rhizoma),Huangqin(Radix scutellariae),Desmopeel,Jingjie(Herba schizonepetae),parsnip,etc.,accounting for more than 69.50%of the total frequency.Moreover,the combination and drug pairs with the strongest and most commonly used high-frequency drugs were found.From the point of medicinal properties of these drugs in the treatment of chronic urticaria,the main drugs are cold,followed by warm and smooth,accounting for 70.75%of the total frequency.From the perspective of the efficacy of these drugs in the treatment of chronic urticaria,heat-clearing drugs are the main ones,followed by relieving drugs and Tonic drugs,accounting for 68.25%of the total frequency.From the perspective of medicine taste,sweet taste is the most important,followed by bitter and pungent taste,accounting for 68.00%of the total frequency.From the perspective of drugs channel tropism,the meridian of spleen is the most important,followed by the meridian of lung,liver,heart,stomach,etc.,accounting for 71.62%of the total frequency.Conclusion:According to the data mining results,traditional Chinese medicine treatment of chronic urticaria is mainly based on dispelling wind,clearing heat and removing dampness,cooling blood and detoxifying,supplemented by nourishing blood and nourishing deficiency.This data mining conforms to the law and principle of traditional Chinese medicine treatment of chronic urticaria,which has certain reference and enlightenment significance for clinical treatment of chronic urticaria.
文摘 Chronic urticaria is a commonly encountered skin illness characterized by protracted course and recurrent episodes. The author had treated 26 cases of chronic urticaria by pricking, cupping and Qu Feng Tiao Ying (QFTY) decoction (祛风调营汤the Wind-dispelling and Ying system-regulating Decoction) with satisfactory results. A report is as follows.……
文摘In order to investigate the association of genotypes of HLA-DRB1 and HLA-DQB1 alleles with the genetic susceptibility of chronic urticaria (CU), genotypes of HLA-DRB1 and HLA-DQB1 genes were detected by polymerase chain reactions with sequence-specific primers (PCR-SSP) in 42 patients with CU (19 men and 23 women, mean age 30.67±12.45 y old as well as 193 racially matched healthy persons in ethnic Han from Hubei provinece. Gene frequencies of HLA-DRB1*12, *0901 (RR=3.11, χ2=7.579, P=0.006; RR=2.47, χ2=5.684, P=0.017) were significantly increased in CU patients as compared with that in healthy people. Gene frequencies of HLA-DQB1*05 (RR=0.26, χ2=6.683, P=0.01) were significantly decreased in CU patients. It was suggested that CU was found strongly associated with HLA-DRB1*12, *0901 and HLA-DQB1*05, the former might be the genetic markers for susceptibility to CU, but the latter might play a resistive role.
文摘Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.
文摘Background Chronic urticaria(CU)has been shown to impact patients'quality of life negatively and may coexist with psychiatric disorders.We systematically reviewed the published evidence of comorbid psychiatric disorders in children and adolescents with CU.Methods A systematic review of studies published until February 2022 in PubMed,Google Scholar,and Scopus was performed.An a priori set of inclusion criteria was predefined for the studies to be included:(1)clear distinction between urticaria and other allergies;(2)precise distinction between acute and CU;(3)participants younger than 18 years old,exclusively;(4)use of appropriate standardized questionnaires,psychometric tools,and standard diagnostic nomenclature for the mental health and behavioral disorders diagnosis;and(5)manuscripts written or published in the English language.Results Our search identified 582 potentially relevant papers.Only eight of them satisfied the inclusion criteria.Quantita-tive meta-analysis was not deemed appropriate,given the lack of relevant randomized control trials,the small number of relevant shortlisted,the small sample size of the patients included in each study,and the remarkable heterogeneity of the studies'protocols.Conclusions The included studies suggest an increased incidence of psychopathology among children and adolescents with CU as opposed to healthy age-matched individuals,but the data are scarce.Further research is required to clarify whether psychopathology is just a comorbid entity,the cause,or the consequence of CU.Meanwhile an interdisciplinary collaboration between allergists/dermatologists and psychiatrists is expected to substantially minimize CU burden and improve patients'quality of life.
文摘Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment.
文摘Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.
文摘Objective： To assess the effect and adverse reaction of total glucosides of paeony capsule （TGPC） in combining with citirizine for the treatment of chronic urticaria. Methods： A total of 120 patients were assigned to two groups by lottery, 65 in the treated group and 55 in the control group. They all were orally treated with citirizine tablet 10 mg per day, but to the treated group, additional 0.2 g TGPC was given three times per day, the therapeutic course for both groups was 4 weeks. The effectiveness of treatment was observed, and the changes of total symptom score, serum levels of interleukin-4 （IL-4）, and immunoglobulin E （IgE） were measured before and after treatment. Moreover, a follow- up was carded out one month after ending the treatment. Results： The dropped cases were two in the treated group and seven in the control group; so, the study was accomplished on 63 patients in the treated group and 48 patients in the control group. The total effective rate was assessed at 73.02% （46/63） in the treated group, which was significantly higher than 47.92% （23/48） in the control group （P〈0.01）. After treatment, the total symptom score decreased in both groups, but the decrement in the treated group was more significant （P〈0.05）. Serum levels of IL-4 and IgE in the treated group lowered significantly, while the changes in the control group were insignificant, so statistical significant differences were shown between groups （P〈0.01）. A follow-up study showed that the relapse rate in the treated group was 30.00% （6/20）, while that in the control group was 90.00% （9/10）, and the former was lower than the latter （P〈0.01）. Adverse reactions, revealed as drowsiness, dizziness, and weakness, were seen in eight cases and seven cases in the two groups, respectively. Besides, mild diarrhea occurred in two cases of the treated group. Conclusions： The treatment of TGPC combining citirizine shows definite curative effect in treating chronic urticaria, with low relapse rate and without evident adverse reaction. Its therapeutic effect might be realized by means of regulating patients＇ immune function. Besides, the medication should be continued for a rather long peried to achieve the full effect.
基金supported by the National Key Research and Development Program of the China-Key Project“Research on Modernization of Traditional Chinese Medicine”——“International Cooperation Research on Evaluation of Acupuncture Advantage Diseases”(No.2017YFC1703600 and 2017YFC1703605)。
文摘Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe treatments for CU are still needed.Objective:This review aims to evaluate the effectiveness and safety of cupping therapy in patients with CU.Search strategy:The search strategy looked for the presence of related keywords,such as‘‘chronic urticaria"and‘‘cupping therapy,"in the title and abstract of research articles indexed in major databases.Randomized controlled trials(RCTs)were selected after querying nine electronic databases from their inception to May 2019 with the above search terms.Inclusion criteria:RCTs were included if they recruited patients with CU who were intervened with dry or wet cupping.Publications could be written in Chinese or English.Data extraction and analysis:Data were extracted,and the studies were assessed for the quality of their methodological design and risk of bias.Meta-analyses of the RCT data were conducted to assess the total effective rate of the treatment as the primary outcome.Skin disease quality of life index score,recurrence rate,and adverse events were assessed as secondary outcomes.Subgroup analyses were conducted based on different interventions.Results:Thirteen comparisons from 12 RCTs involving 842 participants were included.There were no significant differences between wet cupping and medications in total effective rate(n=372;risk ratio[RR]=1.10,95%confidence interval[CI]0.97 to 1.25;P=0.14)or recurrence rate(n=240;RR=0.56,95%CI 0.23 to 1.36;P=0.20).Cupping therapy,in combination with antihistamine treatment was more efficacious than antihistamines alone,with a greater total effective rate(n=342;RR=1.18,95%CI 1.01 to1.39;P=0.03)and lower recurrence rate(n=342;RR=0.52,95%CI 0.32 to 0.84;P=0.007).Cupping therapy combined with acupuncture was more effective than acupuncture alone(n=156;RR=1.25,95%CI 1.07 to 1.46;P=0.006).No serious adverse events were reported.Conclusion:Wet cupping may be as effective as treatment with antihistamines.When cupping therapy is used as an adjuvant therapy to antihistamines or acupuncture,it may enhance the efficacy.Results drawn from these studies should be interpreted with caution and applied with care to clinical practice,because of the poor quality among the studies that were reviewed.Systematic review registration:PROSPERO,CRD42019137451.
文摘Chronic urticaria（CU）is characterized by repeated occurrence of wheals or itching for more than 6 weeks.When urticaria symptoms repeatedly occur despite taking Western medicines such as antihistamines,Chinese medicine（CM）has been shown to relieve symptoms and prevent recurrence.However,the lack of robust evidence from the evidence-based medicine perspective is hindering acceptance of CM by the Western medicine community.In recent years,more and more evidence-based studies of CU treatment by CM were report in English literatures,including acupuncture,herbs,and food,although some of evidence is still with low quality.These progress in CM treatment of CU will inspire high quality evidences via randomized,controlled trials assessing efficacy and safety of CM treatment of CU.
文摘Chronic Spontaneous Urticaria (CSU) is a chronic disease with significant negative impact on quality of life of patients. The direct and indirect costs of the disease can be substantial both for the health care system and society. The aim of this research is to estimate the cost of mild, moderate and severe CSU in Turkey and to forecast the cost of the disease from the payer (Social Security Institution—SSI) perspective. Expert opinions with Delphi technique were used in order to determine the cost items and their frequency. A questionnaire was designed to outline resources used in the out-patient, inpatient and emergency care episodes and was answered by dermatologists followed by a consensus meeting. Unit costs were calculated from the price list of the SSI. The annual total cost of treating the disease to the SSI was estimated as 262,111,978TL (94,417,870€) comprising 0.06% of the total healthcare budget in 2013. Since there is limited information about the cost of CSU in Turkey, the methodology and results of this study are unique and very important.
文摘Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.
文摘Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine
文摘Introduction: The prevalence of urticaria is increasing. Approximately 20% of individuals have suffered from an acute episode of urticaria at least at some point in their lives. The objective of this study was to evaluate the clinical and therapeutic socio-demographic profile and quality of live of patients followed for urticaria in the dermatology-venereology department of the Yalgado Ouédraogo University Hospital in Ouagadougou. Methodology: We conducted a descriptive cross-sectional study over a 5-year period from 1 January 2015 to 31 December 2019. The data were collected retrospectively by analysing the files and prospectively by evaluating the quality of life with DLQI. All the records of patients treated for urticaria at the Dermatology-Venerology Department of the Yalgado Ouédraogo University Hospital during the period were included. Results: Urticarial frequency is 1.91%. There were 36 men (25.71%) and 104 women (74.28%), i.e. a sex ratio of 0.34. The median age was 31 years with extremes of 4 to 70 years. The 30 - 45 age group accounted for 51.42%, followed by the 16 - 29 age group (31.42%), then the 46 - 65 age group (9.28%), the 4 - 15 age group (5.71%) and the over 66 age group (2.14%). In terms of occupation, pupils/students accounted for 37.1%, housewives for 18.6% and workers for 44.3%. As for the residence of the patients, 88.57% lived in Ouagadougou Personal history of atopy, it concerned 19.26% of patients, with precisely 9.28% having asthma history, 7.14% having rhino-sinusitis history, 1.42% of atopic dermatitis and allergic conjunctivitis respectively. For clinical aspects, 97.14% of the patients had superficial urticaria, and 2.86% had facial angioedema. There were 35% (49) patients with acute urticaria and 65% (91) with chronic urticaria. Chronic urticaria was spontaneous in 55% (50) and physically inducible in 10% (9) (sweating, pressure or friction). 97.14% of patients received antihistamines associated with systemic corticoids in 2.86%. For Quality of life, the mean DLQI score was 7.51, indicating a moderate effect of urticaria on patients’ quality of life. The quality of life of women was more affected than that of men, especially in the professional and social spheres. Conclusion: In hospital frequency of urticaria is low in Ouagadougou, a predominance of chronic spontaneous urticaria whose management involves the use of second generation antihistamines at a dosage and duration that do not meet international recommendations. The patients’ quality of life was moderately impaired.
