成人慢性自发性荨麻疹的现代治疗方法

O. Denysenko
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According to domestic and foreign publications, urticaria affects about 15—20 % of the population, while in recent years the number of chronic forms of dermatosis resistant to treatment (registered in about 2 % of the population) is increasing, which reduces the capability for work and quality of life of patients. In more than half of the patients the probable cause of chronic urticaria cannot be determined, which indicates the development of a spontaneous (idiopathic) form of dermatosis. First­line drugs for the treatment of chronic urticaria are non­sedative H1­antihistamines of the second generation, which, however, in many patients do not provide a positive clinical effect in standard doses. In the European recommendations, to increase the effectiveness of treatment of patients with torpid forms of chronic urticaria, it is proposed to increase the daily dose of antihistamines by 4 times. 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引用次数: 0

摘要

目的:研究和分析关于成人慢性自发性荨麻疹发病机制和现代治疗方法的专题出版物。材料和方法。基于循证医学原则,对目前国内外关于慢性自发性荨麻疹发病和治疗方面的文献进行了研究和分析,包括英国国家卫生服务体系(NHS, 2020)关于成人慢性自发性荨麻疹治疗的建议。结果和讨论。根据国内外出版物,荨麻疹影响约15 - 20%的人口,而近年来,对治疗产生抗药性的慢性皮肤病(约占人口的2%)的数量正在增加,这降低了患者的工作能力和生活质量。在超过一半的患者慢性荨麻疹的可能原因不能确定,这表明自发性(特发性)形式的皮肤病的发展。治疗慢性荨麻疹的一线药物是非镇静的第二代h1 -抗组胺药,然而,在许多患者中,标准剂量不能提供积极的临床效果。在欧洲的建议中,为了提高治疗迟钝型慢性荨麻疹患者的有效性,建议将抗组胺药的日剂量增加4倍。根据基于循证医学的NHS建议(2020年),建议慢性自发性荨麻疹成年患者使用成本高且临床有效的第二代抗组胺药西替利嗪作为一线治疗方法,逐步处方,每日剂量增加2-4倍。结论。慢性荨麻疹是当今严重的医学和社会问题。超过一半的慢性荨麻疹患者患有自发性(特发性)皮肤病。第二代h1 -抗组胺药是慢性荨麻疹的一线治疗药物,但由于部分患者在使用标准剂量时缺乏积极作用,建议每日剂量增加4倍。根据NHS的建议(2020),慢性自发性荨麻疹的成年患者被推荐使用有效且具有成本效益的第二代抗组胺药西替利嗪作为一线(剂量递增)治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern approaches to treatment of chronic spontaneous urticaria in adult patients
Objective — to study and analyze thematic publications on aspects of etiopathogenesis and modern approaches to the treatment of chronic spontaneous urticaria in adult patients. Materials and methods. A study and analysis of current domestic and foreign publications was conducted on aspects of the etiopathogenesis and treatment of chronic urticaria, including the recommendations of the National Health Service of the United Kingdom (NHS, 2020) for the treatment of chronic spontaneous urticaria in adult patients, based on principles of evidence­based medicine. Results and discussion. According to domestic and foreign publications, urticaria affects about 15—20 % of the population, while in recent years the number of chronic forms of dermatosis resistant to treatment (registered in about 2 % of the population) is increasing, which reduces the capability for work and quality of life of patients. In more than half of the patients the probable cause of chronic urticaria cannot be determined, which indicates the development of a spontaneous (idiopathic) form of dermatosis. First­line drugs for the treatment of chronic urticaria are non­sedative H1­antihistamines of the second generation, which, however, in many patients do not provide a positive clinical effect in standard doses. In the European recommendations, to increase the effectiveness of treatment of patients with torpid forms of chronic urticaria, it is proposed to increase the daily dose of antihistamines by 4 times. According to NHS recommendations (2020), created on evidence­based medicine, adult patients with chronic spontaneous urticaria are recommended to use a cost­ and clinically effective second­generation antihistamine cetirizine as first­line therapy which is prescribed step by step with increasing daily dose by 2—4 times. Conclusions. Chronic urticaria is a serious medical and social problem today. More than half of patients with chronic urticaria are those having spontaneous (idiopathic) form of dermatosis. H1­antihistamines of the second generation are the first­line therapy for chronic urticaria, but due to the lack of a positive effect in some patients when using their standard doses, it is recommended to increase their daily doses by 4 times. According to NHS recommendations (2020), adult patients with chronic spontaneous urticaria are recommended an efficient and cost­effective second­generation antihistamine cetirizine as first­line (dose­increasing) therapy.
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