中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (11): 782-784.

• 论著 • 上一篇    下一篇

卡介菌多糖核酸联合咪唑斯汀治疗慢性特发性荨麻疹的疗效及对皮肤点刺试验结果的影响

吴黎明1,黄珊珊2,苏明3   

  1. 1. 杭州市第一人民医院
    2. 浙江省杭州市第一人民医院
    3. 杭州市第一人民医院皮肤科
  • 收稿日期:2012-03-20 修回日期:2012-07-01 出版日期:2012-11-15 发布日期:2012-10-31
  • 通讯作者: 吴黎明 E-mail:limingwu1973@163.com

Bacille calmette?鄄guerin polysaccharide nucleic acid and mizolastine for the treatment of patients with chronic idiopathic urticaria: clinical efficacy and effect on skin prick test reactions

  • Received:2012-03-20 Revised:2012-07-01 Online:2012-11-15 Published:2012-10-31

PDF

48

赞

摘要：

目的 观察卡介菌多糖核酸对慢性特发性荨麻疹患者皮肤点刺试验（SPT）结果的影响，探讨卡介菌多糖核酸和抗组胺药物联合治疗慢性特发性荨麻疹的临床效应和机理。 方法 采用非随机、开放性临床试验，将慢性特发性荨麻疹患者分为观察组（85例）和对照组（83例），两组治疗前症状积分、SPT阳性率差异无统计学意义。观察组采用卡介菌多糖核酸（2 ml肌内注射隔日1次）联合咪唑斯汀（10 mg/d）治疗，对照组单用咪唑斯汀（10 mg/d）。两组患者均于治疗开始前及治疗12周后对病情进行评价。采用SPSS 10.0软件，用t检验比较治疗前后组内和组间症状积分下降指数（SSRI），用χ2检验比较治疗前后组内和组间SPT阳性率。 结果 治疗后观察组SSRI（0.92 ± 0.33）明显高于对照组（0.74 ± 0.35），两组比较，t = 2.39，P ＜ 0.05。观察组治愈50例，显效28例，总有效率92.0%；对照组治愈32例，显效30例，总有效率74.6%，观察组总有效率高于对照组（χ2 = 5.62，P ＜ 0.05）。观察组85例治疗前户尘螨和粉尘螨阳性率分别为24.7%（21例阳性）和17.6%（15例阳性），治疗后分别为9.4%（8例）和5.9%（5例）。对照组治疗前户尘螨和粉尘螨阳性率分别为24.1%（20例）和16.9%（14例），治疗后分别为24.1%（20例）和15.7%（13例）。SPT阳性率在治疗前两组之间差异无统计学意义（P > 0.05），治疗后差异有统计学意义（χ2 = 5.82，P < 0.05）；治疗前后SPT阳性率观察组差异有统计学意义（χ2 = 4.56，P < 0.05），对照组差异无统计学意义。结论 卡介菌多糖核酸联合咪唑斯汀治疗慢性特发性荨麻疹较单用咪唑斯汀疗效好，并能降低患者SPT阳性率和对致敏原敏感性。

关键词: 咪唑斯汀

Abstract:

Objective To estimate the effect of bacille calmette-guerin polysaccharide nucleic acid （BCG-PSN） on skin prick test （SPT） reactions, and to assess the clinical efficacy and therapeutic mechanism of BCG-PSN combined with mizolastine, in patients with chronic idiopathic urticaria. Methods A non-randomized, open-label clinical trial was carried out. Totally, 168 patients with chronic idiopathic urticaria were divided into 2 groups to be treated with mizolastine 10 mg once a day combined with BCG-PSN injection at a dose of 2 ml every other day （experiment group, n = 85） or mizolastine 10 mg once a day only （control group, n = 83）. All the patients underwent SPT, and were evaluated by symptom score at the baseline and after 12 weeks of treatment. Statistical analysis was performed by using the SPSS 10.0 software, t test and Chi-square test were used to analyze the intra- and inter-group differences in symptom score reducing index（SSRI） and SPT results. Results After 12-week treatment, SSRI was significantly higher in the experiment group than in the control group （0.92 ± 0.33 vs. 0.74 ± 0.35, t = 2.39, P ＜ 0.05）. In the experiment group, 50 patients were cured, 28 patients received a marked response, with a total response rate of 92.0%; meanwhile, 32 patients were cured and 30 patients received a marked response in the control group with a total response rate of 74.6%; there was a significant difference in the total response rate between the experiment group and control group （χ2 = 5.62, P ＜ 0.05）. The percentage of positive SPT to Dermatophagoides pteronyssinus and Dermatophagoides farinae was 24.7% and 17.6% respectively at the baseline, 9.4% and 5.9% respectively after treatment, in the experiment group, 24.1% and 16.9% respectively at the baseline, 24.1% and 15.7% respectively after treatment, in the control group. Significant differences were observed in the percentage of positive SPT between the control group and experiment group after treatment （χ2 = 5.82, P < 0.05）, but not at the baseline. A statistical decrease in the percentage of positive SPT was induced by the combined therapy with BCG-PSN and mizolastine （χ2 = 4.56, P < 0.05）, but not by mizolastine alone. Conclusions BCG-PSN combined with mizolastine appears superior to mizolastine alone in the treatment of chronic idiopathic urticaria, with a decrease in the percentage of positive SPT reactions and in the sensitivity to allergens.

Key words: BCG-PSN