三联疗法对慢性荨麻疹疗效及血清IgE影响的研究

Study on effect of triple therapy for chronic urticaria patients and the changes of immunoglobulin E in blood serum

目的 观察和评价三联疗法（自血疗法联合咪唑斯汀、雷尼替丁）治疗慢性荨麻疹的临床疗效、安全性及对血清总IgE水平影响。方法将110例慢性荨麻疹随机分为治疗组55例，对照组55例，对照组口服咪唑斯汀缓释片，10mg，每天1次。治疗组采用三联疗法，在对照组用药的基础上口服雷尼替丁胶囊0．15g，每天2次，再联合自血疗法，从患者的静脉里抽取5ml血液，随即直接注射到病人臀部的深层肌肉，3天1次，两组疗程均为30天。两组患者同时检测治疗前及停药后血清总IgE含量，并和病情变化进行相关性分析。观察两组患者疗程结束后、停药3个月后疗效，评价其安伞性，比较治疗前及停药后血清总IgE变化。结果疗程结束后（近期）治疗组有效率为90．1％，对照组有效率为87．3％，近期疗效差异无显著性（P〉0．05）。停药3个月（远期）治疗组有效率为83．6％，对照组有效率为56．4％，远期疗效差异有极显著性（P〈0．01）。两组患者随访三个月，治疗组复发4例（15．4％），对照组复发11例（47．8％）两组复发牟差异有显著性（P〈0．05）。两组血液总IgE水平治疗前差异无显著性（P〉0．05），停药后治疗组总IgE水平降低较明显，与治疗前及对照组比较均差异有极显著性（P〈0．01）。结论采用了联疗法治疗慢性荨麻疹疗效显著，远期疗效理想，能减少复发，明显降低患者血清中总IgE水平，副作用少，值得临床应用。

Objective To observe and evaluate the clinical effect and safety with triple therapy, namely the auto-blood therapy combined with mizolastine and ranitidine hydrochloride capsules, in treating the chronic urticaria patients, and the effect on the level changes of Immnnoglobulin E （IgE）. Methods The 110 chronic urticaria patients were randomly divided into control group, which included 55 patients taking orally mizolastine 10 mg one time a day for 30 days, and the treatment group, including 55 patients treated with triple therapy, which took orally mizolastine 10 mg one time a day plus ranitidine hydrochloride capsules 0.15 mg each time, twice a day, combined with auto-blood therapy which injected 5 ml blood from each patient＇ s vein into their buttock muscles every 3 days, for 30 days. We tested the level of IgE of control group and the treatment group before and after the treatment, and analyzed it with the change of condition of the patients. Then we observed the effect with triple therapy in both of the groups at the end of the course and 3 months after the course respectively, evaluated its safety, and compare the levels of IgE before and after the treatment. Results After the course, the effective rate is 90.1% in treatment group and 87.3% in control group. There was no statistic difference in recent effect （P〉 0.05）. 3 months after the course, the effective rate is 83.6% in treatment group and 56.4% in control group. There is stalistic difference in long-term effect （P〈 0.01）. A follow-up survey of 3 months showed that 4 cases （15.4%） in treatment group and 11 cases （47.8%） of control group （58.3%） were relapsed. There was statistic difference in relapse rate between two groups （P 〉 0.05）. Before the treatment, there was no statistic difference in the level of IgE between two groups （P〉 0.05）. But after the treatment, there was significant decrease in the level of IgE in the treatment group, which was statistically different from the level before the treatment and that in the control group. Conclusion It is very effective for the chronic urticaria patients treated with triple therapy, showing on the long-term effect especially. Triple therapy can reduce the relapse rate, significantly decrease the level of IgE of the patients and has less side effects thus worthy for clinical application.