慢性自发性荨麻疹患者对第二代抗组胺药物依从性调查

Compliance to treatment with second generation antihistamines in patients with chronic spontaneous urticaria

目的:探讨慢性自发性荨麻疹(CSU)患者对第二代抗组胺药物的依从性、影响因素及症状控制情况。方法:将2015年6月-2017年6月于河南省人民医院皮肤科门诊诊断为CSU的患者作为研究对象,采用病例调查和电话随访的方式,对CSU患者首次就诊后6个月和9个月的情况进行回顾性问卷调查,主要观察指标为依从率、不依从原因、依从性影响因素及病情控制情况。结果:共完成有效问卷589份,第二代抗组胺药物依从者233例(依从率为39. 56%),不依从者356例(不依从率为60. 44%)。不依从原因分类包括:不理解医嘱,发病时服药172例;担心药物副作用126例(其中间断服药47例,停药79例);经常忘记,间断服药33例;病情控制不佳停药14例;发生药物副作用停药7例;备孕或怀孕停药3例;经济原因停药1例。233例服药依从者治愈101例,356例不依从者治愈63例,两者差异有统计学意义(2=115. 15,P <0. 01)。文化程度与患者服药依从性有关(OR=1. 53,95%CI为1. 02～5. 39),而经济水平与其依从性无关(OR=0. 93,95%CI为0. 71～1. 55)。结论:慢性自发性荨麻疹患者对第二代抗组胺药物依从性较低,应针对不依从原因加以干预提高依从率。

Objective:To reveal the compliance to treatment with second generation antihistamines,its influential factors,and efficacy in patients with chronic spontaneous urticaria.Methods:From Jun 2015 to Jun 2017,patients with chronic spontaneous urticaria were given questionnaires and phone interviews after 6 months and 9 months of initial visit at Henan Provincial People’s Hospital.The compliance rates,causes of noncompliance,its influential factors and disease control condition were analyzed.Results:A total of 589 valid questionnaires were collected.The rate of compliance to the treatment was 39.56%.Causes of noncompliance included not understanding doctor’s instruction,only taking medication when relapse occurred(172 cases),concern of drug side effects(126 cases),forgetting to take medicines(33 cases),not satisfying with the efficacy(14 cases),etc.The cure rates were significantly higher in patients with compliance than in those without compliance(101/233 vs.63/356,x^2=115.15,P<0.01).The educational level was associated with the compliance rate(OR=1.53,95%CI was 1.02~5.39),while the income level wasn t associated with the compliance rate(OR=0.93,95%CI was 0.71~1.55).Conclusions:The compliance rate in patients with the chronic spontaneous urticaria is relatively low.Intervention of specific noncompliance causes could improve compliance rate.The second generation antihistamines is effective in managing symptoms of chronic spontaneous urticaria.