Tilles Stephen A
University of Washington School of Medicine, Seattle, Washington, USA.
Allergy Asthma Proc. 2005 Jan-Feb;26(1):9-12.
Chronic urticaria is a relatively common disorder in which its management often presents a difficult clinical challenge. Histamine antagonists are the mainstays of therapy, and the second-generation antihistamines offer an attractive combination of efficacy, convenience, and lack of side effects. For patients whose symptoms are not controlled by once daily second-generation antihistamines, adjunct therapy with first generation H1-antihistamines, H2-antihistamines, doxepin, or leukotriene modifiers may be effective. Short-term systemic corticosteroids are useful for acute symptom flares but should not be used chronically. For chronically unremitting disease, immunomodulatory agents such as low-dose oral cyclosporine often are useful.
慢性荨麻疹是一种相对常见的疾病，其治疗往往给临床带来难题。组胺拮抗剂是主要治疗药物，第二代抗组胺药疗效好、使用方便且副作用少，具有很大优势。对于症状不能被每日一次的第二代抗组胺药控制的患者，联合使用第一代H1抗组胺药、H2抗组胺药、多塞平或白三烯调节剂可能有效。短期系统性使用糖皮质激素对急性症状发作有效，但不应长期使用。对于慢性难治性疾病，免疫调节剂如小剂量口服环孢素通常有效。
