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三联中药疗法成功预防三例儿童严重且频繁的食物过敏反应

Successful prevention of extremely frequent and severe food anaphylaxis in three children by combined traditional Chinese medicine therapy.

机构信息

Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA ; Medical Student at Icahn School of Medicine at Mount Sinai, New York, NY USA.

Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA.

出版信息

Allergy Asthma Clin Immunol. 2014 Dec 20;10(1):66. doi: 10.1186/s13223-014-0066-5. eCollection 2014.

Abstract

BACKGROUND

Despite strict avoidance, severely food-allergic children experience frequent and potentially severe food-induced anaphylaxis (FSFA). There are no accepted preventive interventions for FSFA. A Traditional Chinese Medicine (TCM) formula prevents anaphylaxis in murine food allergy models, and has immunomodulatory effects in humans. We analyzed the effects of TCM treatment on three pediatric patients with FSFA.

CASE DESCRIPTION

Three FSFA patients (P) ages 9-16 years (P1 allergic to milk; P2 and P3 to tree nuts) qualified for case analysis. All experienced numerous reactions requiring administration of rescue medications and emergency room (ER) visits during the 2 years prior to starting TCM. P1 experienced approximately 100 reactions, 50 epinephrine administrations, 40 ER visits, and 3 admissions to intensive care units. P2 experienced 30 reactions, all requiring epinephrine administration, as well as 10 emergency hospitalizations. P3 experienced 400 reactions, five of which required epinephrine administration and ER visits. TCM treatment markedly reduced or eliminated reactions in all. P1 experienced no reactions after 2.5 years of TCM. P2 experienced no reactions after 1 year of TCM treatment, at which time she passed an oral almond food challenge. She continues to be reaction-free 6 months off TCM while consuming nuts. P3 has achieved a 94% reduction in reaction frequency following 7 months of TCM, has discontinued daily antihistamine use, and has required no epinephrine administrations or ER visits.

CONCLUSIONS

Three children treated with TCM experienced dramatic reductions or elimination of FSFA. This regimen appears to present a potential option for FSFA, and warrants further investigation in controlled clinical studies.

摘要

背景

尽管严格避免,严重食物过敏的儿童仍会频繁且可能严重地发生食物诱发的过敏反应(FSFA)。目前尚无针对 FSFA 的公认预防干预措施。一种中药(TCM)配方可预防鼠类食物过敏模型中的过敏反应,并对人类具有免疫调节作用。我们分析了 TCM 治疗对 3 例 FSFA 患儿的影响。

病例描述

3 例 FSFA 患儿(P)年龄 9-16 岁(P1 对牛奶过敏;P2 和 P3 对坚果过敏)符合病例分析条件。在开始接受 TCM 治疗前的 2 年内,所有患者均经历了多次需要使用急救药物和急诊(ER)就诊的过敏反应。P1 经历了约 100 次反应,需要 50 次肾上腺素给药,40 次 ER 就诊和 3 次 ICU 入院。P2 经历了 30 次反应,所有反应均需要肾上腺素给药,以及 10 次紧急住院。P3 经历了 400 次反应,其中 5 次需要肾上腺素给药和 ER 就诊。TCM 治疗使所有患者的反应明显减少或消除。P1 在接受 TCM 治疗 2.5 年后未再出现反应。P2 在接受 TCM 治疗 1 年后未再出现反应,当时她通过了杏仁口服食物挑战。在停用 TCM 的 6 个月内,她继续无反应,且可以食用坚果。P3 在接受 TCM 治疗 7 个月后,反应频率降低了 94%,已停止每日使用抗组胺药,且不再需要使用肾上腺素或 ER 就诊。

结论

3 例接受 TCM 治疗的儿童的 FSFA 反应明显减少或消除。该方案似乎为 FSFA 提供了一种潜在选择,值得进一步在对照临床试验中进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10c4/4322482/c66039f84b3f/13223_2014_66_Fig1_HTML.jpg

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