Chawla Vonita, Hogan Mary Beth, Moonie Sheniz, Fenwick Ginger L, Hooft Anneka, Wilson Nevin W
Section of Allergy and Immunology, Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, Nevada, USA.
Allergy Asthma Proc. 2016 Mar-Apr;37(2):157-63. doi: 10.2500/aap.2016.37.3927.
Clinicians have previously prescribed antihistamines for relief of atopic dermatitis (AD) associated pruritus. The use of antihistamines in AD has recently received less emphasis from newly published practice parameters that currently only recommend short-term, intermittent use of first-generation antihistamines to induce sleep in patients with AD.
Our study aimed to determine parents' perception of the usefulness of antihistamines in reducing their child's itch due to AD.
A 12-question survey was mailed to parents of patients who were attending a pediatric allergy clinic. Patients with physician-diagnosed AD who had a clinic visit in the past 3 years were included. Questions included the following: time since AD diagnosis, itching frequency, impact on sleep, frequency and relief provided from using antihistamines, and comparison of antihistamines to other antipruritus treatments.
Sixty-three percent of parents surveyed responded that antihistamines were helpful in the management of their child's AD, and only 5% did not find any itch relief. The majority of the responders were parents of younger patients (ages, 2-10 years) with immunoglobulin E sensitization and AD for more than a year. Eighty-five parents (68.5%) reported no interruption of sleep due to itching, and, among them, an almost equal number were currently solely using either a first- or second-generation antihistamine. The more antihistamines were perceived as relieving itching, the more they were used (ρ = 0.209, p = 0.025) and provided more relief than other products (ρ = -0.336, p < 0.001). When compared, parents ranked antihistamines to be as helpful as topical corticosteroids.
Parents of pediatric patients with AD found that antihistamines were an important part of AD management.
临床医生过去常开具抗组胺药以缓解特应性皮炎（AD）相关的瘙痒。近期发布的实践参数对AD中抗组胺药的使用关注较少，目前仅建议短期、间歇性使用第一代抗组胺药来帮助AD患者入睡。
我们的研究旨在确定家长对抗组胺药减轻其孩子因AD引起的瘙痒的有用性的看法。
向在儿科过敏诊所就诊的患者的家长邮寄了一份包含12个问题的调查问卷。纳入过去3年中有过临床就诊且经医生诊断为AD的患者。问题包括：AD诊断后的时间、瘙痒频率、对睡眠的影响、使用抗组胺药的频率和缓解情况，以及抗组胺药与其他止痒治疗方法的比较。
63%接受调查的家长表示抗组胺药对管理孩子的AD有帮助，只有5%的家长未发现任何瘙痒缓解效果。大多数回复者是年龄较小（2至10岁）、有免疫球蛋白E致敏且患AD超过一年的患者的家长。85位家长（68.5%）报告没有因瘙痒而睡眠中断，其中，目前单纯使用第一代或第二代抗组胺药的家长数量几乎相等。抗组胺药被认为越能缓解瘙痒，使用频率就越高（ρ = 0.209，p = 0.025），且比其他产品提供的缓解效果更好（ρ = -0.336，p < 0.001）。相比之下，家长认为抗组胺药与外用糖皮质激素一样有帮助。
AD患儿的家长发现抗组胺药是AD管理的重要组成部分。
