通过 H1 抗组胺药条件作用产生止痒安慰剂效应。

Antipruritic Placebo Effects by Conditioning H1-antihistamine.

机构信息

From the Health, Medical and Neuropsychology Unit, Institute Psychology, Faculty of Social and Behavioural Sciences, (Meeuwis, van Middendorp, Pacheco-Lopez, Veldhuijzen, Evers), Leiden University; Leiden Institute for Brain and Cognition (Meeuwis, van Middendorp, Veldhuijzen, Evers), Leiden University Medical Center, Leiden, The Netherlands; Health Sciences Department, Campus Lerma (Pacheco-Lopez), Metropolitan Autonomous University, Lerma, Edo Mex, Mexico; and Departments of Pulmonology (Ninaber), Dermatology (Lavrijsen), and of Psychiatry (van der Wee, Evers), Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Psychosom Med. 2019 Nov/Dec;81(9):841-850. doi: 10.1097/PSY.0000000000000743.

DOI:10.1097/PSY.0000000000000743

PMID:31490841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6844655/

Abstract

OBJECTIVE

Allergic rhinitis symptoms can be reduced by behaviorally conditioning antihistamine. It is unclear whether these findings extend to histamine-induced itch or work when participants are informed about the conditioning procedure (open-label conditioning). The current study aims to investigate the efficacy of (open-label) antipruritic behavioral conditioning for histamine-induced itch.

METHODS

Healthy participants (n = 92; 84% female) were randomized to I) an open-label conditioned, II) closed-label conditioned, III) conditioned-not-evoked control, or IV) nonconditioned control group. A two-phase conditioning paradigm was used. During acquisition, a conditioned stimulus (CS; distinctively tasting beverage) was repeatedly paired with the H1-antihistamine levocetirizine (groups I-III). During evocation, the CS was paired with placebo (I, II), or instead of the CS, water was paired with placebo (III). The nonconditioned control group (IV) received CS with placebo in both phases. Itch after histamine iontophoresis and physiological data (i.e., spirometry, heart rate, skin conductance) were assessed. Combined conditioned and combined control groups were first compared, and analyses were repeated for separate groups.

RESULTS

Marginally lower itch was reported in the combined conditioned compared with the control groups (F(1,88) = 2.10, p = .076, ηpartial = 0.02); no differences between separate groups were found. No effects on physiological data were found, except for heart rate, which reduced significantly and consistently for control groups, and less consistently for conditioned groups (group by time interaction: F(7,80) = 2.35, p = .031, ηpartial = 0.17).

CONCLUSION

Limited support was found for the efficacy of antipruritic behavioral conditioning, regardless of whether participants were informed about the conditioning procedure. The application of open-label conditioning in patient populations should be further researched.

TRIAL REGISTRATION

www.trialregister.nl; ID NTR5544.

摘要

目的

通过行为性抗组胺药物条件作用，可以减轻过敏性鼻炎症状。目前尚不清楚这些发现是否适用于组胺引起的瘙痒，或者当参与者了解到条件作用程序（开放标签条件作用）时是否有效。本研究旨在探讨（开放标签）止痒行为条件作用对组胺诱导瘙痒的疗效。

方法

将 92 名健康参与者（84%为女性）随机分为 I）开放标签条件作用组、II）封闭标签条件作用组、III）条件作用但未诱发组或 IV）非条件作用对照组。采用两阶段条件作用范式。在获得阶段，条件刺激（CS；味道独特的饮料）反复与 H1 抗组胺药左西替利嗪（I-III 组）配对。在诱发阶段，CS 与安慰剂配对（I、II 组），或者 CS 与安慰剂配对，而水与安慰剂配对（III 组）。非条件作用对照组（IV 组）在两个阶段均接受 CS 和安慰剂。用组胺离子电渗法评估瘙痒后和生理数据（即肺活量、心率、皮肤电导率）。首先比较了联合条件组和联合对照组，然后对单独的组进行了重复分析。

结果

联合条件组报告的瘙痒程度略低于对照组（F(1,88) = 2.10，p =.076，ηpartial = 0.02）；但两组之间没有差异。未发现对生理数据有影响，除了心率，对照组显著且一致地降低，而条件组则不太一致（组间时间交互作用：F(7,80) = 2.35，p =.031，ηpartial = 0.17）。