Weisshaar E
Berufsdermatologie, Hautklinik, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
Hautarzt. 2020 Jul;71(7):525-527. doi: 10.1007/s00105-020-04617-z.
Antihistamines, mostly H1 antihistamines, administered both topically and systemically, are among the most widely used drugs. While systemically applicable antihistamines are usually taken orally or administered intravenously, while local therapy is used on the eye, nose or skin. Systemic antihistamines are most frequently used during the pollen season (hay fever, asthma) or are used all year round, e.g., for house dust and animal hair allergies. Furthermore, urticaria is a major indication for the use of H1 antihistamines, also as long-term treatment. Although H1 antihistamines are not licensed for pruritus and prurigo, they are frequently used in these diseases. However, since in many diseases with pruritus and prurigo the histamine receptor does not play a decisive role in the pathogenesis of pruritus, they show limited efficacy. Two Cochrane reviews have not shown any significant antipruritic effects of H1 antihistamine treatment in atopic eczema as single therapy or in combination, e.g., with topical glucocorticosteroid therapy. A retrospective case series with a so-called high-dose antihistamine therapy with non-sedating antihistamines was effective in treating chronic pruritus. This article summarizes the possibilities of systemic antihistamines in pruritus, especially with regard to limitations and future prospects.
抗组胺药，主要是H1抗组胺药，可局部和全身给药，是使用最广泛的药物之一。全身适用的抗组胺药通常口服或静脉给药，而局部治疗则用于眼部、鼻部或皮肤。全身抗组胺药最常用于花粉季节（花粉症、哮喘），或全年使用，例如用于治疗屋尘和动物毛发过敏。此外，荨麻疹是使用H1抗组胺药的主要适应症，也可作为长期治疗。虽然H1抗组胺药未被批准用于瘙痒症和痒疹，但它们经常用于这些疾病。然而，由于在许多瘙痒症和痒疹疾病中，组胺受体在瘙痒症的发病机制中并不起决定性作用，因此它们的疗效有限。两项Cochrane综述均未显示H1抗组胺药单一治疗或联合治疗（例如与局部糖皮质激素治疗联合）对特应性皮炎有任何显著的止痒作用。一项回顾性病例系列研究表明，所谓的高剂量非镇静抗组胺药疗法对治疗慢性瘙痒有效。本文总结了全身抗组胺药在瘙痒症治疗中的应用可能性，特别是其局限性和未来前景。
