全科医疗中组胺不耐受的诊断范围、时间进程、阶段及建议:一项非随机、准实验研究

Spectrum, Time Course, Stages, and a Proposal for the Diagnosis of Histamine Intolerance in General Practice: A Nonrandomized, Quasi-Experimental Study.

作者信息

Tamasi József, Kalabay László

机构信息

Department of Family Medicine, Semmelweis University, 1085 Budapest, Hungary.

Department of Internal Medicine and Hematology, Semmelweis University, 1088 Budapest, Hungary.

出版信息

J Clin Med. 2025 Jan 7;14(2):311. doi: 10.3390/jcm14020311.

Abstract

Limited research has explored histamine intolerance from the perspective of primary caregivers. Our objective was to develop a practical symptom profile from the standpoint of general practice. We also aimed to gather data on the frequency and timing of disease progression and to establish a staging system. This study utilized a nonrandomized, quasi-experimental design. An in-depth interview was conducted with 217 patients involving 120 questions. To evaluate associations between food intake and symptoms, we recommended either an exclusion diet or a low-histamine diet. A follow-up questionnaire was subsequently administered. We also analyzed 3831 doctor-patient meetings involving upper respiratory symptoms. Symptoms in 77 patients were associated with histamine-rich meals. The most characteristic symptoms included respiratory symptoms (95%), bloating (94%), headache (91%), fatigue (83%), postprandial drowsiness (81%), skin symptoms (81%), diarrhea/loose stool (77%), psychological symptoms (77%), dyspepsia (69%), and muscle/eyelid twitching (61%). Patients with suspected histamine intolerance visited primary care three times more often with upper respiratory symptoms than those without suspected histamine intolerance. The symptom spectrum of histamine intolerance involves multiple organ systems and occurs in distinct, repeating patterns. Symptoms can be described by their duration, sequence, and severity level, which is the key focus of this research, including visual representations. In its most severe stages, histamine intolerance may potentially involve mast cell activation. A personalized diet is associated with a gradual reduction in both the intensity and frequency of symptoms. : The spectrum of histamine intolerance can be characterized by specific symptom patterns with defined frequencies, timelines, and symptom stages.

摘要

仅有有限的研究从初级护理人员的角度探讨了组胺不耐受。我们的目标是从全科医疗的角度制定一份实用的症状概况。我们还旨在收集有关疾病进展频率和时间的数据,并建立一个分期系统。本研究采用了非随机、准实验设计。对217名患者进行了深入访谈,涉及120个问题。为了评估食物摄入与症状之间的关联,我们推荐了排除饮食或低组胺饮食。随后发放了一份随访问卷。我们还分析了3831次涉及上呼吸道症状的医患会诊。77名患者的症状与富含组胺的膳食有关。最典型的症状包括呼吸道症状(95%)、腹胀(94%)、头痛(91%)、疲劳(83%)、餐后嗜睡(81%)、皮肤症状(81%)、腹泻/大便松散(77%)、心理症状(77%)、消化不良(69%)以及肌肉/眼睑抽搐(61%)。疑似组胺不耐受的患者因上呼吸道症状就诊初级护理的频率是未疑似组胺不耐受患者的三倍。组胺不耐受的症状谱涉及多个器官系统,且以独特的、重复的模式出现。症状可以通过其持续时间、顺序和严重程度来描述,这是本研究的关键重点,包括视觉呈现。在最严重的阶段,组胺不耐受可能潜在地涉及肥大细胞活化。个性化饮食与症状强度和频率的逐渐降低相关。:组胺不耐受的症状谱可以通过具有明确频率、时间线和症状阶段的特定症状模式来表征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e118/11765637/63813baf4d64/jcm-14-00311-g001.jpg

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