应用中西医结合疗法成功治疗小儿慢性荨麻疹和食物过敏:一个病例系列。

Xiaowen Fan, Tory McKnight, Johnathan Neshiwat, Song Park, Danna Chung, Xiu-Min Li
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引用次数: 0

摘要

背景:食物过敏在儿科人群中变得越来越普遍。尽管严格避免食物过敏原,一个亚组的敏感个体仍然出现频繁的,持续的,难以治疗的荨麻疹(FPDTH),没有治愈的治疗。虽然这些病例很少见,但这些患者最需要治疗。病例介绍:本研究回顾性分析了3例高度敏感食物过敏的儿童患者,这些患者最初每天或每隔一天出现一次荨麻疹,或一天多次出现荨麻疹,但经中药治疗后明显缓解。患者1 (P1)是一个5岁的孩子,他一生中经历了140次反应。反应以荨麻疹为主,有4次过敏反应。P1使用强的松20次,注射肾上腺素4次,急诊3次。患者2 (P2)是一名12岁的儿童,从3岁起就出现了荨麻疹。尽管每天使用抗组胺药,P2在他的一生中有超过730次反应,包括2次过敏反应。处方强的松4次,肾上腺素注射2次,1次急诊。患者3 (P3)是一名20个月大的女孩,经历了超过120次过敏反应,包括1次过敏反应。她每天服用地奈德,并经常使用抗组胺药,但仍然需要一次强的松治疗,一次肾上腺素注射,并进行了1次急诊治疗以控制她的反应。在我们诊所就诊后,患者接受内外中医治疗,包括草药浴和药膏(补救措施A-D)作为减少食物反应的基本药物,包括但不限于频繁的荨麻疹。中医药治疗7-9个月内,所有患者均能完全缓解特应性症状。所有三名患者的其他情况也有所改善,包括食物不耐受、腹泻、焦虑、湿疹和环境过敏。经过1年的治疗,这3名患者的食物特异性IgE水平均由之前升高的水平下降,另外,最初总IgE水平较高的P1和P3的总IgE水平也明显下降。所有三名患者都继续在饮食中加入他们之前有反应的食物,并且所有三名患者都没有症状。结论:三名已知多种食物敏感史和医生诊断为食物过敏的儿童患者以FPDTH为表现,接受中医治疗后症状显著改善,IgE水平显著降低。该方案似乎对FPDTH人群有效,但需要在对照临床环境中进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Successful management of chronic urticaria and food allergies in a pediatric population using integrative traditional Chinese medicine therapy: a case series.

Background: Food allergy is becoming increasingly common among the pediatric population. Despite strict avoidance of food allergens, a subgroup of sensitive individuals still develops frequent, persistent, and difficult to treat hives (FPDTH) for which there is no curative therapy. Although these cases are rare, these patients are in most need of therapy.

Case presentations: This is a retrospective review of 3 pediatric patients with highly sensitive food allergies who initially presented with hives daily or every other day, or multiple times a day, but achieved marked remission after traditional Chinese medicine (TCM) therapies. Patient 1 (P1) is a 5-year-old who has experienced 140 reactions in his lifetime. Reactions were mostly hives with 4 episodes of anaphylaxis. P1 had used Prednisone 20 times, had an Epinephrine injection 4 times, and had 3 emergency room (ER) visits. Patient 2 (P2) is a 12-year-old who had experienced hives since age 3. Despite daily antihistamine use, P2 had > 730 reactions in his lifetime at the time of presentation including 2 episodes of anaphylaxis. He had been prescribed prednisone 4 times, an Epinephrine injection 2 times, and had 1 ER visit. Patient 3 (P3) is a 20-month-old girl who had experienced > 120 reactions including 1 episode of anaphylaxis. She was on daily desonide and frequently used an antihistamine, yet still had required a course of prednisone once, an Epinephrine injection once, and had 1 ER visit to manage her reaction. After presenting to our clinic, patients received internal and external TCM treatments, including herbal baths and creams (Remedy A-D) as basic remedies to reduce food reactions, including but not limited to frequent hives. Within 7-9 months of TCM treatment, remarkably all patients had complete remission of atopic symptoms. All three patients also experienced an improvement in other conditions including food intolerance, diarrhea, anxiety, eczema, and environmental allergies. After 1 year of treatment, all three patients had reductions in food-specific IgE levels that had been previously elevated, and additionally, P1 and P3, who initially had high total IgE levels, experienced a marked decrease in total IgE levels as well. All three patients continued to introduce foods into their diet that they previously had reactions to, and all 3 patients remain symptom-free.

Conclusions: Three pediatric patients with a known history of multiple food sensitivities and physician-diagnosed food allergies that presented with FPDTH underwent a TCM regimen and experienced dramatic improvement in symptoms and reduction in their IgE levels. This regimen appears to be effective in FPDTH population although a further study in a controlled clinical setting is required.

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来源期刊
Clinical and Molecular Allergy
Clinical and Molecular Allergy Medicine-Immunology and Allergy
CiteScore
8.20
自引率
0.00%
发文量
11
审稿时长
13 weeks
期刊介绍: Clinical and Molecular Allergy is an open access, peer-reviewed, online journal that publishes research on human allergic and immunodeficient disease (immune deficiency not related to HIV infection/AIDS). The scope of the journal encompasses all aspects of the clinical, genetic, molecular and inflammatory aspects of allergic-respiratory (Type 1 hypersensitivity) and non-AIDS immunodeficiency disorders. However, studies of allergic/hypersensitive aspects of HIV infection/AIDS or drug desensitization protocols in AIDS are acceptable. At the basic science level, this includes original work and reviews on the genetic and molecular mechanisms underlying the inflammatory response.
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