Clinical Analysis Of ASST-positive Chronic Idiopathetic Urticaria And Clinical Observation Of Tripterygium Hypoglaucum Hutch In The Treatment Of The Disease

Objective:Chronic urticaria is a common disease in dermatology,which can happen at any age.The etiology of most patients is still unknown and part of it is related to autoimmunity.The autologous serum skin test(ASST)can be used to screen for autoimmune urticaria.Chronic idiopathetic urticaria(CIU)with ASST positive is manifested by persistent and frequent wheals,which badly affecting the quality of patients' life.Currently,it is still.a challenge to the treatment and management of the disease.This study was conducted to analyze the value of ASST in the clinical application of CIU and observe the clinical efficacy,safety,recurrence,and influence on the quality of life of patients with ASST-positive CIU in the treatment of the proprietary Chinese medicine Tripterygium hypoglaucum hutch(THH)and Desloratadine,which may provide clinical ideas and basis for exploring safe and effective treatment methods.Methods:A total of 120 patients with intractable CIU were investigated and examined by ASST.The clinical features of ASST positive and negative were compared and evaluated.46 cases of ASST positive patients with CIU were randomly divided into 2 groups(28 cases in each group).The treatment group was treated with the proprietary Chinese medicine THH tablet(2 tablets each time,Tid).The control one was given Total glucosides of paeony(TGP)(2 capsules each time,Tid),and two groups were both given desloratadine tablets(5mg/d,Qn).4 weeks as a course of treatment,the total treatment includes 2 courses(8 weeks).Before and after each course of treatment,the urticaria activity score(UAS7)and the quality of life of patients with chronic urticaria(CUQ2oL)were recorded.The adverse reactions during the treatment period were also recorded.4 weeks after the end of the treatment,the patients were followed up to observe the recurrence of the disease.The clinical effect was analyzed and compared between the two groups.Results:(1)Among 120 patients,56 patients were detected positive results,and the positive rate was 46.67%.(2)The CIU patients with ASST positive had more severe symptoms,longer course of disease,higher frequencies of wheals and more severe pruritus than those with ASST negative.The difference was statistically significant(p<0.05).There was no significant difference in the size,number and shape of the wheals,duration of the wheals between the two groups(p>0.05).(3)In the treatment group,both UAS7 and CUQ2oL scores have decreased after two courses of treatment.There was statistical difference(p<0.05)compared with pre-treatment.However,in the control group,UAS7 and CUQ2oL were not statistically difference(p>0.05)between the end of first course and pre-treatment.Only after the end of the second course,the UAS7 and CUQ2oL were statistically difference(p<0.05).(4)At the end of the first course of treatment,there was no significant difference in the UAS7 and CUQ2oL scores of the two groups(p>0.05),and at the end of the second course,the UAS7 and CUQ2oL in the treatment group were significantly lower than those in the control group,which has a statistically difference(p<0.05).(5)At the end of the total treatment,evaluated by SSRI index,the total efficiency was 71.43%in the treatment group,while the efficiency was 39.28%in the control group,the efficiency of the treatment group is better than he control group,two groups of comparison by chi-square test,it was statistically difference(p<0.05).(6)During the follow-up after 4 weeks,UAS7 and CUQ2oL in the treatment group were lower than those in the control group,and the recurrence rate in the treatment group was significantly lower than that in the control group.Both the differences were statistically significant(p<0.05).(7)There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:(1)The clinical symptoms of CIU patients with ASST positive are more severe.Therefore,ASST is certainly valuable for clinical application.(2)The effect of THH with desloratadine on CIU patients with ASST positive was significant,which can effectively decrease the scores of UAS7 and CUQ2oL,reduce the wheal attack,alleviate the symptoms of pruritus,and obviously improve the quality of life of the patients.And with the less side effect and the lower recurrence rate,it can be popularized and applied in clinical practice.