Etiology There are many reasons for urticaria, and the common ones are as follows:
1. Drug 2. Infection 3. Food 4. Environmental factors. Manifestations of systemic diseases. hereditary factor
prescription
1. Pay attention to medication history, diet, infection, mental factors and inhalants (pollen, feathers, paint, etc. ) before the onset, and try to avoid those that may be related to the onset.
2. Take medicine on time, and don't stop taking medicine by yourself. Taking antihistamines has a sedative effect, and it is not suitable for mountaineering and driving after taking them.
3. Patients with shortness of breath, laryngeal edema or dysphagia should seek medical attention immediately.
treat cordially
Finding out the cause and removing the pathogenic factors is the way to cure the problem. But the cause of urticaria, especially chronic urticaria, is often difficult to find, so symptomatic treatment is often used in most cases. People who can't get rid of the disease should reduce various triggering factors, especially physical urticaria. At the same time, we should pay attention to avoid various factors that aggravate skin vasodilation. Can give
1. antihistamines: mainly H 1 receptor antagonists and H2 receptor antagonists. Various antihistamines have different antihistamines and other pharmacological effects. For example, cyproheptadine is effective for cold urticaria, and Antaile is effective for hot urticaria. For intractable urticaria, H 1 and H2 receptor antagonists can be combined to improve the curative effect.
2. Adrenal cortical hormone: used in acute severe or intractable cases, such as anaphylactic shock, serous urticaria, stress urticaria, etc. Hydrocortisone 100~200MG is added into 5% glucose solution for intravenous drip, or 30~40MG of prednisone is taken orally. This therapy is generally not suitable for long-term application.
3. Antibiotics: Those who are infected can choose appropriate antibiotics, especially urticaria caused by obvious or concealed gastrointestinal infections.
4. Drugs that reduce vascular wall permeability: such as vitamin C, vitamin P, calcium, etc. Often used with antihistamines.
5. Sympathomimetic drugs: mainly used for severe acute urticaria's disease, especially when there is anaphylactic shock or laryngeal edema. Subcutaneous injection of 0. 1% epinephrine 0.5~ 1 ml. In severe cases, it can be injected again every 20 to 30 minutes.
6. Histamine globulin: It is a drug that promotes the production of antihistamine antibodies in the body, and has a good effect on chronic urticaria, especially mechanical and cold urticaria. 2~4 ml intramuscular injection each time, 65438+ 0~2 times a week, 6~8 times as a course of treatment.
7. Others: oral vitamin K, vitamin E, vitamin B 12, aminophylline, reserpine, chloroquine, intravenous aprotinin, 6- aminohexyl, sodium thiosulfate, heart and tissue therapy, autologous blood therapy, etc.
8. Local treatment: drugs that can relieve itching can be used externally.
prevent
The cause of urticaria is allergic reaction, which is caused by many factors, such as drugs, food, clothes, pollen, cosmetics and so on. Treatment should start with blocking allergens and anti-allergic treatment. Try to find out the cause and remove it. For example, be careful not to inhale pollen, animal dander, feathers, dust, castor powder, etc., avoid contact with allergens, and ban or fast some drugs or foods that are allergic to the body. If the patient relapses due to cold and hot stimulation, don't avoid it too much. On the contrary, he has to gradually contact and extend the time of hot and cold stimulation to adapt. Actively treat primary diseases, such as acute tonsillitis, cholecystitis, viral hepatitis, appendicitis, intestinal ascariasis, etc. To eliminate the source of the disease. Maintain a cheerful spirit and a good mood at ordinary times. At the same time, we should also pay attention to the temperature change, increase or decrease clothes with the temperature change, and strengthen physical exercise.
However, it is difficult for most patients to find a clear source of allergies. The treatment is oral anti-allergic drugs, which can be combined with calcium, vitamin C and corticosteroids.
In addition, there are some special types of urticaria in clinic. For example:
1. Peptone urticaria: (Acute Peptone Allergic Urticaria) Under normal circumstances, peptone decomposed by food protein is not or rarely inhaled into the blood, which is easy to digest. However, when eating too much (gluttony of pork and seafood), being excited and drinking a lot, peptone can be absorbed into the blood through the intestinal mucosa and cause diseases, resulting in skin congestion, redness, wheal, headache and fatigue. The course of the disease is very short, lasting only 1~2 days, and most of them can disappear within 1~4 hours. It belongs to antigen-antibody reaction, and its pathogenic medium is histamine.
2. Cold urticaria: It is a disease in which urticaria (wheal or vascular edema and erythema) occurs locally after the skin is stimulated by cold. This disease can be divided into two types: familial or hereditary and acquired.
(1) Acquired cold urticaria: It is the most common physical urticaria, which can break out at any age. After skin contact with cold air, cold water, etc. Itchy edema and wheal appear locally within a few minutes, which can last for 30~60 minutes and be relieved after heat preservation. Adhesion test was positive.
(2) Hereditary cold urticaria: It is dominant inheritance, which is more common in women. Infantile onset, lasting for life. A few hours after a cold, the whole body wind mass appears, which has a burning feeling and does not itch, and can last for 48 hours. At the same time, it is accompanied by chills, fever, headache, joint pain and increased cells. The ice viscosity test was negative.
3. Cholinergic urticaria: mostly occurs in young people, and occurs after encountering heat (hot drinks and hot baths), emotional excitement and exercise. The rash is characterized by a small wind mass of 1~3 mm, with redness around it, mostly at the proximal end of trunk and limbs, fatigue and itching. Some patients have digestive tract symptoms, such as abdominal pain and diarrhea.
4. Solar urticaria: The main manifestations are itching, erythema, wheal and vascular edema after skin exposure in the sun for several seconds to several minutes, lasting for 1~2 hours. Most of them are women.
5. Compressive urticaria: The skin appears after being severely and persistently compressed for 4-6 hours, and diffuse edematous pain patches with unclear boundaries appear at the compressed parts, involving the skin and skin tissues. It usually occurs in palms, soles and buttocks, and generally lasts for 8~ 12 hours. Sometimes it is accompanied by chills, headaches, joint pains and general malaise. The pathogenesis is related to kinin.
6. Serum urticaria: caused by drugs (penicillin, furazolidone, etc.). ), vaccine or allogeneic blood. Wind masses, especially polycyclic wind masses, are the most common skin lesions, and toxic erythema and erythema nodosum can also be seen. Patients also have symptoms of serum sickness or serum sickness-like reactions, such as fever, joint pain and lymphadenopathy. It can still damage the heart and kidneys. This is an antigen-antibody complex reaction.
7. Skin scratch: also known as artificial urticaria. After scratching or scratching the skin with a blunt instrument, a strip-shaped bulge appears along the scratch, accompanied by itching, which quickly disappears. Can occur alone or accompanied by urticaria. Can occur at any age. The disease often has no obvious cause, or it may be caused by drugs (especially penicillin). It is also considered to be related to some abnormal functions of skin mast cells.
References:
Luojinyu traditional Chinese medicine skin college-jinyu school