頑固型慢性蕁麻疹治療病例報告

Case Report on the Treatment of Refractory Chronic Urticarial

蕁麻疹是一種門診常見的皮膚疾病，其典型的皮膚病灶為界線清楚且突起的紅色斑塊，皮疹可出現在身體任何部位，常伴隨嚴重的皮膚搔癢。蕁麻疹依照疾病的病程時間，可區分為急性及慢性。慢性蕁麻疹的定義是皮疹反覆出現超過六週，且每週內大多數的日子都會發作。另一方面，急性蕁麻疹的定義則是皮疹出現的病程時間不超過六週。在這份病例報告中，我們探討了一位被皮膚科醫師診斷為頑固型慢性蕁麻疹的50歲女性，她在西醫皮膚科接受了10個月的抗組織胺治療；然而，她的皮膚症狀並沒有完全被控制住。在服用抗組織胺藥物的期間，她的皮疹仍反覆發作且皮膚劃紋症未曾消失。因此，這位婦女來到我們的中醫門診求助並接受了中藥治療。在服用中藥五週後，這位婦女停用了抗組織胺，皮疹未再出現，皮膚劃紋症亦完全消失。由於這位病患對於中藥治療的效果顯著，所以我們將這份病例整理投稿，希望能提供臨床中醫師們在頑固型慢性蕁麻疹治療上的一個參考。

Urticaria is a common clinical skin disorder which presents circumscribed, raised, erythematous plaques and extremely pruritus on any part of the skin. Urticaria can be divided into ＂chronic＂ and ＂acute＂ types according to the duration of the disease. Chronic urticaria is defined by the presence of hives, in the most days of the week, persisted a period of six weeks or longer. On the other hand, acute urticaria is defined by the presence of hives less than six weeks. In this case report, we discussed a 50-year-old women who was diagnosed as refractory chronic urticaria by the dermatologist and has been received anti-histamine treatment for 10 months. However, the symptoms of this women were not under control during anti-histamine therapy as she had recurrent hives and obvious dermatographism. Therefore, the women came to our Chinese medicine OPD for help and received Chinese herbal therapy. After 5 weeks treatment of Chinese herbs, the patient stopped using antihistamine but the hives did not occur anymore and her dermatographism totally disappeared. The result of Chinese herbal therapy in this patient is effective, so we would like to present this patient report to clinical Chinese medicine doctors as a case study of treatment for refractory chronic urticaria.