Chronic urticaria is very torturous and deprives patients of happy life enjoyment.
In addition, chronic urticaria often occurs in an acute way, and severe cases can occur such as laryngeal edema and gastrointestinal urticaria. If it is not treated in time, it will be life-threatening!
Pathogenesis of chronic urticaria
Urticaria is a common skin mucosal vascular reactive disease, which is caused by many different reasons. Clinically, it is characterized by limited, temporary, itchy flushing and wind mass of skin and mucosa. Its pathogenesis can be immune (the most common type I allergic reaction mediated by [1]IgE) and non-immune.
The common causes of urticaria are: (1) food and additives; (2) drugs; (3) infection; (4) Animals, plants and inhalants; (5) Physical factors; (6) visceral diseases; (7) mental factors; (8) Genetic factors. There are many special types according to the etiology. At present, histamine type and cholinergic type are commonly used in clinical diagnosis and treatment.
Syndrome Differentiation of Chronic Urticaria in TCM
Urticaria, called "adult addiction rash" in Chinese medicine, is one of the common and frequently-occurring diseases in dermatology. It is characterized by sudden onset, bright red or reddish wheal on the skin, itching without pain, sometimes without pain, and leaving no trace after fading. The disease mostly occurs in winter and spring, and it is easy to recur with different medical histories. Generally, the course of disease is more than 3 months, which is called chronic urticaria.
The etiology of the disease is complex, and modern medicine believes that it is related to the body's allergies and allergic reactions to certain substances. Traditional Chinese medicine believes that it is caused by "evil combination, and its qi will be deficient". Because the healthy qi of human body is relatively weak, and patients have different constitutions, or they have the evil of food accumulation, pathogenic heat, cold and wind-heat; Or usually weak, yin deficiency and blood deficiency, rash repeated attacks, long-term recovery, blood consumption; Or suffering from chronic diseases (such as intestinal parasites, hepatitis, nephritis, irregular menstruation, etc. ), it can't be vented inside, and it can't be penetrated outside, which is between skin diseases and pathogens. Clinically, it is common in women, especially young people.
In addition to anti-allergy, blocking and autologous blood treatment, the curative effect of western medicine is not exact. Traditional Chinese medicine has different syndromes when treating this disease. Clinically, the author mostly uses the basic treatment of "strengthening the body resistance and eliminating pathogenic factors" to treat dermatosis, and adopts "Xiaofeng Powder" created by Chen Shigong in Ming Dynasty as the main prescription to add and subtract, and unify the zang-fu organs based on syndrome differentiation, which has achieved good results.
A brief introduction is as follows:
1. All patients with abdominal distension, nausea and vomiting, diarrhea or constipation can be differentiated from the spleen and stomach. People with damp-heat use Huoxiang Zhengqi to disperse dry heat. Adding Herba Artemisiae Scopariae, Radix Sophorae Flavescentis, Cortex Dictamni Radicis, etc. Those with deficiency cold should use Jianzhong and Lizhong; Those with deficiency in the middle and stagnation in Yang Qi should use ascending yang to benefit the stomach; Those with mixed cold and heat should be treated with Banxia Xiexin Decoction. People with constipation should take Fangfeng Tongsheng Pill to relieve exterior and interior symptoms.
2. Anyone who suffers from this disease, has dry throat, or coughs, or has a history of allergic rhinitis and is prone to catching a cold can be identified from the lung system. People with qi deficiency and unstable exterior and interior should use Yupingfeng powder; Patients with lung heat can choose Maxingshi Dry Decoction and Mahuang Forsythia Red Bean Decoction.
3. All patients who are irritable, irritable and depressed, or women with irregular menstruation and dysmenorrhea can be differentiated from the liver meridian. Follow the treatment method of "treating wind first, then treating blood, and promoting wind to extinguish itself". Schizonepeta tenuifolia, Saposhnikovia divaricata and tribulus terrestris should be added for patients with blood heat. Add or subtract with Rhinoceros Horn Dihuang Decoction, or add or subtract with Antelope Horn Gouteng Decoction. Xiaoyao powder should be used for patients with liver depression; People with blood deficiency should use Danggui Yinzi, and those with blood stasis should use Tongjing Zhuyu Decoction.
4. All patients with palpitation, palpitation or insomnia and dreaminess can be identified from the heart system. Tianwang Buxin Dan should be used for patients with heart yin deficiency, and Guizhi plus Gulong oyster soup should be used for patients with heart yang deficiency.
5. All patients with soreness of waist and knees can be differentiated from kidney. Those with kidney yin deficiency should use Liuwei Dihuang Pill, and those with kidney yang deficiency should use Erxian Decoction.
In addition to oral administration, external washing with traditional Chinese medicine also has a certain effect on chronic urticaria. External washing prescription: 20 grams of alum, silkworm excrement, mirabilite, Schizonepeta tenuifolia and Sophora flavescens each, decocted in water several times a day.
Clinical manifestations of chronic urticaria
The wind is changeable, and the resulting chronic urticaria is also varied. The common clinical manifestations of chronic urticaria are:
1, the rash is wheal and flushing with different sizes and shapes. It often happens suddenly, appears in batches, and quickly fades after a few hours, leaving no trace after fading. But it can recur;
2. Conscious itching can be accompanied by abdominal pain, nausea, vomiting, chest tightness, palpitation, dyspnea, and a few have symptoms such as fever, joint swelling, hypotension, shock, laryngeal edema, suffocation, etc.
3. The course of acute urticaria is less than 1 month; 1 month or more is chronic;
4. Skin scratch test is positive in some cases.
Special type of clinic
(1) protein urticaria is an antigen-antibody reaction caused by direct absorption of protein through intestinal mucosa.
(2) Cold urticaria can be divided into familial cold urticaria and acquired cold urticaria, which are physical urticaria caused by cold;
(3) Hot urticaria can be divided into acquired urticaria and hereditary urticaria. After contact with hot water, blisters appear at the contact site.
(4) Cholinergic urticaria, induced by heat, mental stress and exercise, is more common in the trunk and proximal limbs. The rash is an air mass of 1-2 mm with redness around it;
(5) Solar urticaria, which is more common in women, occurs after sunlight exposure, and the rash is limited to the exposed parts;
(6) Compressive urticaria, which occurs after severe and long-term compression for 4-6 hours, with diffuse, edematous and painful plaques at the compression site;
(7) Water-borne urticaria, which produces tiny itchy air masses around pores after contact with water and sweat;
(8) Serum urticaria is caused by contact with allogeneic serum, vaccines and drugs. Its clinical manifestations are fever, rash, arthritis and lymphadenopathy;
(9) Autoimmune progesterone urticaria occurs in the early and middle stages and is caused by progesterone.
Matters needing attention
1, Don't scratch: Most people's intuitive response to skin itching is to scratch with their hands, but you may not know that this action can not only stop itching, but also make it itch more and more, mainly because when you scratch a local itch, it will raise the local temperature and release more histamine (allergen) in the blood, thus aggravating the condition.
2. Don't apply hot compress: Some people will use hot compress to relieve itching. Although heat can temporarily relieve the local area, it is actually another stimulus, because heat will make blood vessels tense and release more allergens.
Some people soak in hot springs or take a bath in winter, or wrap themselves in thick quilts, which may cause urticaria.
3. Avoid eating foods containing artificial additives and eat more fresh fruits and vegetables. Fried, fried or spicy foods are more likely to cause urticaria recurrence.
4. Eat more fresh fruits and vegetables rich in vitamins or take vitamins C and B, or B6 in group B. ..
5. Eat more alkaline foods, such as grapes, green tea, kelp, tomatoes, sesame seeds, cucumbers, carrots, bananas, apples, oranges, mung beans and coix seed.
6, rest more, don't be tired, exercise moderately.
1. Chronic urticaria is a disease without cause.
The patient's body, face or limbs often develop red, swollen and itchy rash patches from time to time, and the more he scratches, the more itchy he is, and the more swollen he scratches. The number of attacks varies from several times a day to once a few days.
2. Chronic urticaria is a disease that can be cured.
In fact, this skin disease takes a long time to take medicine to change the constitution, and then there is a way to cut off the roots; Usually, the longer the onset time, the longer the medication time. If you can cooperate with the doctor and take medicine patiently and regularly, you will generally recover within a few months (stubborn may take 1 to 2 years).
3. Is it related to diet?
It is true that some urticaria is caused by eating some food or drinking alcohol, but chronic urticaria is not absolutely related to food. It's just that some people will make the rash worse after eating certain foods (such as seafood, mushrooms, bamboo shoots, wine, mangoes, strawberries). Therefore, in the process of drug control of urticaria, if those foods are found to aggravate urticaria, we should try our best to avoid them.
4. Can "allergen test" find the reason? Or help disease control?
At present, allergen testing is mainly used for patients with atopic constitution (atopic dermatitis). After years of medical research, it is true that a higher proportion of allergens can be detected in patients with atopic dermatitis than in normal people. However, among patients with chronic urticaria, only a few patients can find a few allergic foods during blood test; Even more ridiculous, even if patients avoid these foods, urticaria will still happen correctly. Therefore, allergen testing for urticaria patients not only wastes medical resources, but also gives patients more injections because of repeated blood drawing. Patiently cooperating with doctors and receiving oral antihistamine desensitization treatment regularly is a safe and effective method, which does not waste time and money.
5. Will long-term medication cause physical burden or even affect liver and kidney function?
At present, the first-line drug for dermatologists to treat chronic urticaria is antihistamine, which is quite safe, will not cause physical burden and will not affect liver and kidney function. Only some patients will have side effects such as "drowsiness and dry mouth" at the beginning of taking the medicine, but they can adapt to it in 3 ~ 7 days, so you can use it with peace of mind. Very few diseases that are difficult to control must be supplemented with second-line drugs. At this time, the doctor will discuss the advantages and disadvantages of medication with you.
Eat more foods that enhance immunity or take some drugs.
I have been suffering from chronic urticaria since 1999. I once went to Peking Union Medical College Hospital for an expert clinic for 4 hours. The expert said these words to me: "your illness doesn't need treatment, forget it." Pay attention to improving your physical fitness at ordinary times, and you will get better slowly. Go home. " There will be hot and cold in recent years, but it's no big deal.
I wish you a speedy recovery.