We experienced four cases of urticaria (two patients with cholinergic urticaria, one patient with chronic idiopathic urticaria and one patient with cold urticaria) successfully treated with Kampo therapy. The factors for outbreak or aggravation of urticaria were stress of looking after the father in law and hysterectomy in the first case, psychological stress due to familial trouble in the second case, panic disorder like episode in the third case, and solicitude and anxiety for family in the fourth case. The effective Kampo formulae that improved the dermatological symptom were keishibukuryogan, hangekobokuto, yokukansankachimpihange and kamishoyosan, respectively. It was helpful that to clarify the psychological background affecting the dermatological symptom in the determination of Kampo formulae. It would be useful that careful and repetitious question and answer about psychological background in the treatment of intractable urticaria.
Urticaria ; Medicine, Kampo ; Chronic ; Therapeutic procedure ; Cases

OBJECTIVETo observe short-term therapeutic effect and safety of Bo's abdominal acupuncture for treatment of chronic urticaria.

METHODSSixty-one cases of chronic urticaria were randomly divided into an observation group (n = 31) and a control group (n = 30). They were treated respectively with Bo's abdominal acupuncture and cetirizine. Their therapeutic effects were compared.

RESULTSThe effective rate was 80.7% in the observation group and 76.7% in the control group with no significant difference, but no adverse effect was found in the observation group, and the adverse effects such as sleepiness, headache, thirsty and so on were found in the control group.

CONCLUSIONBo's abdominal acupuncture has a short-term therapeutic effect similar to cetirizine on chronic urticaria, and has no adverse effect of anti-histamine agents, being more safe.

Abdomen ; Acupuncture Therapy ; Chronic Disease ; Humans ; Urticaria ; drug therapy

The treatment idea for chronic urticaria with acupuncture and moxibustion by "mind-body regulation" is explored in reference with "psychosomatic medicine". Chronic urticaria refers to "mind and body comorbidity" because qi and blood dysfunction and emotional abnormality are presented simultaneously in the disease and affected each other. In clinical diagnosis and treatment, the mutual regulation of mind and body should be considered to improve the curative effect. In treatment with acupuncture and moxibustion, through regulating the mind of brain, heart and zang organs, as well as qi movement, the mental activity is adjusted; through harmonizing the defensive qi and the nutrient blood, eliminating wind and stopping itching, the unhealthy conditions of body are treated. The comprehensive therapy of acupuncture is adopted in combination with moxibustion, bloodletting and auricular point therapy, in which, "regulating the mind" goes through the whole process of treatment, and the doctors and patients are well cooperated to ensure the qi-blood harmonization and the mind-body wellness.
Humans ; Moxibustion ; Acupuncture Points ; Acupuncture Therapy ; Bloodletting ; Chronic Urticaria

BACKGROUND: Chronic urticaria is defined as repeated episodes of wheals lasting for 6 weeks or longer. Nowadays, the role of vitamin D in various chronic diseases is a matter of great interest, but limited data is available on the vitamin D status in patients with chronic urticaria. OBJECTIVE: The goal of this study was to investigate the relationship between vitamin D status and clinical characteristics of chronic urticaria. METHODS: The clinical records of 72 patients with chronic urticaria, 26 with acute urticaria and 26 with atopic dermatitis, along with 72 healthy controls, were retrospectively reviewed. RESULTS: The serum 25-(OH)D3 level was found to be significantly reduced in patients with chronic urticaria compared to those in the other groups. In particular, the proportion of patients with critically low vitamin D levels (<10 ng/ml) was significantly higher in the chronic urticaria group than in the other groups. The serum vitamin D levels showed significant negative associations with urticaria activity score and disease duration. In addition, serum vitamin D levels were significantly lower in subjects with a positive autologous serum skin test than in subjects with a negative result. CONCLUSION: In conclusion, the serum vitamin D level was more likely to be critically low in patients with chronic urticaria, and an inverse relationship with disease severity and disease duration was observed. These findings may open up the possibility of the clinical use of vitamin D as a contributing factor in the pathogenesis of chronic urticaria and a predictive marker for disease activity in chronic urticaria.
Chronic Disease ; Dermatitis, Atopic ; Humans ; Retrospective Studies ; Skin Tests ; Urticaria* ; Vitamin D* ; Vitamins*

BACKGROUND: Chronic spontaneous urticaria (CSU) is considered a different disease entity from acute urticaria in relation to its pathogenesis, despite both disease types having similar clinical manifestations that include wheals, flares, and angioedema. OBJECTIVE: We sought to identify the clinical factors that might predict the disease course of new-onset urticaria, determine whether the disease will be limited to an acute course or if it will progress to a chronic course, and to estimate the chronic progression rate in relation to the presence of each clinical factor and laboratory abnormality. METHODS: We retrospectively reviewed the medical records of 348 patients with new-onset urticaria. Of these, 141 patients had progressed to chronic disease and 207 patients showed a limited to acute course with disease durations of less than 6 weeks. We compared the progressed to chronic and limited to acute disease groups in relation to differences in their clinical presentations and severities, and the laboratory data. RESULTS: The overall chronic progression rate of new-onset urticaria was 40.5%. The chronic progression rate was highest in patients aged 30~39 years (52.3%), in patients prescribed antihistamines (52.9%), and when the cause of urticaria was unknown (51.8%). The laboratory test results did not differ significantly between the study groups. CONCLUSION: Patients with new-onset urticaria are likely to have chronic courses when they are aged 30~39 years, when they have mild clinical symptoms initially, and when the cause of urticaria is difficult to identify.
Acute Disease ; Angioedema ; Chronic Disease ; Disease Progression* ; Histamine Antagonists ; Humans ; Medical Records ; Prognosis ; Retrospective Studies ; Urticaria*

OBJECTIVE: To compare the clinical therapeutic effect and the impacts on recurrence rate on chronic spontaneous urticaria (CSU) between the combined treatment of bloodletting therapy and auricular point sticking on the base of xuanfu theory and the oral solution of levocetirizine hydrochloride. METHODS: A total of 86 patients with CSU were randomized into an observation group (43 cases, 1 case dropped off) and a control group (43 cases, 3 cases dropped off). In the observation group, bloodletting therapy at Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17) and Pishu (BL 20) was combined with auricular point sticking at lung (CO₁₄), kidney (CO₁₀), shenmen (TF₄) and heart (CO₁₅), etc. This combined treatment was given once every two days. In the control group, the oral solution of levocetirizine hydrochloride was prescribed, 10 mL each time, once daily. The treatment lasted for 4 weeks in the two groups. Before and after treatment, urticaria activity score 7 (UAS7), the score of dermatology life quality index (DLQI) and the levels of serum immune globulin E (IgE), interleukin 4 (IL-4) and interferon γ (IFN-γ) were compared in the patients between the two groups. The clinical therapeutic effect was evaluated in patients of the two groups and the recurrence rate was followed up 4, 8 and 12 weeks after treatment separately. RESULTS: After treatment, the scores of UAS7 and DLQI, as well as the levels of serum IgE and IL-4 were all reduced as compared with those before treatment in the two groups (P<0.05), and the level of serum IFN-γ was increased (P<0.05). The total effective rate was 83.3% (35/42) in the observation group and was 85.0% (34/40) in the control group. There was no statistical significance for the difference in the clinical therapeutic effect between the two groups (P>0.05). Eight and 12 weeks after treatment, the recurrence rates were 21.1% (4/19) and 26.3% (5/19) in the observation group, lower than 55.0% (11/20) and 65.0% (13/20) in the control group, respectively (P<0.05). CONCLUSION The combined therapy of bloodletting and auricular point sticking on the base of xuanfu theory relieves the clinical symptoms, regulates the levels of serum IgE, IL-4 and IFN-γ and improves the quality of life in the patients with CSU. The clinical therapeutic effect of this combined treatment is similar to the oral solution of levocetirizine hydrochloride. But, the recurrence rate of the combined treatment of bloodletting and auricular point sticking is lower and its long-term curative effect is better.
Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Bloodletting ; Chronic Urticaria ; Humans ; Quality of Life ; Treatment Outcome

To examine the effectiveness and safety of erythropoietin on the anemia of end-stage chronic renal failure, we administered recombinant human erythropoietin(rHuEPO), Eporon(R), to 66 patients with anemia and chronic renal failure who were undergoing hemodialysis or peritoneal dialysis. All received Eporon(R) intravenously, two or three times per week at 150unit/kg, and then the dose of Eporon(R) was adjusted to 75-300unit/kg/week according to the hemoglobin response. The results of this study judged 19(39.6%) of 48 patients as being in a "markedly improved" condition while 23(47.9%) of 48 patients were judged as being in an "improved" condition. At results, the response rate of this study was 87.5%(42/48 patients). This was the same as the target response rate, 90%(p= 0.564). Serious adverse events occured in 6 cases during the study, but all proved to be unrelated to Eporon(R). These events included itching 1(1.5%), urticaria 1(1.5%) and headache 1(1.5%). No patients discontinued to participate in the study except one patient who withdrew from the study voluntarily. The symptoms of all adverse events eventually decreased and disappeared during the clinical study. No factors in the clinical laboratory tests changed significantly (p<0.05) except for the decrease of TSR and ferritin, a consequence of using iron hemoglobin synthesis caused by Eporon(R) administration. The significant increase in blood pressure, which could not be proved to be related to Eporon(R), disappeared during the study. Anti-Epo antibody was not detected in any samples. These results demonstrate that Eporon(R) is effective in many patients with the anemia of end-stage chronic renal failure.
Anemia* ; Blood Pressure ; Erythropoietin ; Ferritins ; Headache ; Humans* ; Iron ; Kidney Failure, Chronic* ; Peritoneal Dialysis ; Pruritus ; Renal Dialysis ; Urticaria

Contact Urticaria is a wheal-and-flare response to chemicals applied to the skin. Contact urticaria due to bee sting therapy has never been reported in Korea. A 45-year-old male was seen for erythematous plsques and patches with the duration of 3 days. Histologicall, the skin biopsy specimen showed necrosis and dyskeratotic cells in the epidermis. Collagen degenerati in and perivascular lymphocytic infiltrates were seen in the upper dermis.
Bees* ; Biopsy ; Bites and Stings* ; Chronic Pain* ; Collagen ; Dermis ; Epidermis ; Humans ; Korea ; Male ; Middle Aged ; Necrosis ; Skin ; Urticaria*

OBJECTIVETo observe differences of therapeutic effect between acupuncture combined with bloodletting and regular western medication on chronic urticarial.

METHODSOne hundred and sixty patients were randomly divided into an acupuncture bloodletting group and a loratadine group, 80 cases in each group. In the acupuncture bloodletting group, Quchi (LI 11), Neiguan (PC 6), Xuehai (SP 10) and Sanyinjiao (SP 6) were selected and manipulated with reducing method, and pricking bloodletting with three-edge needle and cupping were given at Feishu (BL 13) and Geshu (BL 17), once every other day. The oral administration of 10 mg loratadine was applied in the loratadine group, once a day. The therapeutic effect in two groups was observed and compared after four weeks.

RESULTSThe cured and markedly effective rate was 91.3% (73/80) in the acupuncture bloodletting group, which was similar to 81.3% (65/80) in the loratadine group (P > 0.05). The scores of symptom-sign in the two groups were reduced after treatment (10.14 +/- 1.95 vs 2.12 +/- 40.32, 10.30 +/- 1.82 vs 3.21 +/- 0.28, both P < 0.01), but there was no statistically significant difference between two groups after treatment (P > 0.05). There was no obvious adverse effect in the acupuncture bloodletting group while 3 cases of mild somnolence were reported in the loratadine group.

CONCLUSIONThe acupuncture bloodletting is an effective method for chronic urticarial, which has similar effect to loratadine without adverse effect.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Urticaria ; therapy ; Young Adult

Acupuncture Points ; Acupuncture, Ear ; Adolescent ; Adult ; Aged ; Child ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Urticaria ; therapy ; Young Adult