Mr. Wang, who is more than 30 years old, has been plagued by repeated erythema and wheals around him in the past 3 years, especially at night, because of severe itching and scratching almost all night, which seriously affects sleep and has a bad impact on work. Mr. Wang sought medical treatment everywhere, was diagnosed by dermatologists as "chronic urticaria", was told that it was an allergic disease, but checked several allergens, and did not find a clear allergic food and contact, each time the doctor gave a variety of anti-allergic drugs, symptoms can be alleviated when taking medicine, and once the drug is stopped, it is still repeated.
Mr. Wang was introduced to the Department of Dermatology of the Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, and after receiving the doctor to learn more about the condition, he suggested that he do a "carbon 14 blow test" examination, and the result was positive for Helicobacter pylori (hp). After two weeks of anti-HP treatment and 1 month of Traditional Chinese medicine therapy, Mr. Wang's chronic urticaria finally stopped flare up and did not recur after three months of tracking. It turned out that Mr. Wang's erythema itching for many years was actually Helicobacter pylori at work!
Helicobacter pylori (hp) is the only microbial species known to survive in the human stomach, hp infection is listed as a class of carcinogens by the World Health Organization's International Agency for Research on Cancer, generally causing chronic gastritis, peptic ulcer, stomach cancer, lymphoproliferative gastric lymphoma and other diseases. In fact, Mr. Wang usually does not have stomach discomfort, why should the doctor do this examination? This has to start with chronic urticaria.
Urticaria is a localized edematous reaction due to dilation and increased permeability of small blood vessels in the skin and mucous membranes, and is clinically manifested by rapid onset, recurrent erythema and wheals, accompanied by varying degrees of pruritus. It is generally divided into acute urticaria and chronic urticaria. Lesions that recur for more than 6 weeks are called chronic urticaria. Acute urticaria often has systemic symptoms, chronic urticaria in addition to itching systemic symptoms are generally mild, skin lesions are more and less frequent, recurrent, often for months or years, lasting for a long time, seriously affecting the quality of life of patients.
The causes of urticaria are complex and may be caused by drugs, food and food additives, inhalants, infections, psychiatric factors, physical factors, visceral and systemic diseases. Food and drugs are often the cause of acute urticaria, and chronic urticaria is not directly related to food and drugs.
Clinically, we have found that chronic urticaria is mostly related to the following factors:
Mental factors: such as nervousness, anxiety, depression, insomnia, etc., can induce or aggravate urticaria.
Physical factors: some have seizures in case of heat, such as easy to attack when exercising or taking a hot bath, and some are prone to cold air blowing under cold water.
Visceral and systemic diseases: such as lupus erythematosus, Behcet's disease, rheumatoid arthritis, gastritis, hepatitis, hyperthyroidism, diabetes, lymphoma, etc. can be called urticaria, especially the cause of chronic urticaria.
Various infections: chronic infections caused by bacteria, viruses, fungi, parasites, etc.
In recent years, some chronic urticaria has been reported to be associated with Helicobacter pylori infection, such as an increasing incidence of urticaria in people infected with Helicobacter pylori. Most patients with chronic urticaria are not significantly upset in the stomach, so the importance of improving Helicobacter pylori-related tests is easily overlooked, so that conventional treatment can affect the efficacy. Mr. Wang is in this situation.
Helicobacter pylori lives in the pyloric part of the human stomach and is one of the most common bacterial pathogens. More than half of the world's population or even 90% of people have been infected with Helicobacter pylori, which can cause chronic gastritis, peptic ulcer, gastric cancer, gastric mucosal-associated lymphoid tissue lymphoma and other gastric diseases. But extragastric disease caused by Helicobacter pylori, you know?
Helicobacter pylori infection can cause iron deficiency anemia, idiopathic thrombocytopenic purpura, henoch-schönlein purpura, megaloblastic anemia, coronary heart disease, chronic urticaria, oral diseases and many other extragastric diseases. And there are studies reporting that patients with chronic refractory urticaria have Helicobacter pylori infection, and most patients no longer develop urticaria after anti-hp treatment. Other HP-related diseases can also be improved to varying degrees after regular anti-HP treatment.
Therefore, for patients with chronic urticaria, the cause or possible precipitating factors should be actively sought out, and these factors should be removed to cure. For the doctor who is interviewed, it is also necessary to patiently ask the medical history, cooperate with the relevant examinations, and analyze the internal and external causes that may be relevant one by one. For patients who can hardly find the cause, learn more about the patient's mental and physical conditions, through the control of Western medicine in the early stage of treatment and the whole process of Traditional Chinese medicine dialectics and traditional Chinese medicine maintenance, most of the chronic urticaria can be gradually cured.
Author: He Dawei, Department of Dermatology, Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine, and Hu Jinyang, Department of Gastroenterology
[Editor-in-Charge: Ling Quan]
[Source: New Hunan Client]