蕁麻疹
楊惟婷整理
您是否曾發現自己或家人的皮膚上,突然莫名地鼓出許多一塊塊粉紅色劇癢且類似蚊蟲咬傷的疹子?這樣的皮疹,很可能就是蕁麻疹。
雖然對多數的人來說,蕁麻疹是不會造成很大的危害,但約有四分之一的人,卻要經歷長達一至二個月、甚至半年以上才能完全擺脫蕁麻疹帶來的困擾。
一、何謂蕁麻疹?
蕁麻疹 (urticaria) 俗稱風疹塊,經常是急性發作,說來就來。
蕁麻疹是一種常見的因個人特殊體質引起的皮膚過敏,所以同桌吃飯的人,可能只有其中一人有對某種食物有過敏的反應。
二、蕁麻疹的症狀
大多數的急性蕁麻疹患者,皮膚上會突然出現搔癢性的浮腫紅疹,疹子大多在數小時內消失,但是新的疹子又不斷的在其他部位出現,整個病程通常在二至三週會痊癒,不需再接受藥物的治療,不過,少數人的病程會長達六週以上,這時就歸類為慢性蕁麻疹。
急性蕁麻疹的症狀除了皮疹以外,較嚴重者還會伴隨眼皮、嘴唇、耳朵或臉部腫脹,極少數個案會出現呼吸道緊縮,造成呼吸困難、甚至窒息。
三、蕁麻疹的病因
如何找出引起蕁麻疹的原因?
大約百分之二十五的蕁麻疹患者會有家族史,而曾有蕁麻疹病史的人,以後再接觸到相同的致病因子,還是很有可能再犯。
一般而言,急性蕁麻疹常因食物或藥物過敏所引起,慢性蕁麻疹則可能和一些慢性感染有關。
誘發蕁麻疹(特別是急性蕁麻疹)的原因有很多,常見的有食物(如海鮮、蛋奶類製品、豆類、核果類、茶、咖啡、巧克力、草莓、芒果等)、藥物、細菌或病毒感染、蚊蟲咬傷等,其它較少被注意到的因素有冷熱之刺激、情緒或是精神上的壓力等;然而,約有一半的的蕁麻疹患者,是找不出其誘發因子的。
在食物方面,現在可藉由抽血來檢驗是否是對某些食物過敏所造成的;另外,也可自行觀察所食用的食物或藥物與蕁麻疹出現時間有無關聯,再儘量避免這些致病因素。
引起慢性蕁麻疹的原因更難尋找,大多為”特異性”的(也就是找不到原因),找得到原因的,則多數與引起急性蕁麻疹的誘因類似,然而,要小心的是,也有極少部分的慢性蕁麻疹與血管炎或其它全身系統性疾病有關。至於其它的因素,可能需尋找醫師來評估了。
總之,引起尋麻疹的原因很多,下列是比較常見的原因:
1、飲食引起的蕁麻疹:
由食物引起的蕁麻疹過敏,只有某些特殊體質的人會發生,此不同於食物中毒。
反之,食物中毒是由食物本身的毒素(例如河豚)或是細菌的毒素(例如葡萄球菌)所引起,所以幾乎每個人都會發生。
食物引起蕁麻疹,例如食用章魚、螃蟹及貝類等,都會引起蕁麻疹;有些體質比較特別的人,甚至食用雞蛋、牛肉、豬肉,也會引起蕁麻疹。
2、寄生蟲、病菌感染引起的蕁麻疹:
感染寄生蟲時,也可能會引起蕁麻疹。例如海鮮中的寄生蟲也可能是引起蕁麻疹的原因(因為含有不同的的蛋白質,也就含有不同的過敏原)。而蕁麻疹也可能感染細菌,如感冒、鏈球菌喉嚨感染。
3、藥劑刺激引起的蕁麻疹:
例如服用或注射藥劑時也可能會引起蕁麻疹。藥物如阿斯匹靈、盤尼西林、磺胺類是引起過敏性或免疫性蕁麻疹的常見原因。
而輸血、血清或抗生素的使用不當,更容易引起蕁麻疹。
4、物理性刺激引起的蕁麻疹:
當皮膚受到各種物理的刺激時,也容易引起蕁麻疹。
如由緊身衣物經常性加壓所引起(如腰帶、襪帶、胸罩、束帶或緊身衣),使皮膚受到機械性的刺激而引起的蕁麻疹,稱為機械蕁麻疹;
如用手搔癢,症狀就會逐漸擴展,所以又稱為人工蕁麻疹;
5、溫風、溫水等所引起的蕁麻疹:
此又稱為溫熱蕁麻疹,可分為僅在熱作用的局部蕁麻疹,以及全身性的蕁麻疹二種,特別溼熱易令人流汗滿身。
6、冷水、寒風所引起的蕁麻疹:
身體接觸低温後所引發,此又稱為冷蕁麻疹,可分為寒風、冷水都會引起的蕁麻疹,以及只有其中之一會形成蕁麻疹二種。如突然跳入冷水游泳池、皮膚接觸冰塊。
7、心因性蕁麻疹:
情緒過度的緊張、不穩定,也有可能會引起蕁麻疹。
8、其他原因引起的蕁麻疹:
其他引發蕁麻疹的原因包括:例如當皮膚接觸到毛毛蟲、蜜蜂、螞蟻等,或吸入貓、狗、鳥的毛或吸入花粉等,也很容易引起蕁麻疹;
食物的新鮮度(例如吃新鮮的海鮮不會過敏,吃不新鮮的就會);
食物的烹調方式也可能是引起蕁麻疹的原因,也許並不是對海鮮過敏,而是對調味料或是使用的油(例如花生油),或是添加的薑、蔥等辛香料過敏;不是對茶或是咖啡過敏,而是對加入的檸檬或是奶精過敏;
更有對豬肉或雞肉中殘留的抗生素過敏的可能性,使得探討食物的過敏與否更加複雜。
最近一些研究顯示有些慢性蕁麻疹是由自體免疫機轉所引起,病人對自己的皮膚成份產生免疫反應所致。某些自體免疫疾病如紅斑性狼瘡、乾燥症等,也可能以蕁麻疹的方式表現。
四、蕁麻疹的預防
麻疹的最佳治療為去除誘發因子,這不是一件簡單的事,而且不容易辦到。所以,蕁麻疹的患者最常問到的問題是:什麼食物不能吃?
一般而言,常見可能會引發蕁麻疹的食物:包括花生、巧克力、乾果、核桃;雞肉、雞肝、香腸、火腿;芋頭、香菇、筍子、青椒、菠菜、茄子、黃豆、小麥、花生油;蔥、薑、蒜、洋蔥、辣椒、肉桂,丁香、山葵等辛香調味料;水果中的番茄、草莓、芒果、柿子、奇異果、香蕉、酪梨、金瓜;養樂多、優酪乳、牛奶、蛋、魚鬆、肉鬆;
食品添加物:例如人工色素(果汁、汽水、糖果)、酵母(麵包、洋香腸、紅酒、啤酒、葡萄、醋、起司、酵母片),零食及泡麵等可能含防腐劑的食品。
為了找出食物中可能的過敏原,推薦患者可以做飲食紀錄,每次發作前24小時或最好48小時內(因為食物須經消化吸收,所以不一定吃後會馬上發作),所吃的東西都要巨細靡遺的紀錄。
如果每次蕁麻疹發作之前,都曾吃到某種食物,就要注意可能是引發的原因,最好暫時停吃該項食物,停止食用該項食物二至三週後蕁麻疹得到改善或消失,再次食用後蕁麻疹又加重或發作,則可以確立該食物和蕁麻疹發做的因果關係。這雖然是一種笨方法,卻也常是最有效的方法。
另外,也應詳細記錄可正在服用的藥物、居家環境等資訊,都有助於醫師尋找出蕁麻疹的誘發因子。
必要時,請過敏免疫科醫師為您安排血液、尿液常規、X光片檢查及皮膚試驗,和特殊的免疫檢查如抗細胞核抗體 (ANA)、類風濕因子 (RF)、血清免疫球蛋白E (IgE)、多重過敏原同時檢測試驗 (MAST)等,都有助於蕁麻疹誘發因子的鑑定。
另外,在藥物治療方面,以口服一種或合併使用二種抗組織胺為主,對於減少皮疹發作及控制搔癢的症狀有很好的效果,一般是建議使用抗組織胺至皮疹完全不再長出後二至三天才停止;對於已使用抗組織胺治療的患者,如果症狀仍然難以控制或是病程無法縮短,可以考慮再加上口服類固醇治療。若已引發呼吸困難,則須儘速送至急診處理。
只要能配合醫囑規則服藥,多數會在一至四抗組織胺週恢復,若是蕁麻疹時常反覆發生,最好還是能積極尋找可能的過敏原或致病因子。
慢性蕁麻疹在處理上較為棘手,病因也較複雜,病程有可能長達一至二年,治療的原則也是以口服抗組織胺為主,有些醫師會加上隔日使用口服類固醇;不過,對於慢性蕁麻疹之患者,建議還是尋求過敏免疫專科醫師的協助。
【蕁麻疹自我治療小妙方】
1.冷敷
2.塗抹鹼性物質,如氧化鎂乳液,可有些許效果
留言列表(144条)
I constantly emailed this blog post page to all my associates, because if like to read it then my links will too.
Yes! Finally something about %keyword1%.
I enjoy, lead to I found exactly what I used to be taking a look for. You have ended my 4 day long hunt! God Bless you man. Have a nice day. Bye
If some one desires expert view concerning blogging after that i suggest him/her to visit this webpage, Keep up the pleasant job.
I am really loving the theme/design of your web site. Do you ever run into any web browser compatibility problems? A handful of my blog visitors have complained about my website not operating correctly in Explorer but looks great in Opera. Do you have any suggestions to help fix this issue?
If some one desires expert view about blogging then i advise him/her to pay a visit this weblog, Keep up the nice job.
WOW just what I was searching for. Came here by searching for %keyword%
I have been surfing online more than 2 hours today, yet I never found any interesting article like yours. It’s pretty worth enough for me. In my opinion, if all site owners and bloggers made good content as you did, the internet will be much more useful than ever before.
Hey very interesting blog!
Really no matter if someone doesn’t know after that its up to other users that they will help, so here it occurs.
Pretty great post. I simply stumbled upon your blog and wanted to mention that I have really enjoyed browsing your blog posts. In any case I’ll be subscribing on your feed and I am hoping you write again soon!
Hey! This is my 1st comment here so I just wanted to give a quick shout out and tell you I truly enjoy reading through your articles. Can you suggest any other blogs/websites/forums that go over the same subjects? Thank you so much!
What’s up, yeah this piece of writing is in fact good and I have learned lot of things from it concerning blogging. thanks.
Hello! I’ve been following your web site for a while now and finally got the bravery to go ahead and give you a shout out from Houston Tx! Just wanted to mention keep up the excellent job!
Hi there, I enjoy reading all of your post. I like to write a little comment to support you.
Hi there, yes this article is actually pleasant and I have learned lot of things from it about blogging. thanks.
Hey There. I found your blog using msn. This is a very smartly written article. I will be sure to bookmark it and come back to read more of your useful information. Thank you for the post. I will definitely comeback.
Hi there to all, it’s in fact a good for me to go to see this site, it consists of precious Information.
If you are going for most excellent contents like me, simply visit this website every day since it offers quality contents, thanks
Woah! I’m really loving the template/theme of this site. It’s simple, yet effective. A lot of times it’s tough to get that “perfect balance” between user friendliness and visual appearance. I must say that you’ve done a amazing job with this. Additionally, the blog loads extremely fast for me on Opera. Exceptional Blog!
Yes! Finally something about %keyword1%.
It’s going to be end of mine day, but before end I am reading this impressive article to increase my knowledge.
I am curious to find out what blog system you are working with? I’m experiencing some minor security problems with my latest site and I would like to find something more safe. Do you have any solutions?
Thank you for the auspicious writeup. It in fact was a amusement account it. Look advanced to far added agreeable from you! By the way, how can we communicate?
Hi, Neat post. There is a problem together with your web site in internet explorer, may check this? IE still is the marketplace leader and a big section of folks will miss your fantastic writing due to this problem.
Hi friends, its great post concerning tutoringand completely explained, keep it up all the time.
I’ve read several good stuff here. Definitely worth bookmarking for revisiting. I wonder how much attempt you set to create this kind of fantastic informative web site.
I needed to thank you for this excellent read!! I certainly enjoyed every little bit of it. I have you book marked to check out new stuff you post
Saved as a favorite, I like your web site!
Wow, marvelous blog layout! How long have you been blogging for? you make blogging look easy. The overall look of your site is magnificent, let alone the content!
I’m not sure where you are getting your info, but good topic. I needs to spend some time learning more or understanding more. Thanks for fantastic information I was looking for this information for my mission.
Good day! Do you use Twitter? I’d like to follow you if that would be ok. I’m definitely enjoying your blog and look forward to new updates.
What’s up friends, its wonderful piece of writing concerning tutoringand completely explained, keep it up all the time.
Excellent post. I used to be checking continuously this blog and I am inspired! Very useful information particularly the remaining part 🙂 I maintain such info a lot. I used to be seeking this particular info for a long timelong time. Thank you and good luck.
I’m not sure why but this site is loading extremely slow for me. Is anyone else having this issue or is it a problem on my end? I’ll check back later and see if the problem still exists.
wonderful post, very informative. I wonder why the other experts of this sector do not understand this. You should continue your writing. I am sure, you have a huge readers’ base already!
Wow that was strange. I just wrote an very long comment but after I clicked submit my comment didn’t show up. Grrrr… well I’m not writing all that over again. Anyway, just wanted to say wonderful blog!
I am regular reader, how are you everybody? This post posted at this web site is in fact pleasant.
Good post. I am dealing with some of these issues as well..
If you desire to increase your familiarity only keep visiting this website and be updated with the newest information posted here.
These are really wonderful ideas in concerning blogging. You have touched some pleasant points here. Any way keep up wrinting.
Wow, this piece of writing is nice, my sister is analyzing such things, thus I am going to inform her.
Excellent post. I used to be checking continuously this blog and I am inspired! Very useful information particularly the last phase 🙂 I care for such info a lot. I used to be seeking this particular info for a long timelong time. Thank you and good luck.
Thanks for a marvelous posting! I definitely enjoyed reading it, you might be a great author.I will ensure that I bookmark your blog and will come back sometime soon. I want to encourage you to ultimately continue your great job, have a nice day!