皮膚疾患に伴う掻痒に対する塩酸オロパタジンの効果の検討  [in Japanese] CLINICAL EFFECTS OF OLOPATADINE HYDROCHLORIDE ON PRURITIS IN SKIN DISEASES  [in Japanese]

【目的】各種皮膚疾患の〓痒に対する第2世代抗ヒスタミン薬の臨床効果を経日的に検討した.【方法】塩酸オロパタジン(アレロック^[○!R])5mgを1日2回投与し,2,4週後に〓痒の程度と掻破痕のスコアを投与前と比較した.日中・夜間の〓痒の程度は患者の痒み日記でvisual analogue scale(VAS),痒みスコアにより評価した.【結果】日中・夜間の痒みスコア,掻破痕スコアおよび痒み日記によるVAS値,痒みスコアは,投与後に有意に低下した.VAS値は,痒み日記および医師の問診による痒みスコアと有意な相関を示した.疾患ごとの層別解析では蕁麻疹は投与翌日より速やかな痒みの改善がみられ,次いで皮脂欠乏性湿疹,アトピー性皮膚炎の順であった.【結語】痒みのVAS値は,経日的な痒みの評価に適した方法であることが示された.また,即時的作用をもつ第2世代抗ヒスタミン薬は,蕁麻疹に対しては投与1日目より高い止痒効果を示すが,ヒスタミン以外の痒みが関与する皮脂欠乏性湿疹やアトピー性皮膚炎に対しては連用することで止痒効果が高まると考えられた.

Objective: The clinical effects of second generation antihistamines on pruritis caused by various skin diseases were examined by keeping a daily record of their effects. Methods: Five mg of olopatadine hydrochloride (Allerock^[○!R]) was admininstered to the subjects twice daily. The severity of the pruritis and the scratch scars were scored before, and then 2 weeks and 4 weeks after, commencement of treatment. The severity of the pruritis during the day and night was measured by using a visual analogue scale (VAS), and a daily 'itch score' was recorded in an 'itch diary.' Results: The itch scores for both day and night, as well as the scratching scores, the VAS values and the 'itch score,' significantly decreased after administration of olopatadine. The VAS value was significantly correlated with the itch scores and patient responses in the medical interview. Statistical analysis showed that there was a prompt alleviation of the pruritis in uriticaria a day after administration, followed by asteatotic dermatitis and atopic dermatitis, in the order of improvement, within the next several days. Conclusion: The VAS value for pruritis was highly correlated with the itch score, showing that the VAS value was suitable for evaluating daily changes in the severity of pruritis. These results suggest that second generation antihistamines like olopatadine hydrochloride, which showed a prompt response to histamine, are effective against pruritis in uriticaria, and that continuous use of these antihistamines is effective against pruritis in other forms of skin disease, such as asteatotic dermatitis and atopic dermatitis in which other chemical mediators besides histamine may be the triggers for pruritis.