特应性皮炎螨过敏原特异性免疫治疗的评价——荟萃分析  

Clinical efficacy of specific immunotherapy on atopic dermatitis: meta-analysis

作　　者：任香玉[1] 吴忠[2] 李宏 

机构地区：[1]上海市皮肤病性病医院皮肤科,上海200050 [2]江苏大学附属医院风湿免疫科 [3]中国医学科学院协和医院变态反应科

出　　处：《中国麻风皮肤病杂志》2009年第6期435-438,共4页China Journal of Leprosy and Skin Diseases

摘　　要：目的:评价特异性免疫治疗(SIT)对特应性皮炎的疗效和安全性。方法:收集螨过敏原SIT特应性皮炎的随机对照研究和临床观察性研究的文献数据,采用Stata 10.0统计软件进行荟萃分析,对临床观察性研究进行定性分析。结果:26篇相关文献中15个纳入系统评价。3个以是否好转为效应指标的随机对照研究的荟萃分析显示SIT无效;2个以AD病情严重性评分SCORAD为效应指标的随机对照研究的荟萃分析显示SIT有效,同时显著减少药物的用量;10个临床观察性研究的定性分析,9个研究显示有效,有效率45%～95%;15个纳入的研究中大多数副作用轻微,仅5例病情加重或发生严重不良事件,总的发生率<1%(5/649)。结论:对尘螨过敏的特应性皮炎患者,特异性免疫治疗是有效和安全的。Objective： To assess the efficacy and the safety of specific immunotherapy （SIT） in patients with atopic dermatitis. Methods： The relevant data on randomized controlled trials and cohort studies from 1974 to 2007 were retrieved from Medline, EMBASE, Cochrane and CHKD. Methodological quality of randomized controlled trials was assessed based on the Cochrane Reviewer＇ s Handbook and Jadad＇ s Score Scale. Statistical software STATA 10.0 was used for meta- analysis. The data was treated by intention - to - treat method. Qualitative analysis was performed in cohort studies. Results： A total of 26 relevant papers were screened. Five randomized controlled clinical trials （RCTs） from European studies met the inclusion criteria. Ten clinical observational studies from European and China were enrolled in the systemic review. Three RCTs which used the improvement or no change as a effect index reported 72 cases of atopic dermatitis showed that SIT had no protection with a pooled relative ratio of 1.47 （95% CI 0.85 - 2.56, P = 0. 169）. Other two RCTs which used the SCORAD as a effect index reported 145 cases showed that SIT significantly reduced the SCORAD with a pooled standardized mean difference of 2.08 （95 % CI 1.63 - 2.53, P = 0.000）, and there was a significant reduction in the use of medications. Qualitative analysis of ten chnical observational studies including 713 cases showed that nine studies revealed significant curative effect with effective power ranged from 45% to 95%. Among the enrolled 15 studies, side effects were mild in majority of the patients. The severe adverse effects were reported only in 5 cases （ 〈 1%, 5/649）. Conclusion： SIT is effective and safety in the treatment of atopic dermatitis sensitized to house dust mite allergens.

关 键 词：特异性免疫治疗 特应性皮炎 荟萃分析 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]