变应性鼻炎集群免疫治疗与常规免疫治疗的临床疗效及安全性对照研究  

Comparative study on cluster and conventional immunotherapy in patients with allergic rhinitis

作　　者：罗志红[1] 李彬[1] 万浪[1] 彭聪[1] 

机构地区：[1]黄石市中心医院耳鼻咽喉科,湖北435000

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第2期105-109,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家“十一五”科技支撑计划（2007BA1185815）

摘　　要：目的观察并比较应用标准化尘螨变应原集群免疫治疗和常规免疫治疗变应性鼻炎（allergic rhinitis，AR）之间的临床疗效及安全性。方法接受免疫治疗的中一重度持续性螨过敏AR患者共110例，采用随机数字表法分为2组，分别接受常规免疫治疗A组（57例）及集群免疫治疗B组（53例），A组失访7例，脱落率12．28％，B组失访1例，脱落率1．89％，比较两组在治疗7周、15周、1．0年、1．5年、2．0年时的鼻部症状评分、药物评分、迷你型鼻结膜炎生活质量调查问卷（Mini RQLQ）评分、临床疗效等，同时观察治疗2年过程中局部不良反应和全身不良反应发生率。以SPSS19．0软件进行统计学分析。结果2组鼻部症状评分、药物评分、MiniRQLQ评分均较治疗前降低（P值均〈0．05）。在7周和2．0年时集群免疫治疗组鼻部症状评分[（0．55±0．21）、（0．57±0．27）分]、5项MiniRQLQ评分及临床有效率（86．5％、94．2％）均优于常规治疗组[鼻部症状：（1．41±0．65）、（0．83±0．30）分，t值分别为11．344、5．649，P值均〈0．05；MiniRQLQ评分：P值均〈0．05；临床有效率：60．0％、80．0％，）（2值分别为9．224、4．642，P值均〈0．05]。在7周时集群免疫治疗组药物评分[（0．11±0．04）分]低于常规治疗组[（0．47±0．11）分，t=27．665，P〈0．05]。局部和全身不良反应发生率在剂量累加阶段和剂量维持阶段集群免疫治疗组与常规免疫治疗组相比，差异均无统计学意义（P〉0．05）。结论对中．重度持续性螨过敏的AR，集群免疫治疗是一种安全的治疗方法，较常规免疫治疗更有效且起效更迅速。Objective To compare the efficacy and safety of subcutaneous immunotherapy with dermatophagoides pteronyssinus standardized extract given in conventional and cluster immunotherapy schedules for persistent allergic rhinitis. Methods One hundred and ten patients with moderate to severe allergic rhinitis caused by dust mites, in accordance with the immunotherapy inclusion criteria, were allocated to receive conventional immunotherapy as group A （ n = 57 ） or cluster immunotherapy as group B （n = 53）. In group A, 7 cases were lost to follow-up, the expulsion rate of group A was 12. 28% ; in group B, 1 case was lost to follow-up, the expulsion rate of group B was 1.89%. Nasal symptom scores, medicine scores and mini rhinoconjunctivitis quality of life questionnaire （ Mini RQLQ） were recorded and compared before and after 7 weeks, 15 weeks, 1.0 year, 1.5 years, 2. 0 years. All the scores were assessed to evaluate the clinical efficacy, and also the incidence of local and systemic adverse reactions were registered to evaluate the safety. SPSS 19. 0 software was used to analyze the data. Results Nasal symptom scores, medicine scores and Mini RQLQ of both groups were significant lower than those before the treatment （all P 〈 0.05）. Mini RQLQ and nasal symptom scores in cluster group （0.55 ±0.21,0.57 ±0. 27 ） were more significantly declined than the conventional group after 7 weeks and 2.0 years of observation （ all PMinl RQLQ 〈 0. 05;nasal symptom scores： 1.41±0. 65,0.83 ±0. 30, t value was 11. 344, 5. 649, both P 〈0. 05）. The clinical efficiency rate in cluster group （86. 5%, 94. 2% ） were more significantly bighter than those （60. 0% , 80.0% ） in the conventional group after 7 weeks and 2 years of observation（ X2 value was 9. 224, 4. 642, both P 〈 0. 05 ）. The medicine scores in cluster group （ 0. 11 ± 0.04 ） was more significantly declined than conventional group （0. 47 ± 0.11 ） after 7 weeks （ t = 27. 665, P 〈 0.05 ）. The incidence of local and systemi

关 键 词：鼻炎 变应性 常年性 脱敏法 免疫 治疗结果 问卷调查 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]