标准化粉尘螨滴剂舌下免疫治疗变应性鼻炎的疗效及安全性研究  

Study on the efficacy and safety of sublingual immunotherapy with standardized dermatophagoides farinae drops for allergic rhinitis

作　　者：黄少鹏[1] 谢秀芳 陈勇[1] 吴丽华[1] 李瑞玉[1] 沈帆[1] 陈洪[1] 

机构地区：[1]福建医科大学省立临床学院耳鼻咽喉科福州,350001 [2]福建省宁德市中医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第7期618-621,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：福建省卫生厅青年科研基金(No:2008-1-7)

摘　　要：目的:评价标准化粉尘螨滴剂舌下特异性免疫治疗成人变应性鼻炎(AR)的疗效及安全性。方法:收集成人AR患者112例,随机分为舌下免疫治疗组(SLIT组)56例和对照组56例,前者以标准化粉尘螨滴剂舌下含服免疫治疗,辅以药物对症治疗,后者单纯使用药物对症治疗,观察并记录治疗后2年症状评分、药物评分、鼻炎生活质量评分、不良反应以评价舌下免疫治疗的疗效及安全性。结果:SLIT组和对照组分别有5例和4例脱落,SLIT组症状评分从7.81±3.14降到3.89±2.01、药物评分从2.86±0.75降到0.44±0.06(t值分别为5.13和5.64,P<0.01);对照组症状评分从8.01±3.32降到5.20±2.43、药物评分从2.95±0.80降到1.75±0.40(t值分别为2.07和3.87,P<0.01),差异均有统计学意义。鼻结膜炎生活质量调查问卷(RQLQ)评估,SLIT组2年后总体生活质量治疗组从43(39,46)降到19(15,22)(Z值为-6.10,P<0.01),且明显低于对照组36(26,47)(Z值为-5.21,P<0.01)。SLIT组有4例(7.14%)出现不良反应,不良反应发生率为未出现严重的全身不良反应。结论:标准化粉尘螨滴剂舌下免疫治疗AR能明显改善症状,减少药物,提高患者生活质量,且安全性较高。Objective：To evaluate the efficacy and safety of the sublingual immunotherapy with dermatophagoides farinae drops on patients with allergic rhinitis.Method：One hundred and twelve cases were collected from adult patients with dust-mite allergic rhinitis of our hospital who could adhere to treatment and regular follow-up.These patients were randomly allocated to receive either sublingual immunotherapy（SLIT group,n=56）or medical treatment（Control group,n=56）.To evaluate the clinical efficacy by side effects which were registered,symptom and medication scores which were assessed and rhinoconjunctivitis quality of life questionnaire（RQLQ）which was completed in the baseline and two years after treatment.Result：Dropouts after the 2years′treatment were 5of SLIT group and 4of Control group respectively.SLIT group induced the significant reductions on both the symptom scores（7.81±3.14 to 3.89±2.01,P〈0.01）and the medication scores（2.86±0.75 to 0.44±0.06,P〈0.01）.Meanwhile,Control group induced the reductions on both the symptom scores（8.01±3.32to5.20±2.43）and the medication scores（2.95±0.80 to 1.75±0.40）.There were significant differences（P〈0.01）in symptom and medication scores between the two groups after 2-year treatment.The patients in SLIT group had fewer symptoms and lower intake of medication.There were statistically significant differences in RQLQ between SLIT group[19（15,22）]and Control group[36（26,47）]after two years treatment（Z=-5.21,P〈0.01）.SLIT group also had significant improvement in RQLQ（Z=-6.10,P〈0.01）between before and after the treatment.There were 4patients who showed adverse reactions in SLIT group（3occurred in increment period,and 1occurred in the maintenance period）.The incidence of adverse reactions was 7.14%.No severe systemic side effects were registered.Conclusion：SLIT with standardized dermatophagoides farinae drops in China is safe and effective to patients with allergic rhinitis.

关 键 词：鼻炎 变应性 免疫治疗 投药 舌下 治疗效果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]