标准化粉尘螨滴剂治疗单一和多重过敏变应性鼻炎患儿的长期疗效评估  

Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis

作　　者：崔珑[1] 夏忠芳[1] 王智楠[1] 徐忠强[1] 

机构地区：[1]武汉市儿童医院耳鼻咽喉科,武汉430000

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第12期1094-1097,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：湖北省自然科学基金(No:2008CDZ059);武汉市卫生局基金(No:WX09A06)

摘　　要：目的:评估标准化粉尘螨滴剂舌下特异性免疫治疗(SLIT)对单一过敏和多重过敏变应性鼻炎(AR)患儿的长期疗效。方法:根据皮肤点刺试验结果将162例接受标准化粉尘螨滴剂SLIT治疗的AR患儿分为单一过敏组和多重过敏组。在治疗前、治疗2年和停药3年评估两组患儿的鼻部症状总评分(TNSS)、药物总评分(TMS)和不良反应发生率。结果:SLIT治疗2年、停药3年后,单一过敏组的TNSS(分别为3.14[2.47;3.65]、3.45[2.76;3.92])和TMS(分别为0.42[0.36;0.57]、0.35[0.26;0.44])均显著低于治疗前(TNSS为9.00[8.00;10.00],TMS为2.16[1.88;2.37]),差异有统计学意义(均P<0.05);SLIT治疗2年、停药3年后,多重过敏组的TNSS(分别为3.14[2.46;3.63]、4.23[3.65;4.96])和TMS(分别为0.42[0.36;0.58]、0.50[0.34;0.72])均显著低于治疗前(TNSS为9.00[8.00;10.00],TMS为2.18[1.95;2.37]),差异有统计学意义(均P<0.05)。SLIT治疗前、治疗2年,单一过敏组与多重过敏组TNSS、TMS分别进行组间比较,差异均无统计学意义(均P>0.05);停药3年后,单一过敏组TNSS、TMS均低于多重过敏组,差异有统计学意义(均P<0.05)。治疗期间仅有11例(单一过敏组7例,多重过敏组4例)患儿发生轻微不良反应,并且两组之间的不良反应发生率差异无统计学意义(P>0.05)。结论:标准化粉尘螨滴剂对单一和多重过敏的AR患儿均有长期疗效。此外,对于多重过敏患儿,尚需更长的SLIT疗程(>2年)来巩固疗效。Objective：To evaluate the efficacy of sublingual immunotherapy（SLIT）with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis.Method：The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively.These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests.The total nasal symptoms score（TNSS）,the total medication score（TMS）and adverse effects（AEs）were evaluated before treatment,2year after SLIT treatment and 3year after drug discontinuance.Result：After SLIT treatment for 2years and drug discontinuance for 3years,the TNSS（3.14[2.47;3.65],3.45[2.76;3.92],respectively）and TMS（0.42[0.36;0.57],0.35[0.26;0.44],respectively）in the monoallergen sensitized group were lower than that before the treatment（TNSS：9.00[8.00;10.00],TMS：2.16[1.88;2.37]）,which have showed a statistically significant difference（P〈0.05）.Similarly,after SLIT treatment for 2years and drug discontinuance for 3years,the TNSS（3.14[2.46;3.63],4.23[3.65;4.96],respectively）and TMS（0.42[0.36;0.58],0.50[0.34;0.72],respectively）in the polyallergen sensitized group were lower than that before the treatment（TNSS：9.00[8.00;10.00],TMS：2.18[1.95;2.37]）,which have showed a statistically significant difference（P〈0.05）.No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2years after treatment,respectively.However,a statistically significant finding could be observed between two groups in the drug discontinuance for 3years（P〈0.05）.Eleven patients suffered local adverse effects,and the incidence of adverse effects showed no significantly difference（P〉0.05）.Conclusion：SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis.Moreov

关 键 词：鼻炎 变应性 常年性 脱敏法 免疫 儿童 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]