特异性免疫治疗儿童咳嗽变异性哮喘远期疗效分析  

Analysis of Long-term Efficacy of Specific Immunotherapy for Cough Variant Asthma in Children

作　　者：王翠华[1] 汤林[1] 

机构地区：[1]菏泽市立医院儿科,山东菏泽274031

出　　处：《医学综述》2015年第23期4406-4408,共3页Medical Recapitulate

摘　　要：目的探究并分析特异性免疫治疗儿童咳嗽变异性哮喘（CVA）远期疗效。方法选取2010年1月至2012年1月菏泽市立医院收治的儿童CVA的112例，按照随机数字表法分为观察组（60例）和对照组（52例）。对照组接需给予对症治疗（包括B2激动剂，或缓释茶碱，或白三烯调节剂糖皮质激素等），观察组患者在常规治疗基础上给予舌下特异性免疫治疗（SLIT），于清晨早饭前将滴剂滴于舌下，含1～3min后吞服，每日1次，具体用药剂量也可根据患者治疗情况给予调整，已达到最佳治疗效果，治疗时间为2年，停药后随访1年。观察两组患儿治疗开始1、2年及停药1年的咳嗽发作次数、持续的时间、每年患儿儿童哮喘控制测试中文版（Ch—CACT）测试、峰值呼气流速（PEF）监测，每年CVA转变为典型哮喘的例数。结果两组患儿随着治疗的进行Ch—CACT评分呈上升趋势[对照组：（21．0±2．1）分、（22．4±1．9）分、（22．2±1．5）分；观察组：（20．6±22）分、（25．1±15）分、（24．4±1．3）分]，观察组治疗结束时和治疗后1年Ch-CACT评分高于对照组（P〈0．05）。观察组患儿治疗后PEF实测值／预计值呈先上升趋势[观察组：（88±5）％、（96±6）％、（97±5）％、（96±5）％]，停药1年末略有降低；对照组入组、治疗1年末、治疗2年末、停药1年末PEF实测值／预计值波动较大[对照组：（88±17）％、（92±6）％、（89±7）％、（90±5）％，P〈0．05]。观察组与对照组患儿治疗后咳嗽次数呈下降趋势[观察组：（4．68±1．87）次，（2．33±0．58）次，（236±0．41）次；对照组：（4．75±1．79）次，（4．26±0．73）次，（3．98±0．66）次]，且观察组患儿停药后1年咳嗽次数明显少于对照组（P〈0．05）。观察组患儿治疗后持续时间组间呈下降趋势（P〈0．05），且观察组患儿停药后1年持续Objective To explore and analyze the long-term efficacy of specific immunotherapy for children with cough variant asthma. Methods A total of 112 children with cough variant asthma（CVA） were selected in Shandong province from Jan. 2010 to Jan. 2012. According to the random number table method, they were randomly divided into observation group （60 cases ） and control group （52 cases ）. The control group was treated according to symptoms（ including 132 agonists, or sustained-release tbeophylline or leukotriene modifier glucocorticoid）, patients in the treatment group received the conventional treatment and sublingual immunotherapy （SLIT）, drops under the tongue early in the morning before breakfast, swallowing after containing 1-3 min, 1 time a day, specific dosage can be adjusted according to the treatment condition, so as to achieve the best treatment effect,treatment duration was 2 years, after discontinuation of the drug they were followed up for 1 year. The cough episodes, the coughing days number, children asthma control test （Ch-CACT） every year, peak expiratory flow rate （PEF） monitoring, number of CVA developing into typical asthma per year of the two groups at the start of treatment, after 1 year and 2 years of treatment, and after 1 year of discontinuation were observed. Results The Ch-CACT score of both groups increased as the treatment progressed [ control group ： （21.0 ± 2. 1 ） scores, （ 22.4 ±1.9 ） scores, （ 22.2 ±1.5 ） scores ; observation group ： （20.6 ± 2.2） scores, （25.1 ±1.5 ） scores, （24.41±1.28 ） scores ]. At the end of the treatment and 1 year after the observation group was higher than the control group （ P 〈 0.05 ）. After treatment, the PEF measured value/expected value of the observation group were increased [ observation group ： （ 88 ± 5 ） %, （96 ± 6 ） % , （ 97 ±5 ） % , （ 96 ± 5 ） % ] , and was slightly lower at 1 year of discontinuation. The PEF measured value/measured value of the control group fluc

关 键 词：咳嗽变异性哮喘 儿童 特异性免疫治疗 远期疗效 

分 类 号：R752[医药卫生—皮肤病学与性病学]