不同疗程舌下特异性免疫治疗成人变应性鼻炎患者的疗效评估  

Efficacy of sublingual immunotherapy with different treatment courses in adult patients with allergic rhinitis

作　　者：黄秋菊[1] 林霞[1] 魏欣[1] 郑静[1] 粘家斌[1] HUANG Qiu-ju;LIN Xia;WEI Xin;ZHENG Jing;NIAN Jia-bin(Department of Ear-nose Head and Neck Surgery, Hainan General Hospital, Haikou 570311, Hainan, CHINA)

机构地区：[1]海南省人民医院耳鼻咽喉头颈外科海南省耳鼻咽喉头颈外科医院,海南海口570311

出　　处：《海南医学》2019年第5期585-587,共3页Hainan Medical Journal

基　　金：国家自然科学基金地区科学基金(编号:81760187);海南省卫生计生行业科研项目(编号:18A200022);海南省重点研发项目(编号:ZDYF2017115)

摘　　要：目的评估不同疗程标准化粉尘螨滴剂舌下含服特异性免疫治疗(SLIT)成人变应性鼻炎患者的疗效。方法回顾性分析了2014年4月至2015年10月期间在海南省人民医院接受SLIT治疗的305例18～69岁粉尘螨致敏的变应性鼻炎患者的临床资料。根据SLIT疗程的长短将其分为半年、1年、2年和3年组,分别为98例、56例、58例和93例。分析四组患者治疗前后的鼻炎四大症状评分、药物评分和VAS评分。结果与SLIT治疗前比较,四组患者的喷嚏、流涕、鼻塞、鼻痒和总鼻炎症状评分以及鼻炎药物评分、VAS评分均明显降低,差异均具有统计学意义(P<0.05);SLIT治疗后,与疗程半年组的总鼻部症状评分1.00 (0.75,2.00)分比较,1、2、3年组患者的总鼻部症状评分分别为0.00 (0.00,1.00)分、0.00 (0.00,0.00)分、0.00 (0.00,1.00)分,差异均具有统计学意义(P<0.05);2年组和3年组患者的药物评分分别为0.00 (0.00,0.00)分、0.00 (0.00,0.00)分,明显低于半年组的0.00 (0.00,1.00)分,同时也明显低于1年组的0.00 (0.00,1.00)分,差异均具有统计学意义(P<0.05);2年组患者的VAS评分为1.00 (0.00,1.00)分,明显低于半年组的2.00 (0.00,2.00)分,3年组患者的VAS评分为0.00 (0.00,0.00)分,均明显低于半年组、1年组和2年组的VAS评分,差异均具有统计学意义(P<0.05)。结论与半年和1年疗程比较,2年以上SLIT治疗AR成人患者疗效更佳,3年SLIT治疗的VAS评分比2年改善更明显,3年疗程疗效最佳。Objective To evaluate the efficacy of sublingual immunotherapy(SLIT) with Dermatophagoides farinae drops according to different duration with allergic rhinitis in adult patients. Methods The clinical data of the305 adult patients with allergic rhinitis aged from 18 to 69 years, who admitted to Hainan General Hospital from April2014 to October 2015, was retrospectively analyzed. According to the SLIT treatment duration, patients were defined as the four groups(half a year, 1-year, 2-year, and 3-year), and there were 98, 56, 58 and 93 cases respectively. The four symptom scores, total medication scores, and Visual Analogue Scale(VAS) scores of the four groups before and after SLIT were evaluated. Results Compared with before SLIT, the sneezing, runny nose, stuffy nose, nasal itching, total symptom scores(TNSS), total medication scores(TMS), and VAS of the four groups decreased significantly, and the differences were statistically significant(P<0.05). After the treatment, the TNSS of the half a year group was 1.00(0.75,2.00), which showed significant differences with 0.00(0.00, 1.00), 0.00(0.00, 0.00), 0.00(0.00, 1.00) of the 1-year,2-year, and 3-year groups(P<0.05). The TMS of 2-year and 3-year groups were 0.00(0.00, 0.00) and 0.00(0.00, 0.00),which were significantly lower than 0.00(0.00, 1.00) and 0.00(0.00, 1.00) of the half a year and 1-year group(P<0.05).The VAS scores of 2-year group was 1.00(0.00, 1.00), which was significantly less than 2.00(0.00, 2.00) of half a year;while the VAS scores of the 3-year group was 0.00(0.00, 0.00), which were significantly less than corresponding 2.00(0.00, 2.00), 1.50(0.00, 2.00) and 1.00(0.00, 1.00) of the half a year group, 1-year group, and 2-year group(P<0.05).Conclusion Compared to six months and one year of treatment, more than two years of treatment were more effective in the treatment of AR adults, and the VAS score was better for three years of treatment than two years, with three years of treatment having the best curative effect.

关 键 词：变应性鼻炎 舌下含服 特异性免疫疗法 疗程 疗效 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]