特异性免疫治疗尘螨和花粉多重致敏变应性鼻炎的应用研究  

Application research on specific immunotherapy in the treatment of allergic rhinitis sensitized by dust mites and pollen

作　　者：薛林 杨莉萍[1] 陈月华[1] 李健鹰[1] 汪贺媛[1] 刘彬 周克燕 XUE Lin;YANG Liping;CHEN Yuehua;LI Jianying;WANG Heyuan;LIU Bin;ZHOU Keyan(The First Hospital of Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市第一医院,河北050000

出　　处：《医学动物防制》2020年第5期418-422,共5页Journal of Medical Pest Control

基　　金：石家庄市科学技术研究与发展支撑计划——中重度变应性鼻炎综合治疗的临床研究(151461123)。

摘　　要：目的探讨特异性免疫治疗对尘螨及花粉多重致敏变应性鼻炎的疗效和皮下注射免疫治疗安全性评估。方法采用随机对照临床研究,入组的55例变应性鼻炎病人被随机分成特异性皮下免疫治疗组(过敏原注射液)和抗过敏药物治疗组(可选择抗过敏药物,包括:鼻喷激素、二代抗组胺剂和白三烯受体拮抗剂),对两组治疗前后鼻部症状、抗过敏药物及日常生活质量评分进行评估。同时观察并评估在特异性皮下免疫治疗过程中产生的不良反应。结果经治疗特异性免疫治疗组、抗过敏药物治疗组各项指标(症状评分、药物评分及生活质量评分)均较用药前降低,差异有统计学意义(Z治疗组组内=4.440、4.469、4.522、4.387、4.424、4.413、4.507、4.463、4.523、4.540、4.490、4.562、4.523,Z对照组组内=4.506、4.453、4.400、4.472、4.419、4.123、3.606、4.264、4.243、4.359、4.491、3.606、4.000,P均<0.05)。特异性免疫治疗组评分也低于抗过敏药物治疗组,差异有统计学意义(Z=5.184、6.080、3.581、5.017、4.562、2.760、2.843、2.532、3.132、4.096、4.659,P均<0.05)。在皮下免疫治疗期内仅少数病人产生局部不良反应,无明显全身严重不良反应。结论在尘螨和花粉多重致敏的变应性鼻炎病人中,使用尘螨和花粉联合免疫治疗安全、有效,比单纯使用药物治疗效果更佳,值得临床推广。Objective To evaluate the efficacy of specific immunotherapy in the treatment of patients with allergic rhinitis sensitized by dust mites and pollen,and to evaluate the security of subcutaneous immunotherapy.Methods A randomized controlled clinical trial was conducted.A total of 55 patients with allergic rhinitis were randomly divided into specific subcutaneous immunotherapy group and anti-allergic drug treatment group.The patients in specific subcutaneous immunotherapy group were treated with allergen injection,while patients in anti-allergic drug treatment group were treated with anti-inflammatories,including nasal spray hormone,second-generation antihistamines and leukotriene receptor antagonists.The scores of nasal symptom,medication and life quality were compared before and after treatment.Side effects in the course of specific immunotherapy were also observed and evaluated.Results After 2 years of treatment,the scores of nasal symptom,medication and life quality in both groups were lower than before,and there was statistically significant difference(Zexperimental group=4.440,4.469,4.522,4.387,4.424,4.413,4.507,4.463,4.523,4.540,4.490,4.562,4.523,Zcontrol group=4.506,4.453,4.400,4.472,4.419,4.123,3.606,4.264,4.243,4.359,4.491,3.606,4.000,P<0.05).Compared with the anti-allergic drug treatment group,the above indexes of specific immunotherapy group were lower,there was statistically significant difference(Z=5.184,6.080,3.581,5.017,4.562,2.760,2.843,2.532,3.132,4.096,4.659,P<0.05).During the period of specific subcutaneous immunotherapy,only a few patients developed local adverse reaction,and no significantly systemic and severe adverse reaction were found.Conclusion The combined immunotherapy was safer and more effective than pure drug therapy in patients with allergic rhinitis sensitized by dust mites and pollen.It is worthy for clinical application.

关 键 词：变应性鼻炎 免疫治疗 尘螨 花粉 安全性评估 

分 类 号：R765.22[医药卫生—耳鼻咽喉科]