舌下免疫与吸入激素在儿童尘螨过敏咳嗽变异性哮喘中的早期疗效比较  

Comparison of early efficacy between sublingual immunization and inhaled hormones in children with dust mite allergy cough variant asthma

作　　者：王凡 赵军[2] 杨家武[1] 张曙冬[1] WANG Fan;ZHAO Jun;YANG Jia-wu;ZHANG Shu-dong(PCCM of Kunming Children's Hospital,Kunming Yunnan 650034,China;Preventive Medicine Teaching and Research Office of Public Health School of Hubei University of Medicine,Shiyan Hubei 442000,China)

机构地区：[1]昆明市儿童医院呼吸与危重症科,云南昆明650034 [2]湖北医药学院公共卫生与健康学院预防医学教研室,湖北十堰442000

出　　处：《云南医药》2021年第4期307-310,共4页Medicine and Pharmacy of Yunnan

基　　金：昆明市科技计划重点项目(2017-1-S-16421)。

摘　　要：目的探讨舌下免疫与吸入糖皮质激素治疗在儿童尘螨过敏咳嗽变异性哮喘中早期疗效。方法选取我院尘螨过敏咳嗽变异性哮喘儿童60例,其中舌下免疫治疗组29例、吸入激素治疗组31例。对每位患者随访并记录在第1个月、4个月和7个月各项指标。采用广义估计方程比较2组的治疗效果。结果使用舌下免疫及吸入激素均能够改善咳嗽症状评分、用药评分及肺功能指标(FEV1、FEV1%pred、PEF),治疗前后差异均有统计学意义(P<0.05)。2组间进行比较,治疗后吸入激素组咳嗽症状积分低于舌下免疫组(P<0.05),肺功能指标(FEV1和FEV1%pred)的改善高于舌下免疫研究组(P<0.001),用药评分高于舌下免疫组(P<0.001)。结论对于尘螨过敏咳嗽变异性哮喘患儿,早期使用舌下免疫治疗能够改善咳嗽症状和肺功能,减少临床用药,且安全性良好。与吸入激素比较,咳嗽症状及肺功能的改善程度不及吸入激素。Objective To explore the early effect of sublingual immunization and inhaled glucocorticoid on allergic cough variant asthma of dust mite in children.Methods 60 children with cough variant asthma due to dust mite allergy in Kunming children's hospital were selected,including 29 cases in sublingual immunotherapy group and 31 cases in inhaled hormone treatment group.All patients were followed up and recorded in the first,forth and seventh month.The treatment effects of the two groups were compared by using the generalized estimation equation.Results The cough symptom score,medication score and pulmonary function index(FEV1,FEV1%PRED,PEF)were improved by sublingual immunization and inhaled corticosteroids,there was statistical significance in difference before and after treatment(P<0.05).After treatment,the cough symptom score of inhaled hormone group was lower than that of sublingual immunization group(P<0.05),the improvement of pulmonary function index(FEV1 and FEV1%PRED)was higher than that of sublingual immunization group(P<0.001),and the medication score was higher than that of sublingual immunization group(P<0.001).Conclusions For children with dust mite allergy cough variant asthma,early use of sublingual immunotherapy can improve cough symptoms and lung function,reduce clinical medication,and has good safety.Compared with inhaled corticosteroids,the improvement of cough symptoms and lung function is not as good as inhaled corticosteroids.

关 键 词：舌下特异性免疫治疗 吸入激素 尘螨过敏儿童咳嗽变异性哮喘 临床疗效 

分 类 号：R725.6[医药卫生—儿科]