皮下注射和舌下含服免疫治疗儿童变应性鼻炎伴哮喘的长期疗效研究  

Long-term efficacy of subcutaneous and sublingual immunotherapy on children patients with allergic asthma and rhinitis

作　　者：胡斌 谭允宁[1] 柯婧姝 何清泉[1] HU Bin;TAN Yunning;KE Jingshu;HE Qingquan(Otolaryngology department,Foshan women and children hosptial,Foshan,528000,China)

机构地区：[1]广东佛山市妇幼保健院眼耳鼻喉科,528000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2021年第5期347-351,359,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的评估皮下注射免疫治疗(SCIT)和舌下含服免疫治疗(SLIT)儿童变应性鼻炎伴哮喘的长期疗效。方法回顾性分析2012年1月~2018年12月期间在我院完成治疗的98例5~13岁变应性鼻炎伴哮喘患儿的临床资料,进行开放性对照研究,根据免疫治疗的给药途径分为SCIT组和SLIT组,每组各49例患者完成治疗且档案资料完整。比较分析SCIT和SLIT两组患儿治疗前、治疗1、2、3年以及停药2年后的哮喘日间和夜间症状评分(DASS和NASS)、鼻炎症状总分(TNSS)、哮喘药物积分(TAMS)、鼻炎药物积分(TRMS)和第1秒用力呼气容积(FEV1)。结果与基线相比,在治疗1、2、3年和停药2年后,SCIT和SLIT两组患儿的DASS、NASS、TNSS、TAMS、TRMS和FEV1均显著改善(P<0.05)。与治疗1年相比,SCIT组患儿的DASS、NASS和FEV1在治疗2年后得到持续改善(t分别为3.77、4.09、-4.61,P<0.05);与治疗2年相比,治疗3年后仅DASS进一步降低(t=3.93,P<0.05)。与治疗1年相比,SLIT组患儿在治疗2年后TNSS和FEV1得到持续改善(t分别为3.71、-4.79,P<0.05);与治疗2年相比,治疗3年后DASS进一步显著降低(t=4.12,P<0.05)。与治疗3年后相比,在停药2年后两组患儿的DASS、NASS、TNSS、TAMS、TRMS和FEV1差异均不显著(P>0.05)。基线时,两组患儿间的DASS、NASS、TNSS和TRMS差异均不显著(P>0.05),而SLIT组患儿的TAMS和FEV1显著低于SCIT组(P<0.05);治疗1年后,SLIT组的DASS、TAMS和FEV1显著低于SCIT组,而SCIT组患儿的TNSS明显更低(P<0.05);在治疗2、3年和停药2年后,两组间的DASS、NASS、TNSS、TAMS、TRMS和FEV1差异均不显著(P>0.05)。结论皮下注射和舌下含服免疫治疗都能够有效地控制哮喘和鼻炎症状,减少抗过敏药物使用,显著改善肺功能,并在终止治疗2年后仍能保持显著的疗效。Objective To evaluate the long-term efficacy of subcutaneous and sublingual immunotherapy on pediatric patients with allergic rhinitis and asthma.Methods The clinical data of 98 children aged 5~13 years with rhinitis and asthma admitted to our hospital from January 2012 to December 2018 were retrospectively analyzed,and open control studies were conducted.According to the route of administration of immunotherapy,The patients were divided into the SCIT group and SLIT group,49 patients in each group completed treatment and had complete archives.Before the treatment and after the treatment for 1,2,3 years and 2 years after stopping treatment,the daytime asthma symptoms scores、nighttime asthma symptoms scores、total nasal symptoms scores、total asthmatic medication scores、total rhinitis medication scores and forced expiratory volume in one second DASS、NASS、TNSS、TAMS、TRMS and FEV1 of both groups were evaluated.Results The DASS、NASS、TNSS、TAMS、TRMS and FEV1 had continuously improved significantly after treatment for half 1,2,3 years and 2 years after stopping treatment in two groups as compared with baseline(P<0.05).In the SCIT group,DASS,NASS and FEV1 showed continuous improvement after 2 years of treatment as compared with after 1 years of treatment(t was 3.77,4.09,-4.61,P<0.05),and only DASS was further reduced after 3 years of treatment as compared with after 2 years of treatment(t=3.93,P<0.05).Compared with 1 years after treatment,SLIT patients sustained improvement in TNSS and FEV1 after 2 years of treatment(t was 3.71,-4.79,P<0.05),and further significant reduction in DASS after 3 years of treatment as compared with after 2 years of treatment(t=4.12,P<0.05).Compared with 3 years after treatment,there was no significant difference in DASS,NASS,TNSS,TAMS,TRMS and FEV1 between the two groups at 2 years after stopping treatment(P>0.05).At baseline,there were(no)significant differences in DASS,NASS,TNSS and TRMS in the two groups(P>0.05),SLIT patients'TAMS and FEV1 were significantly lower than t

关 键 词：皮下注射 舌下含服 免疫治疗 鼻炎 哮喘 长期疗效 

分 类 号：R725.6[医药卫生—儿科] R765.21[医药卫生—临床医学]