舌下特异性免疫联合鼻内镜下腺样体切除术治疗小儿变应性鼻炎合并中重度腺样体肥大的疗效  

The efficacy of sublingual specific immunotherapy combined with endoscopic adenoidectomy in the treatment of children with allergic rhinitis complicated with moderate to severe adenoid hypertrophy

作　　者：余琼 张涛 YU Qiong;ZHANG Tao(Changshou District People′s Hospital, Chongqing 401220, China)

机构地区：[1]重庆市长寿区人民医院,重庆401220

出　　处：《实用医院临床杂志》2022年第3期35-38,共4页Practical Journal of Clinical Medicine

基　　金：重庆市卫生计生委医学科研计划面上项目(编号2017MSXM05146)。

摘　　要：目的探讨鼻内镜下腺样体切除术联合舌下特异性免疫治疗小儿变应性鼻炎合并中重度腺样体肥大的疗效,分析对血清白细胞介素(IL-17)、白细胞介素(IL-10)水平的影响。方法选择2019年1月至2020年1月我院收治的142例变应性鼻炎合并中重度腺样体肥大患儿,采用随机数字表法分为两组各71例,对照组采用鼻内镜下腺样体切除术联合常规药物治疗,观察组在对照组基础上增加舌下特异性免疫治疗,两组均治疗12周。定期门诊复查和随访,比较两组疗效、临床症状评分、血清IL-17、IL-10水平及两组复发率、不良反应情况。结果观察组治疗有效率高于对照组(P<0.05),治疗后打鼾、张口呼吸、鼻阻、流涕、鼻痒、打喷嚏评分及血清IL-17水平低于对照组,血清IL-10水平高于对照组(P<0.05)。观察组不良反应率,复发率均低于对照组(P<0.05)。结论鼻内窥镜腺样体切除手术联合舌下特异性免疫治疗可更有效抑制炎症反应,提高变应性鼻炎合并中重度腺样体肥大临床疗效,降低复发和不良反应率。Objective To investigate the efficacy of nasal endoscopic adenoidectomy combined with sublingual immunotherapy(SLIT)in the treatment of children with allergic rhinitis(AR)complicated with moderate to severe adenoid hypertrophy,and to analyze the effects of the treatment on the levels of serum interleukin 17(IL-17)and interleukin 10(IL-10).Methods One hundred and forty-two AR children with moderate to severe adenoid hypertrophy admitted to our hospital from January 2019 to January 2020 were selected.The patients were divided into an observer group and a control group by using random number table method,71 in each group.The control group received endoscopic adenoidectomy combined with conventional drug treatment for 12 weeks,and the observation group received SLIT based on the control group.Regular outpatient review and follow-up were conducted.The efficacy,recurrencerate,adverse reactions,clinical symptom scores and serum IL-17 and IL-10 levels were compared between the two groups.Results The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the scores of snoring,mouth breathing,nasal obstruction,runny nose,nasal itching and sneezing as well as the serum IL-17 level were lower while the serum IL-10 level was higher in the observation group than thosein the control group(P<0.05).The adverse reaction rate and recurrence rate of the observation group were lower than those of the control group(P<0.05).Conclusion Nasal endoscopic adenoidectomy combined with SLIT can more effectively inhibit the inflammatory response,improve the clinical efficacy,and reduce the recurrence and adverse reaction rates in children with AR.

关 键 词：腺样体切除术 舌下特异性免疫 变应性鼻炎 腺样体肥大 白细胞介素-17 白细胞介素-10 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]