245例变应性鼻炎患者舌下免疫治疗的依从性及脱落原因分析  

Compliance and withdraw reason of sublingual immunotherapy in 245 patients with allergic rhinitis

作　　者：夏彩风 颜榕 王全桂[1] XIA Caifeng;YAN Rong;WANG Quangui(Department of Otolaryngology Head and Neck Surgery,Peking University First Hospital,Beijing,100034,China)

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,北京100034

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第4期277-281,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨变应性鼻炎(AR)患者接受舌下免疫治疗(SLIT)的依从性及其影响因素。方法:回顾性分析2016年1月-2018年1月于北京大学第一医院接受尘螨SLIT的291例AR患者的临床资料,并对其进行门诊或电话随访。对于治疗时间不满2年脱落的患者,记录其脱落时间以及脱落原因。结果:291例患者中成功随访245例(84.2%),中途脱落(治疗时间<2年)193例(78.8%),整体依从率为21.22%(52/245)。儿童依从率较成人依从率高(χ^(2)=21.306,P<0.05),性别、受教育程度对依从率无明显影响。脱落人数最多的时间段为治疗后6~<12个月(68例,27.8%),主要脱落原因为症状缓解,认为治愈(16.7%);治疗后3个月内61例(24.9%)患者脱落,其中34例(13.9%)脱落原因为用药麻烦、经常漏服而停药。193例患者整体脱落原因排名前三位的是:59例(30.6%)症状减轻后认为治愈,44例(22.8%)用药麻烦、漏服后停药,26例(13.5%)起效慢或者无效。结论:AR患者行SLIT的整体依从性较差,儿童依从性较成人好。临床医生应针对患者不同时段的脱落原因加强患者教育,增强患者治疗信心,提高患者依从性。Objective: To investigate the compliance of patients with allergic rhinitis(AR)receiving sublingual immunotherapy and its influencing factors.Methods: The clinical data of 291 AR patients who received sublingual immunotherapy for dust mites at the First Hospital of Peking University from January 2016 to January 2018 were retrospectively analyzed,and their outpatient or telephone follow-up was conducted.For patients whose treatment time was less than 2 years,the time and reason for the loss were recorded,and the factors affecting their compliance were discussed from the aspects of gender,age,and education.Results: Among the 291 patients,245 cases(84.2%)were successfully followed up,and 193 cases(78.8%)fell off midway(treatment time<2 years).The overall compliance rate was 21.22%(52/245).The compliance rate of children is higher than that of adults(χ^(2)=21.306,P<0.05),and gender and education level have no significant effect on the compliance rate.The time period for the largest number of shedding was 6-<12 months after treatment(68 cases,27.8%).The main cause of shedding was symptom relief,which was considered cured(16.7%).Secondly,within 3 months after treatment,a total of 61 patients(24.9%)fell off,of which 34 cases(13.9%)fell off because of troublesome medication,often missed medication,and simply stopped taking the drug.Statistics on the overall reasons for shedding in 193 patients,the top three shedding reasons were:cured after symptom relief(59 cases,30.6%),troublesome medication,discontinuation after missed dose(44 cases,22.8%),slow onset or ineffectiveness(26 cases,13.5%).Conclusion: The overall compliance of sublingual immunotherapy in patients with allergic rhinitis is poor,and the compliance of children is better than that of adults.Clinicians should focus on the reasons for patients to fall off at various times,strengthen patient education,enhance patient confidence in treatment,and improve the compliance of patients.

关 键 词：变应性鼻炎 舌下免疫治疗 依从性 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]