黄花蒿花粉变应原舌下滴剂治疗季节性变应性鼻炎的疗效观察及依从性分析  

Efficacy observation and compliance analysis of pollen allergen drops in seasonal allergic rhinitis

作　　者：于东东 刘瑛[2] 郑智英[2] 张婧[1] 高露 张敏[2] 何婵 郝建利 张克军[2] 冯彦[2] Yu Dongdong;Liu Ying;Zheng Zhiying;Zhang Jing;Gao Lu;Zhang Min;He Chan;Hao Jianli;Zhang Kejun;Feng Yan(First Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China;Department of Otolaryngology Head and Neck Surgery,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]山西医科大学第一医院耳鼻咽喉头颈外科,太原030001

出　　处：《中华预防医学杂志》2023年第12期1996-2001,共6页Chinese Journal of Preventive Medicine

基　　金：山西省科协健康科普课题项目(JKKP202135);山西省回国留学人员科研资助项目(2022-194);山西医科大学第一医院专项经费科研项目(Y2022136020);山西医科大学第一医院专项经费科研项目(Y2022136021)。

摘　　要：探讨黄花蒿花粉变应原舌下滴剂对季节性变应性鼻炎进行免疫治疗的疗效及其影响免疫治疗的依从性因素。本研究采用单中心对照研究,于2021年7—9月,共纳入80例就诊于山西医科大学第一医院耳鼻喉科门诊对黄花蒿花粉过敏的季节性变应性鼻炎患者,其中40例接受舌下免疫治疗作为舌下免疫治疗组(SLIT组),另40例仅接受对症药物治疗作为对照组。记录并比较两组患者在治疗开始前蒿属花粉高峰期、治疗后第一年蒿属花粉高峰期的鼻结膜炎症状总评分(total rhinoconjunctivitis symptom score,TRSS)、视觉模拟量表评分(the visual analogue scale,VAS)、总用药评分(total medication score,TMS)、药物鼻结膜炎症状联合评分(combined scores of medication and rhinoconjunctivitis symptoms,CSMRS),用于评估黄花蒿花粉舌下免疫治疗的疗效。跟踪分析研究免疫治疗过程中患者的脱落情况,详细记录脱落原因,分析探讨其安全性及影响免疫治疗依从性因素。结果显示,治疗前蒿属花粉高峰期两组患者TRSS、VAS、TMS、CSMRS比较,TRSS(SLIT组:12.393±3.023,对照组:12.450±3.029,t=-0.077,P=0.939)、VAS(SLIT组:8.357±1.026,对照组:8.400±0.982,t=-0.173,P=0.862)、TMS(SLIT组:3.214±0.568,对照组:3.175±0.501,t=0.301,P=0.764)、CSMRS(SLIT组:5.286±0.680,对照组:5.253±0.677,t=0.199,P=0.843),组间比较差异均无统计学意义(P>0.05);治疗后第一年花粉高峰期SLIT组的相应各项观察评分低于对照组,TRSS(SLIT组:3.964±1.551,对照组:7.750±2.169,t=-7.918,P<0.05)、VAS(SLIT组:2.893±0.956,对照组:5.175±1.481,t=-8.286,P<0.05)、TMS(SLIT组:1.821±0.863,对照组:3.175±0.501,t=-8.163,P<0.05)、CSMRS(SLIT组:2.489±0.921,对照组:4.468±0.601,t=-10.723,P<0.05),组间比较差异均有统计学意义(P<0.05);SLIT组在治疗后第一年花粉高峰期的相应各项评分较治疗前显著降低,TRSS(治疗前:12.393±3.023,治疗后:3.964±1.551,t=20.576,P<0.05)、VAS(治疗前:8.357±1.02To study the efficacy and compliance analysis of pollen allergen drops in the treatment of allergic rhinitis.The method of single-center controlled was used to analyze the dates′results.From July 2021 to September 2021,80 patients with seasonal allergic rhinitis were referred to the clinic of otorhinolaryngology in First Hospital of Shanxi Medical University.40 patients received sublingual immunotherapy(SLIT group),and the other 40 patients received symptomatic drug treatment as the control group.The total rhinoconjunctivitis symptom score(TRSS),the visual analogue scale(VAS),total medication score(TMS)and combined scores of medication and rhinoconjunctivitis symptoms(CSMRS)of the patient before the start of the treatment and after the first year of the treatment were compared to assess the efficacy of sublingual immunotherapy of Artemisia pollen.Follow the shedding during the study,the safety of the drug and the causes for compliance analysis were analyzed and recorded.The results of comparison with TRSS,VAS,TMS and CSMRS in two groups in the period of pretherapy were as follows:TRSS(12.393±3.023,12.450±3.029,t=-0.077,P=0.939),VAS(8.357±1.026,8.400±0.982,t=-0.173,P=0.862),TMS(3.214±0.568,3.175±0.501,t=0.301,P=0.764),CSMRS(5.286±0.680,5.253±0.677,t=0.199,P=0.843),there was no significant difference(P>0.05);lower observed symptom scores were got in the post-treatment pollen peak SLIT group compared to the control group,TRSS(3.964±1.551,7.750±2.169,t=-7.918,P<0.05),VAS(2.893±0.956,5.175±1.481,t=-8.286,P<0.05),TMS(1.821±0.863,3.175±0.501,t=-8.163,P<0.05),CSMRS(2.489±0.921,4.468±0.601,t=-10.723,P<0.05),and the differences between the groups were statistically significant(P<0.05);the SLIT group significantly reduced all symptom scores at the first peak compared to the starting,TRSS(12.393±3.023,3.964±1.551,t=20.576,P<0.05),VAS(8.357±1.026,2.893±0.956,t=30.070,P<0.05),TMS(3.214±0.568,1.821±0.863,t=7.151,P<0.05),CSMRS(5.286±0.680,2.489±0.921,t=14.533,P<0.05)and there was statistical difference(

关 键 词：季节性变应性鼻炎 舌下免疫治疗 依从性 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]