舌下特异性免疫治疗儿童变应性鼻炎长期疗效观察

发布时间：2019-03-16 12:47

【摘要】：目的:评估舌下特异性免疫治疗(SLIT)2年对儿童变应性鼻炎(AR)疗效和停止治疗1年后的持续疗效。方法:本观察为随机、开放、前瞻性研究。选取2008-11-2009-06期间到我科就诊的尘螨过敏的AR患儿120例进行3年观察,随机分为2组:SLIT组60例患儿使用SLIT 2年,停止SLIT后继续随访1年,同时联合3年对症药物治疗;对照组60例患儿使用仅3年对症药物治疗,评估基线、第2年结束时和SLIT停止1年时2组患儿喷嚏、流涕、鼻塞、鼻痒、药物评分的变化和不良反应。结果:①组间比较:SLIT 2年结束时和SLIT停止1年时SLIT组的药物总评分(TMS)、症状总评分(TNSS)、流涕、鼻塞和鼻痒症状评分均明显低于对照组(P0.01);SLIT组喷嚏症状也低于对照组(P0.05)。②组内比较:SLIT组第2年结束时、SLIT停止1年时和基线相比,所有症状和用药评分均有明显降低(P0.01);SLIT组第2年结束时与SLIT停止1年时症状和药物差异无统计学意义(P0.05);对照组在第2年结束时、SLIT停止1年时和基线相比,药物评分明显升高(P0.01),SLIT停止1年时与基线相比,鼻塞评分升高(P0.05)。结论:SLIT联合对症药物治疗AR临床效果优于单纯对症药物治疗且持续疗效明显。单纯对症药物治疗AR无持续疗效并需要增加对症药物剂量来控制症状以达到治疗前水平。
[Abstract]:Objective: to evaluate the efficacy of sublingual specific immunotherapy (SLIT) in the treatment of children with allergic rhinitis (AR) for 2 years. Methods: this observation was a randomized, open, prospective study. A total of 120 AR patients with dust mite allergies who visited our department during 2008 / 11 / 09 / 06 were randomly divided into two groups: SLIT group (n = 60) treated with SLIT for 2 years, followed up for 1 year after stopping SLIT, and treated with 3-year symptomatic drugs at the same time. 60 children in the control group were treated with symptomatic drugs for only 3 years, and the baseline was evaluated. At the end of the second year and at the end of the first year of SLIT, the sneezing, runny, nasal congestion, nasal itching, changes in drug scores and adverse reactions were observed. Results: 1 comparison between the two groups: at the end of two years after SLIT and one year after SLIT stopped, the total score of (TMS), symptoms in SLIT group was significantly lower than that in control group (P0.01), the total score of (TMS), symptoms in SLIT group was significantly lower than that in control group (P0.01). The symptoms of sneezing in SLIT group were also lower than those in control group (P0.05). At the end of the second year in SLIT group, at the end of the second year, at the end of 1 year after SLIT stopped, all symptoms and drug scores were significantly lower than those at baseline (P0.01). There was no significant difference in symptoms and drugs between SLIT group and SLIT group at the end of the second year (P0.05). At the end of the second year in the control group, the drug score at the end of 1 year after SLIT stopped was significantly higher than that at baseline (P0.01). The nasal congestion score at the end of the second year was significantly higher than that at baseline (P0.05). Conclusion: the clinical effect of SLIT combined with symptomatic drugs on AR is better than that of simple symptomatic drugs, and the continuous curative effect is obvious. Simple symptomatic drugs have no lasting effect on AR and need to increase the dosage of symptomatic drugs to control symptoms to achieve pre-treatment levels.
【作者单位】：南京医科大学附属南京儿童医院耳鼻咽喉科;
【分类号】：R765.21

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