舌下含服粉尘螨滴剂治疗儿童哮喘1年疗效的初步观察

目的初步观察舌下含服粉尘螨滴剂治疗儿童变应性哮喘1年的临床疗效。方法收集2009年5月至2010年6月我院哮喘门诊就诊轻中度哮喘患者55例,采用随机、开放、平行对照的的研究方法将其分为:试验组(粉尘螨滴剂+吸入激素)30例,对照组(单纯吸入激素)25例。临床观察1年,比较2组哮喘症状评分、急性发作次数、发作持续天数、吸入激素量、肺功能及呼气峰流量变异率的改变情况。结果从治疗的第36周开始2组患儿的日均哮喘症状评分出现差异,差异持续至1年观察结束。试验组1年哮喘的急性发作次数、发作持续天数明显少于对照组;从治疗的40周开始2组患儿ICS用量出现差异,差异持续至1年观察结束。治疗1年后试验组肺功能FEF50、MMEF占预计值百分比明显高于对照组(P<0.05),而2组FEV1、PEF、FEF75比较未见明显差异(P均>0.05)。试验组PEFR变异率于治疗29～56周小于对照组(P<0.05)。结论舌下含服粉尘螨滴剂可改善哮喘患儿症状,减少哮喘急性发作次数、持续天数及严重程度,减少ICS剂量、改善患儿小气道肺功能、降低PEFR变异率。

Clinical observation of 1-year sublingual specific immunotherapy with dermatophagoides farinae drops on children with allergic asthma

Specific immunotherapy for allergic asthma has got the focus attention as the sole treatment method for allergic asthma.To observe the efficacy of specific immunotherapy with dust mite on children with asthma,55 children with asthma were divided into two groups,experiment group of 30 cases(dust mite drops + inhaled corticosteroid) and control group of 25 cases(inhaled corticosteroid).All the patients were observed for 1 year.Symptom scores,frequencies,days and severity of asthma acute attack,ICS dosage,PEFR(PEFam and PEFpm variation),and pulmonary function were compared between the two groups.Compared with the control group,the mean daily asthma symptom scores in the experiment group decreased significantly(P < 0.05) from 36 weeks after sublingual dust mite drops during 1 year treatment,till the end of study.Compared with the control group,average frequencies and days of acute asthma attack of experiment group decreased significantly(P < 0.05),and the proportion of patients with mild asthma decreased more significantly.The mean daily dosage of corticosteroid in active group decreased significantly compared with control group(P < 0.05) from 40 weeks after treatment to the end of treatment.Compared with control group,FEF50 and MMEF percentage of predicted value in the experiment group were improved significantly(P < 0.05),but FEV1,PEF or FEF75 had no significantly improvement between the two groups(P > 0.05).Furthermore,PEFR(PEFam and PEFpm variation) decreased significantly after 29-56 weeks treatment as compared with the control group.From all the result,we draw a conclusion that sublingual dust mite drops in treatment of children with allergic asthma is effective and could reduce the symptom scores,the amount of inhaled corticosteroid,the frequencies,days and severity acute asthma attack,as well as improve the characteristics of small airway function in children.