特异性变应原雾化吸入减敏防治过敏性支气管哮喘的临床研究

目的探讨特异性变应原雾化吸入减敏防治过敏性支气管哮喘的临床效果、可行性及其优缺点。方法采用随机对照的方法，将40例未控制、尘螨阳性的过敏性支气管哮喘患者随机分为A组（常规治疗组，20例）和B组（吸入减敏组，20例）。两组接受相同的基础治疗，同时A组雾化吸人生理盐水5ml每周2次，B组雾化吸人特异性变应原每周2次持续6个月。治疗前后检测如下指标：（1）哮喘症状控制测试（ACT）评分；（2）肺功能及气道反应性测定；（3）皮肤过敏原测试；（4）平均每周使用万托林喷数。结果治疗后两组ACT评分较治疗前明显改善（P均〈0．05）；两组肺功能FEV．占预计值百分比较治疗前均有明显上升（P均〈0．05）；两组皮试强度反应性均较治疗前无明显变化（P均〉0．05）；两组使用万托林喷数明显较治疗前减少（P均〈0．05）。支气管激发试验阴性率B组高于A组（80．0％W55．0％，P〈0．05）。结论特异性变应原雾化吸人减敏可有效降低气道高反应，因此在防治过敏性支气管哮喘中具有II缶床价值。

Study on desensitization by specific allergen nebulization inhalation for prevention and treatment of allergicbronchial asthma

Objective To explore the clinical effect, feasibility, merits and demerits of desensitization by specific allergen nebulization inhalation for prevention and treatment of allergic bronchial asthma. Methods A ran- domized controlled study was conducted in 40 uncontrolled bronchial asthmatic patients with positive skin pick test （SPT） by Dermatophagoides farinae （ Der. f） and Dermatophagoides pterronyssinus （ Der. p）. The 40 asthmatic pa- tients were randomly allocated to two groups （n = 20 each） ： routine therapy group （group A） and desensitization group （group B）. On top of routine basic treatment, nebulization inhalation with 5ml normal saline was given twice a week for six months in group A, while specific allergen nebulization inhalation was given twice a week for six months in group B. Before and after treatment, the following indexes were detected： asthmatic symptoms score in asthma control test （ACT）, lung function（ FEV1 ）, airway responsiveness, SPT and presses of ventolin use each week. Results After treatment in both two groups , ACT scores were significantly improved （ all P 〈 0.05 ） ; the percentages of determined value to estimated value of FEVI were significantly increased （all P 〈 0.05） ; the presses of ventolin use significantly decreased （ all P 〈 0.05 ）, and no changes of SPT reactivity were observed （ P 〉 0.05 ）. compared with pre-treatment. The negative rate of bronchial asthma provocative test in group B was higher than that in group A （80.0% vs 55.0% , P 〈 0.05 ）. Conclusions Desensitization by specific allergen nebulization inhala- tion can effectively decrease airway hyper-responsiveness thereby has clinical value for prevention and treatment of allergic bronchial asthma.