变应性鼻炎的特异性免疫治疗

变应性鼻炎的患病率近年呈明显增加趋势.特异性免疫治疗不仅可以预防新的致敏且远期疗效较好,是目前惟一有可能通过免疫调节机制改变变应性疾病自然进程的治疗方法.本文综述变应性鼻炎的特异性免疫治疗疗效及安全性研究进展.     

成年变应性鼻炎相关危险因素分析

目的分析成年变应性鼻炎的危险因素。方法选取来笔者所在医院进行治疗的变应性鼻炎患者350例,同时选取相应例数的健康患者作为对照组,变应性鼻炎患者的一般资料采用问卷调查的方式进行收集,结果采用数理统计方法进行分析。结果多因素分析结果表明变应性鼻炎患者的危险因素为过敏史、母亲变应性疾病史及工作环境接触粉尘(P0.01),保护因素为开窗通风(P0.01)。结论多种因素都会对成年患变应性鼻炎造成严重的影响,临床应该提高重视程度。     

不同地区变应性鼻炎患者吸入性变应原的分布研究

变应性鼻炎( allergic rhinitis,AR)是临床上常见的鼻部疾患,是发生在鼻黏膜的变态反应性疾病,鼻黏膜反应性增高是其主要特点,近年来发病率呈上升趋势,严重影响患者的学习、生活和工作,已经成为国内外学者们关注的热点课题.明确致敏原种类对于变应性鼻炎的预防、诊断及治疗尤其重要.AR患者之间虽然在临床表现及发病机制上非常相似,但由于地理环境和气候的不同,各地诱发变应性鼻炎发病的变应原差异也较大,具有明显的地区性.同时采用不同检测方法和试剂对变应性鼻炎患者进行测试,所得出的结果也会有差异.为了解我国不同地区变应性鼻炎患者吸入性变应原的分布特点,我们检索了2006至2010年国内杂志对变应性鼻炎患者吸入性变应原检测的报道,分析其特点,综述如下.     

苏州地区变应性鼻炎患者变应原调查

变应性疾病是一种全球性的人类多发病,且发病率日渐增高,病情日益复杂,目前WHO已将其列为21世纪重点研究和防治疾病.因此了解本地区变应原分布,对变应鼻炎的预防及治疗具有重要意义.本研究检测苏州地区1044例变应性鼻炎患者的变应原分布状况.现报道如下.     

变应性鼻炎的免疫治疗

特异性免疫治疗已经被证实可以改变变应性疾病的自然进程,具有确切的临床疗效,并且在疗程结束后其治疗作用仍可以维持很长时间。同时,免疫治疗既可以阻断变应性鼻炎发展成为哮喘,又可以阻止针对新的变应原激发炎性反应[1]。皮下免疫治疗(subcutaneous immunotherapy,SCIT)和舌下免疫治疗(sublingual immunotherapy,SLIT)是目前国际上两种治疗变应性疾病如变应性鼻炎(allergic rhinitis,AR)的脱敏疗法。其中,皮下免疫治疗已经应用于临床多年,其疗效     

下鼻甲注射复方倍他米松注射液治疗变应性鼻炎疗效分析

变应性鼻炎是特应性个体接触致敏原后由IgE介导的超敏反应,是一种免疫反应性疾病,其病理过程有多种免疫活性细胞和细胞因子参与,并以鼻黏膜血管扩张、分泌亢进为基本特征。治疗变应性鼻炎的方法很多,鼻腔内使用糖皮质类固醇,被认为是目前治疗变应性鼻炎最有效的药物。我科使用下鼻甲注射复方倍他米松注射液（得宝松）治疗变应性鼻炎65例,取得良好治疗效果,报告如下。     

类固醇鼻喷剂治疗变应性鼻炎的护理体会

变应性鼻炎(AR)是特应性个体接触致敏原引发的由IgE介导,多种免疫活性细胞和细胞因子参与的鼻腔黏膜慢性炎性反应性疾病。近年来患病率明显上升,现已成为全球性健康问题。AR患者除流涕、鼻塞、鼻痒、喷嚏等症状外,日常生活、工     

外泌体与变应性鼻炎的相关研究进展

变应性鼻炎,是特应性个体接触致敏原后由IgE介导的鼻黏膜慢性炎症反应性疾病,以鼻痒、喷嚏、鼻分泌亢进等为其主要特点。近年来随着社会工业化进展,环境改变,中国变应性鼻炎患病率呈上升趋势。外泌体是近几十年新发现的一种纳米级的囊泡,内含蛋白质、核酸等物质,在细胞间沟通发挥着重要作用。现就近些年关于外泌体的相关基础研究进行总结,重点讨论其在变应性鼻炎中的作用机制,同时总结外泌体在变应性鼻炎治疗的潜在价值。     

粉尘螨滴剂舌下含服脱敏治疗变应性鼻炎117例疗效观察

变应性鼻炎(AR)是变应原刺激机体后产生的主要由IgE介导的速发型非感染性的慢性炎症[1].尘螨是我国引起AR和哮喘的主要致敏原之一[2].变应原特异性免疫治疗(ASIT) 是目前被认为是惟一可以针对变应性疾病病因的对因治疗方法,并可预防AR发展成哮喘或其它变态反应性疾病[3-5],ASIT初始给予最小剂量变应原刺激,后逐步增加患者变应原接触量,以逐渐诱导机体免疫耐受,使患者再次接触相应变应原时不产生临床症状或者症状较前减轻.近年来舌下含服特异性免疫治疗(SLIT)作为ASIT的一种新型给药方式,对IgE介导的I型过敏性疾病安全有效,它具有安全性高、使用方便、患者依从性好等优点.     

变应原疫苗治疗常年性变应性鼻炎疗效观察

常年性变应性鼻炎(PAR)是特应性个体接触致敏原后由IgE介导的以介质释放为开端的,有多种免疫活性细胞和细胞因子等参与的鼻黏膜慢性炎症反应性疾病.变应性鼻炎的免疫治疗是世界卫生组织(WHO)推荐使用的唯一对因治疗手段.2004年6月至2006年3月,在我院确诊为PAR患者应用变应原疫苗(阿罗格NHD)进行免疫治疗,取得较好疗效,报告如下.     

Bepotastine besilate for the treatment of perennial allergic rhinitis

ABSTRACT

Introduction: Bepotastine besilate (BB) is a second-generation H1-antihistamine that, as an ophthalmic solution, is approved in the United States by the Food and Drug Administration (FDA) for the treatment of allergic conjunctivitis. In other countries, the oral presentation of BB is widely used for the improvement of symptoms of allergic rhinitis (AR) as well as urticaria and chronic pruritus with results similar to those by other drugs of the same class.

Areas covered: This article was created from a comprehensive literature search with information taken from clinical trials. The articles that have been selected evaluate the clinical and non-clinical pharmacology of BB as well as its use in AR and its efficiency in the improvement of symptoms, its safety, common adverse effects, and overall experiences of its use.

Expert opinion: BB is effective and well-tolerated in the treatment of allergic rhinitis. Side effects are infrequent in patients with AR who do not have kidney or liver disease. Clinical trial experience with oral bepotastine outside the United States has confirmed its safety. BB can be useful as a therapeutic option in patients with AR who would like to explore an alternative to the currently available once-daily oral H1-antihistamines.     

Pharmacokinetic evaluation of olopatadine for the treatment of allergic rhinitis and conjunctivitis

INTRODUCTION: Olopatadine hydrochloride is an antihistamine and mast cell stabilizer available in three forms, including oral, intranasal and ocular preparations. Most of the practical applications focus on the use of olopatadine for the treatment of allergic rhinitis and conjunctivitis via intranasal and ocular routes. AREAS COVERED: This article was formed from a comprehensive literature search with information taken from meta-analyses, systematic reviews, treatment guidelines and clinical studies on children and adults. Articles that have been selected evaluate the use of intranasal and ocular antihistamines and their role in allergic rhinitis and conjunctivitis. EXPERT OPINION: Olopatadine is significantly more effective than placebos in alleviating the symptoms of allergic rhinitis and conjunctivitis. Olopatadine is a viable alternative and addition to the mainstay therapy of these conditions with intranasal steroids and oral antihistamines. The compliance of the patients would be improved if a once-per-day formulation of olopatadine was developed for intranasal application. The future treatments of allergic rhinitis will probably involve a combination of intranasal antihistamine and steroid because clinical trials have demonstrated an improved efficacy without a significant increase in adverse effects.     

变应性鼻炎的中药治疗

目的考察中药治疗变应性鼻炎疗效。方法患者随机分为三组,分别使用中药玉屏风散加味、麻黄附子细辛汤加味、黄芪建中汤加味治疗变应性鼻炎。结果三组总有效率分别为78.3%、75.4%、79.6%。χ2比较三组总有效率无显著性差异（P〉0.05）。结论中药对变应性鼻炎有较好的效果,但其治疗机理有待进一步明确。     

Specific IgE for wheat in tear fluid of patients with allergic conjunctivitis

Context: Allergy to hydrolyzed wheat protein in facial soap has become a major social issue in Japan. It has been reported that the most frequent early symptoms of allergy to hydrolyzed wheat protein in soap are allergic conjunctivitis and rhinitis, while wheat-dependent exercise-induced anaphylaxis can be induced by long-term use.

Objective: We evaluated the relation between tear fluid levels of specific IgE for wheat and the features of allergic conjunctivitis.

Methods: A prospective, non-randomized, cross-sectional study was conducted in 103 patients with moderate to severe allergic conjunctivitis (allergic group) and 20 age- and sex-matched healthy control subjects (control group). Specific IgE for wheat was measured in tear fluid with an immunochromatography assay, and a skin prick test (SPT) was also performed. Symptoms (sneezing, rhinorrhea, nasal obstruction, ocular itching, and lacrimation) were assessed in each subject along with the activities of daily living (ADL) score and the total ocular symptom score for allergic conjunctivitis. A severity score (0, 1, 2, or 3) was assigned for various changes of the palpebral and bulbar conjunctiva, as well as for limbal and corneal lesions associated with allergic conjunctivitis.

Results: The IgE positive rate and specific IgE score were both higher in the allergic group than in the control group (71.8% versus 40.0% and 1.9?±?0.7 versus 1.4?±?0.5). A positive SPT for wheat was also more frequent in the allergic group than in the control group (6.8% versus 0.0%). Within the allergic group, patients with a positive SPT had higher specific IgE scores than patients with a negative SPT (3.3?±?0.5 versus 1.8?±?0.6, p?r?=?0.665), tearing (r?=?0.672), and the total ocular symptom score (r?=?0.204). Wheat IgE in tear fluid was also correlated with the severity of rhinitis symptoms, including sneezing (r?=?0.610), nose blowing (r?=?0.640), and nasal obstruction (r?=?0.677). Furthermore, the tear fluid wheat IgE score was correlated with five objective features of allergic conjunctivitis (p?Conclusions: These results suggest that wheat allergy may be involved in the development of allergic conjunctivitis.     

Economic impact and quality-of-life burden of allergic rhinitis

SUMMARY

Allergic rhinitis can be a debilitating condition which, if untreated, can result in considerable health-related and economic consequences. A review of the published literature was conducted, with quantitative/qualitative analysis as appropriate, to explore the direct, indirect, and hidden costs of allergic rhinitis, as well as the quality-of-life burdens that the disease presents to patients and to the healthcare system. Lack of treatment, undertreatment, or nonadherence

to treatment in allergic rhinitis were seen to increase direct and indirect costs, reinforcing the need for patient education and for physicians to implement existing evidence-based guidelines for prevention and treatment. It was concluded that greater awareness of the total economic burden of allergic rhinitis should encourage appropriate intervention and ultimately ensure clinically favorable and cost-effective outcomes.     

伯克纳(丙酸倍氯米松鼻气雾剂)治疗变应性鼻炎的疗效观察

目的 探讨局部应用伯克纳(丙酸倍氯米松鼻气雾剂)治疗变应性鼻炎的临床效果.方法 对96例变应性鼻炎患者,分两组,一组应用鼻腔内鼻喷雾剂伯克纳,每次每侧鼻孔内喷50ug,2个鼻孔共1 00ug;另一组口服抗组织胺药酮替芬,每次1mg,共治疗4周.做症状及体征分级记分及疗效评定.结果 治疗后各项症状及体征评分均明显下降,治疗后与治疗前比较,症状及体征评分差异有统计学意义(P＜0.05);总有效率为87.5%(伯克纳)、79.1%(酮替芬).二者疗效比较无统计学意义(P＞0.05).结论 伯克纳可有效控制与改善变应性鼻炎患者的临床症状.     

奥洛他定滴眼液治疗变态反应性结膜炎的临床观察

目的观察奥洛他定滴眼液在变态反应性结膜炎中的临床疗效。方法入选变态反应性结膜炎患者56例（88眼）,给予患者0．196盐酸奥洛他定滴眼液,每眼1滴,早晚各1次,共7d。观察治疗前后变态反应性结膜炎各项症状与体征的变化情况。结果奥洛他定滴眼液治疗变态反应性结膜炎的总有效率为94．696．变态反应性结膜炎的各项症状和体征均得到显著的改善。治疗期间未观察到明显的不良反应。结论奥洛他定滴眼液治疗变态反应性结膜炎具有较好的疗效和安全性。     

Levocabastine. A review of its pharmacological properties and therapeutic potential as a topical antihistamine in allergic rhinitis and conjunctivitis.

Levocabastine is a long acting, highly potent and selective histamine H1-receptor antagonist, which has been developed for nasal and ocular administration. In controlled trials performed to date levocabastine was effective and well tolerated in the treatment of allergic rhinitis and allergic conjunctivitis. Comparative studies have demonstrated that levocabastine is superior to placebo and at least as effective as sodium cromoglycate (cromolyn sodium) in alleviating symptoms associated with seasonal allergic conditions. Although levocabastine appears to be less effective than the topical corticosteroid beclomethasone with regard to relieving runny and blocked nose, further comparative trials between these 2 agents would be desirable. Similar to other antihistamines, levocabastine provides minimal relief of nasal blockage, but this symptom is believed to be mediated by receptors other than histamine H1. The prompt onset of antiallergic activity after application differentiates levocabastine from the reference topical antiallergic, sodium cromoglycate, which has an onset of efficacy characterised by a lag period, thereby necessitating maintenance treatment. The incidence of adverse effects associated with levocabastine therapy is low and is similar to that observed with placebo and sodium cromoglycate. Levocabastine provides prophylactic protection as well as acute relief from nasal and ocular symptoms in patients with seasonal allergic disorders. With the ever increasing trend towards topical therapy for the treatment of allergic rhinitis and allergic conjunctivitis, levocabastine is a useful addition to the range of drugs currently available. Possible avenues for additional research should include determining whether the antiallergic efficacy of topical levocabastine is superior to that of oral agents such as astemizole and terfenadine, and whether topical therapy is indeed preferred, considering the relative ease of administration of effective oral antiallergic agents.     

奥洛他定联合萘敏维治疗过敏性结膜炎疗效研究

目的研究比较0.1%奥洛他定联合萘敏维滴眼液治疗过敏性结膜炎的疗效。方法 180例过敏性结膜炎患者随机分成观察组和对照组,对照组90例采用奥洛他定,观察组90例采用奥洛他定联合萘敏维,并于3d、7d、14d和停药1周后随访观察疗效。结果观察组眼痒眼红有效率明显高于对照组(P<0.05或0.01),无明显的不良反应。结论奥洛他定联合萘敏维治疗过敏性结膜炎效快、疗效好,且对组织几乎无不良反应,是治疗过敏性结膜炎的一种较理想药物。