舌下含服粉尘螨滴剂治疗儿童变应性鼻炎的临床疗效与安全性评估

目的比较舌下含服标准化粉尘螨滴剂治疗不同程度尘螨过敏的变应性鼻炎患儿的疗效。方法 137例尘螨过敏的患儿,按变应原皮肤点刺试验结果分为两组,＂＋＋＂、＂＋＋＋＂组为A组（62例）,＂＋＋＋＋＂组为B组（75例）,采用标准化粉尘螨滴剂进行舌下特异性免疫治疗（SLIT）1年,记录和比较两组治疗前和治疗后1年的症状评分和药物评分,同时比较两组间的疗效。应用SPSS 19.0软件对数据进行统计学分析。结果 109例尘螨患儿完成1年SLIT,两组患儿治疗前后症状评分均得到明显改善,A组尘螨过敏的患儿组治疗前后症状评分分别为（10.34±1.25）、（2.85±1.47）分,B组尘螨过敏的患儿组治疗前后症状评分分别为（11.24±1.55）、（3.74±1.66）分,组内比较差异均有统计学意义。但两组间症状评分的改善无明显差异。同样,两组患儿治疗前后药物评分均得到明显改善,A组尘螨过敏的患儿组治疗前后药物评分分别为（1.37±0.35）、（0.45±0.27）分,B组尘螨过敏的患儿组治疗前后药物评分分别为（1.56±0.42）、（0.52±0.31）分,组内差异具有统计学意义,但两组之间药物评分的改善无明显差异。结论舌下含服标准化粉尘螨滴剂可以明显改善不同程度尘螨过敏儿童变应性鼻炎患儿的鼻部症状,减少对症药物应用,不同程度尘螨过敏儿童变应性鼻炎患儿之间免疫治疗疗效无明显差异。因此舌下含服标准化粉尘螨滴剂对所有不同程度尘螨儿童变应性鼻炎患儿都有疗效。

Efficacy and safety of sublingual immunotherapy with house dust mite extract in children with allergic rhinitis

Objective To compare the efficacy of sublingual immunotherapy （ SLIT ） with standardized house dust mite extract in children with allergic rhinitis （ AR ） of different degrees. Methods 137 children who were sensitized to house dust mites and treated with SLIT for at least 1 year were included. Group A included 62 patients whose allergen skin tests were ＂ ＋ ＋ ＂ or ＂ ＋ ＋ ＋ ＂ , while group B included 75 patients whose allergen skin tests were ＂ ＋ ＋ ＋ ＋ ＂. A standardized extract of house dust mites was used for immunotherapy. Anti-allergic medication and total nasal symptom （ AAMS, TNSS ） of both groups were evaluated before and one year after SLIT. Results 109 children completed one-year SLIT. The TNSS got significant improvement after SLIT in both groups. The TNSS scores before and one year after SLIT of group A were 10.34 ＋ 1.25 and 2.85 ＋ 1.47 （P 〈0.01 ） , while those of the group B were 11.24 ~ 1.55 and 3.74 ~ 1.66 （P 〈0.01 ）. But the difference of improvement between the two groups was statistically insignificant （ P 〉 0.05 ）. The AMSS scores were decreased significantly after SLIT in both groups. The AMSS scores before and one year after SLIT of group A were 1.37 ± 0.35 and 0.45 ± 0.27 （ P 〈0.01）, while those of the group B were 1. 56 ±0. 42 and 0. 52 ±0. 31 （P 〈0. 01）. The difference of improvement of AMSS scores between the two groups was statistically insignificant （ P 〉 0.05 ）. Conclusions SLIT can improve both nasal symptoms and rescue medication scores in AR patients. Therefore, SLIT can be considered for AR patients with allergen skin tests of ＂ ＋ ＋ ＂, ＂ ＋ ＋ ＋ ＂ and ＂ ＋ ＋ ＋ ＋ ＂