舌下含服粉尘螨滴剂治疗变应性鼻炎的疗效观察

Efficacy of sublingual immunotherapy with dermatophagoides farianae drops in patients with allergic rhinitis

目的评价以粉尘螨滴剂变应原疫苗对变应性鼻炎（allergic rhinits，AR）患者进行舌下免疫治疗（sublingual immunotherapy，SLIT）的长期疗效。方法206例年龄4～60岁AR患者，123例患者完成1年以上治疗，其中完成1、1．5、2年疗程的患者分别为61、41、21例。对3组患者治疗前后的鼻炎症状评分和用药评分进行分析比较。并且对用药1年和2年组患者停药1年后的症状进行比较分析，以SAS6．12统计软件对数据进行统计学分析。结果SLIT治疗1、1．5、2年后患者较治疗前出现明显症状改善，症状总分平均（x±s，下同）由治疗前的（6．00±2．27）、（7．39±1．99）、（6．29±2．14）分降低为（2．95±1．82）、（3．28±2．58）、（2．48±1．99）分，差异有统计学意义（t值分别为8．19、10．29、5．97，P值均〈0．01）。治疗后1、1．5、2年3个组无需用药患者的比例分别为68．9％、73．2％、80．9％，治疗前后差异有统计学意义（x2值分别为50．391、43．619、27．776，P值均〈0．01）。SLIT治疗1、1．5、2年3组患者喷嚏、流涕、鼻塞、鼻痒症状改善相似，差异无统计学意义（F值分别为1．200、1．276、2．333，P值均〉0．05）。2年组在SLIT结束后的1年观察中，无需用药患者百分比（76．2％）高于SLIT1年组（61．3％），但差异无统计学意义（x2=1．263，P〉p．05）。结论粉尘螨滴剂SLIT治疗1年即可较好地缓解AR症状，2年的疗程对于巩固疗效特别是降低对症药物的使用具有一定意义。

Objective To evaluate the efficacy of sublingual immunotherapy （SLIT） with dermatophagoides farianae drops in patients with allergic rhinitis （AR）. Methods Two hundred and six patients with AR aged from 4 to 60 years were included in this study. Among them, 123 patients completed more than one year treatment, the number of patients completed one year, one year and a half, two years were 61, 41, 21 cases. Rhinitis symptom scores and medication scores of the three groups before and after treatment were compared. And rhinitis symptom scores and medication scores of patients with one year drug withdrawal after one and two years treatment were aslo compared. Results After SLIT one year, one year and a half, two years treatment, the symptoms in these patients were significantly improved compared with before. The symptom scores （x ±s） were reduced from 6.00 ±2.27, 7.39 ± 1.99 and 6.29 ±2.14 to 2.95 ± 1.82, 3.28± 2.58, 2.48 ± 1.99. The differences were statisticly significant （t value was 8.19, 10.29, and 5.97, all P 〈0.01 ）. The proportion of patients without drug treatment of the three group were 68.9% , 73.2% and 80.9% , there was statistical significance before and after treatment in every group （ value was 50.391, 43. 619, 27. 776, all P 〈 0. 01 ）. Symptom improvement of sneezing, runny nose, nasal congestion, nasal itching were similar after one year, one year and a half, two years SLIT treatment, the differences were not statistically significant （ F values were 1. 200, 1. 276 and 2. 333, all P 〉 0.05 ） . The proportion of patients without drug treatment in the group which stopped medication one year after two year SLIT （76.2%） was higher than group stoped medication one year after one year SLIT （61.3%）. There was no statistical significance （ X2 = 1. 263, P 〉 0.05）. Conclusion The dust mite drops can relieve symptoms after one year treatment, but the proposed two years treatment is important for the consolidation of improved sympotoms, especially for the effect of reducing the use of symptomatic medication.