舌下免疫治疗在变应性鼻炎中的依从性和安全性分析

Clinical Research on the Sublingual Immunotherapy in Mitesensitized Patients with Allergic Rhinitis

目的探讨舌下特异性免疫治疗(sublingual immunotherapy,SLIT)中-重度持续性变应性鼻炎(allergic rhinitis,AR)患者的疗效、安全性和依从性。方法本文对320例尘螨皮肤点刺呈阳性的中-重度持续性AR患者进行舌下特异性免疫治疗。采用数字表法随机分两组:单纯SLIT治疗160例AR为第1组;SLIT治疗且初始3个月中联合使用鼻喷糖皮质激素辅舒良160例为第2组。并收集两年来未经SLIT系统治疗的尘螨AR患者60例作为对照(对照组)。随访2年,对治疗前后的症状及体征分别进行评分,在2年的治疗中记录不良反应事件和停药原因。结果 SLIT组及SLIT组+鼻喷激素组治疗后的症状及体征评分值均明显低于治疗前,差异具统计学意义(P均<0.01)。治疗期间,两组患者不良反应总发生率为16.6%,无严重全身反应发生。SLIT组患者依从率为73.1%,SLIT+鼻喷激素组依从性为83.2%,两者差异具统计学意义(χ2=4.68,P<0.05)。结论 SLIT治疗中-重度持续性尘螨变应性鼻炎安全、有效,同时早期联合使用鼻喷类固醇激素治疗变应性鼻炎可以提高患者的依从性。

Objective To evaluate the clinical affectivity and safety of sublingual immunotherapy（SLIT） in mite sensitized patients with allergic rhinitis（AR）. The treatment compliance and related factors were also particularly analyzed. Methods A total of 320 patients with moderate - to - severe AR were enrolled in this study, All patients were divided into two groups ： SLIT group and SLIT associ- ated with endonasal glucoeorticosteroids. The grade of symptoms and signs, adverse events, as well as patient＇s adherence to the treat- ment, were carefully recorded and analyzed during the two years＇ sublingual immunotherapy. Statistical analysis was performed using SPSS software. Results A total of 43 patients in first group and 27 patients in second group were withdraw from the therapy group and the rate of compliance respectively were 73.1% and 83.1%. After the whole period of treatment ,both two groups＇ grade of symptoms and signs were significantly failed. During the course of treatment, no severe general reaction happened. Conclusion The SLIT is effective and safe in mite - sensitized patients with AR. In the early stage of SLIT, association with endonasal glucoeortieosteroids can raise the compliance.