舌下含服粉尘螨滴剂免疫治疗儿童多种变应原过敏哮喘鼻炎的疗效研究

Clinic study of the sublingual immunotherapy of dermatophagoides farinae drops in children sensitized to many kinds anaphylactogen with asthma and allergic rhinitis

目的探讨舌下含服尘螨变应原疫苗对多种变应原过敏哮喘鼻炎儿童治疗的临床疗效。方法选291例年龄4～13岁哮喘缓解期伴变应性鼻炎患儿为免疫治疗对象,根据皮肤点刺试验结果分成尘螨过敏组(80例)、尘螨及蟑螂过敏组(71例)、尘螨及花粉过敏组(74例)、尘螨及狗毛过敏组(66例)共4组。全部病例完成包括尘螨在内的10种常见过敏原皮肤点刺实验,点刺试验后观察阳性反应。应用浙江我武生物科技有限公司提供的"粉尘螨滴剂"进行临床免疫治疗,记录治疗前后症状和体征评分以及不良反应。结果哮喘并变应性鼻炎完成1年免疫治疗的总有效率为62.5%,其中尘螨过敏组为53.8%,尘螨及蟑螂过敏组为66.2%,尘螨及花粉过敏组为70.3%,尘螨及狗毛过敏组为60.6%。各治疗组间有效率比较差异无统计学意义(x^2=5.107,P>0.05)。与用药有关的皮疹、鼻咽痒和哮喘发作的不良反应发生率为23.67%,未出现过敏性休克的严重副作用。结论舌下含服尘螨变应原疫苗对单一变应原和多种不同变应原混合过敏的哮喘和鼻炎儿童免疫治疗是安全有效的。

Objective To explore the efficacy and safety of the specific sublingual immunotherapy of dermatophagoides farinae drops in children sensitized to many kinds anaphylactogen with stable asthma and allergic rhinitis. Methods 291 cases of children sensitized to dermatophagoides farinae in four to thirteen years old with asthma in remission stage and allergic rhinitis were assigned into four groups according to the results of skin prick test： only sensitized to mites（eighty cases）, sensitized to mites and cockroach （seventy-one cases）, sensitized to mites and pollen （seventy-four cases）, and sensitized to mites and dog wool（ sixty-six cases）. Skin prick test with ten common anaphylactogen including mites were taken in children and positive reaction to anaphylactogen was confirmed. Lung functions in all children were in predicted value scope. ＂Dermatophagoides farinac drops （DFD）＂ provided by Wolwo Biotech Co, Ltd. in Zhejiang province, be used for sublingual immunotherapy. Clinic symptom score before and after treatment and side reaction were recorded. Results The clinical effective rate of desensitization with DFD after one year the sublingual immunotherapy in children with asthma and allergic rhinitis was 62. 5%. Among them, group sensitized to mites was 53.8%, group sensitized to mites and cockroach were 66.2%, group sensitized to mites and pollen were 70. 3%, group sensitized to mites and dog wool were 60. 6%. There was no statistically significant between two groups on clinic effective rate of immunotherapy. The incidences of side reaction related to immunotherapy including skin rash and nasopharynx itches and asthma attack was 23.67%, while no anaphylactic shock happened. Condusion Sublingual immunotherapy method with dermatophagoides farinae drops was obvious clinically safe and effective for children with asthma and rhinitis, not only for those only sensitive to dermatophagoides farinae, also dermatophagoides farinae accompany with other anaphylactogen.