变应原特异性免疫治疗对螨过敏的难治性变应性鼻炎症状和生活质量的影响

Effect of house-dust-mite specific immunotherapy on symptoms and quality of life in patients with perennial allergic rhinitis refractory to common methods

目的评估变应原特异性免疫治疗(specific immunotherapy,SIT)对常规方法症状控制不满意的难治性变应性鼻炎(AR)患者症状和生活质量的影响。方法选取螨过敏的常年性AR患者47例,经过常规避开螨、药物治疗效果不佳后进行变应原SIT,使用鼻部症状总评分(total nasal symptoms scores,TNSS)问卷和鼻结膜炎相关生活质量问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ),在治疗前,治疗后3、6、12个月时分别评估患者症状和生活质量。结果 TNSS总分和各症状评分、RQLQ总评分及各分项评分在治疗前,治疗后3、6、12个月的评分均有不同程度降低。相关分析显示TNSS评分同RQLQ总分之间呈正相关。结论常规方法控制无效的螨过敏AR患者的症状和生活质量经过变应原SIT后有着明显提高,治疗后3个月已经开始有效,随着治疗的时间延长,疗效进一步提高。

OBJECTIVE To evaluate the effect of subcutaneous immunotherapy（SIT）on symptoms of allergic rhinitis and quality of life in patients with perennial allergic rhinitis who were refractory to common methods.METHODS Forty seven allergic rhinitis patients who were sensitive to house dust mite and responded poorly to routine pharmacotherapy were included in this study.Allergen immunotherapy with Dermatophagoides pteronissinus and D.farinae was given by subcutaneous route.The change in nasal symptoms was assessed using total nasal symptoms scores（TNSS）,and the quality of life was evaluated using the rhinoconjunctivitis quality of life questionnaire（RQLQ）.Follow up questionnaires（during SIT）were answered at basline（before treatment）,3 months,6 months,and 12 months after treatment.RESULTS Three months,six months,and 12 months after treatment,TNSS and RQLQ reduced（TNSS： 8.6,5.8,4.4 and 2.7,RQLQ： 2.9,2.0,1.4 and 0.9）.There was a significant difference in symptom and quality of life scores between each consecutive treatment.There was a correlation between TNSS and RQLQ score.CONCLUSION The symptom and quality of life of patients sensitive to house dust mite was improved after SIT.Three months after treatment,the efficacy started and it continually improved as time went on.