粉尘螨滴剂舌下特异性免疫治疗对儿童咳嗽变异性哮喘的有效性

Efficacy of specific sublingual immunotherapy with dermatophagoides farinae drops in the treatment of cough variant asthma in children

目的探讨粉尘螨滴剂舌下特异性免疫(SLIT)治疗对儿童咳嗽变异性哮喘的有效性及安全性。方法将确诊为咳嗽变异性哮喘并且粉尘螨变应原皮肤点刺试验呈阳性反应的106例4～14岁患儿随机分为SLIT组(n=53)和常规治疗组(n=53)。常规治疗组按照儿童哮喘规范化治疗方案治疗,SLIT组在常规规范化治疗的基础上,加用舌下含服粉尘螨滴剂。观察两组患儿治疗后咳嗽哮喘症状评分改善情况及临床症状开始改善的时间,同时检测血嗜酸性粒细胞(EOS)水平以及最大呼气峰流速(PEF)的变化。记录两组不良反应发生情况。结果治疗25周后,SLIT组的症状评分降低值、PEF升高幅度及血EOS比例下降程度均显著高于常规治疗组,差异均有统计学意义(P<0.05);SLIT组症状改善时间较常规治疗组短,差异亦有统计学意义(P<0.05)。SLIT组的有效率显著高于常规治疗组,差异有统计学意义(85%vs 68%,P<0.05)。SLIT组部分患儿出现红、肿、瘙痒等局部反应,均于次日自行消失。结论粉尘螨滴剂舌下免疫对儿童咳嗽变异性哮喘具有良好的效果,且安全性高。

Objective To study the efficacy and safety of specific sublingual immunotherapy with dermatophagoides farinae drops in the treatment of cough variant asthma in children. Methods A total of 106 children aged 4-14 years old with cough variant asthma and positive skin prick test responses to dermatophagoides farinae allergens were randomly divided into two groups ： SLIT group （ n = 53 ）, which received specific sublingual immunotherapy with dermatophagoides farinae drops as well as standardized treatment and conventional treatment group （ n = 53 ）, which received standardized treatment alone. Improvement in cough/asthma symptom scores and the time taken for symptoms to improve were observed after treatment. Serum eosinophil （EOS） level and peak expiratory flow （PEF） were measured after treatment. The side effects were observed. Results Compared with the conventional treatment group, the SLIT group showed significant decrease in symptom scores and serum EOS level and significant increase in PEF （P 〈 O. 05）. The time at which symptoms began to improve in the SLIT group was earlier than in the conventional treatment group （P 〈0： 05）. The effective rate in the SLIT group was significant!y higher than in the conventional treatment group （85% vs 68% ; P 〈 0.05）. Local reactions such as redness, swelling, and itching occurred in some children of the SLIT group but disappeared on the following day. Conclusions Specific sublingual immunotherapy with dermatophagoides farinae drops is an effective and highly safe treatment for cough variant asthma in children.