舌下特异性免疫治疗儿童变态反应性哮喘的疗效分析

Effect of Sublingual Specific Immunotherapy in Children With Persistent Allergic Asthma

目的探讨舌下含服粉尘螨滴剂l～4号舌下特异性免疫治疗(SLIT)对儿童持续性变态反应性哮喘的临床疗效。方法选取2011年1月至2011年8月于本院儿科门诊接受舌下粉尘螨滴剂含服治疗并随访26周的78例轻-中度持续性变态反应性哮喘患儿为研究对象。将其按照就诊顺序随机分为SLIT组(n=40)和对照组(n=38)。持续性变态反应性哮喘的诊断标准参照《儿童支气管哮喘诊断与防治指南》。两组患儿性别、平均年龄、病程及病情严重度等比较,差异无统计学意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与其签署临床研究知情同意书)。SLIT组患儿舌下含服粉尘螨滴剂l～4号联合吸入糖皮质激素(ICS)布地奈德气雾剂治疗,对照组仅给予布地奈德气雾剂吸入治疗(剂量与治疗组相同)。比较两组患儿哮喘控制测试(ACT)评分、布地奈德气雾剂吸入剂量、呼气流速峰值(PEFR)占预计值百分比(%)及不良反应发生情况。结果与对照组比较,SLIT组在治疗结束26周时,ACT评分高、布地奈德气雾剂吸入剂量小、PEFR占预计值的百分比高,且差异均有统计学意义(P<O.05)。两组均无重度全身不良反应发生。结论 SLIT能明显改善持续性变态反应性哮喘患儿的临床症状,减少布地奈德气雾剂吸入量,提高患儿的生活质量。

Objective To investigate the effects of sublingual Dermatophagoides Farinae drops 1-4 by sublingual specific immunotherapy （ SLIT ） in children with persistent allergic asthma. Methods The clinical data of 78 patients with mild to moderate persistent allergic asthmatic who had been treated by sublingual Derrnatophagoides Farinae drops from January to August, 2011 in the department of pediatrics in Guangdong Women and Children＇s Hospital and received 26 weeks of follow up. They were randomly divided into SLIT group （n = 40） and control group （n= 38） according to visiting sequence. Persistent allergic asthma diagnostic criteria was Children Bronchial Asthma Diagnosis and Prevention Guide. There had no significance difference between two groups among gender, average age, course and severity of persistent allergic asthma （P〉0.05）. Informed consent was obtained from the parents of each participating child. Treatment projects of SLIT group and control group were sublingual Derrnatophagoides Farinae drops 1-4 combined with an inhaled eorticosteroid （ICS） budesonide aerosol, and an inhaled ICS budesonide aerosol （the same dosage as SLIT group） only,respectively. Analysis of asthma control test （ACT） score, dosage of budesonide aerosol, peak expiratory flow rate （PEFR） in predicted percentage （%）, and severe adverse events in two groups. Results After 26 weeks of the end of treatment, there had significance difference between two groups among ACT score, dosage of budesonide aerosol, PEFR in predicted percentage （P〈0. 05）. There were no severe adverse events in both groups. Conclusions SLIT can obviously improve the clinical symptoms of children with persistent allergic asthma, decrease of ICS content, improve the quality of life of children.