舌下含服粉尘螨滴剂治疗儿童过敏性哮喘的临床研究

Clinical research for sublingual immunotherapy of allergic asthma with dermatophagoides farinae drops

【目的】观察和评价舌下含服粉尘螨滴剂2年特异性免疫治疗儿童哮喘的疗效和安全性。【方法】2009年10-12月本院哮喘专科门诊110例6～14岁非急性发作期轻-中度过敏性哮喘儿童,随机分成实验组和对照组各55例。实验组按照GINA方案常规治疗和舌下含服粉尘螨滴剂,对照组按照GINA方案常规治疗。通过2年随访,每6个月复查肺功能FEV1%、PEF,每12个月复查IgG4、sIgE、粉尘螨皮肤点刺检测、日、夜间哮喘症状、C-ACT评分及安全性进行评价。【结果】1)治疗24个月实验组肺功能FEV1%、IgG4值、C-ACT评分较对照组升高,日、夜间哮喘症状评分较对照组降低(P<0.05);2)治疗24个月实验组粉尘螨皮试等级变化、sIgE、肺功能PEF值与对照组比较差异无统计学意义(P>0.05);3)实验组IgG4值在治疗12个月和治疗24个月逐年升高,差异有统计学意义(P<0.000 1);【结论】实验组在改善过敏性哮喘患儿的肺功能、日夜间哮喘症状、C-ACT评分方面优于对照组。舌下粉尘螨特异性免疫治疗2年中,IgG4值呈逐年显著升高。粉尘螨滴剂是一种安全有效地治疗过敏性哮喘儿童的特异性免疫药物。

[Objective] To observe and evaluate the efficacy and safety of two years sublingual Dermatophagoides Farinae Drops of specific immunotherapy in children with asthma. [Methods] 110 children aged 6～14 years old with acute exacerbation of mild-moderate allergic asthma from Department of Asthma bronchitis of Fuzhou Children＇s Hospital were selected and divided randomly into experimental group and control group of 55 cases each from October to December in 2009. The experimental group was given to sublingual Dermatophagoides Farinae Drops and conventional treatment in accordance with the GINA, control group was given conventional treatment in accordance with the GINA. IgG4, sIgE, skin prick test,FEV1 % and the PEF of pulmonary function test, and the security were detected before and after treatment of 6 months or 12 months through 2-year follow-up. [Results] 1）The FEVI% of lung function,the value of IgG4 and the score of C-ACT in experimental group were higher than control group for 24 months treatment, and the score of the day night time asthma symptom was lower than the control group（P-（0.05） ;2） The dust mite skin test level changes,slgE and the PEF values of lung function for 24 months treatment in the experimental group showed no differences with the control group（P〉0.05） ;3）The value of IgG4 in experimental group increased year by year between treatment for 12 months and 24 months, the difference of IgG4 between the experimental group and the control group was statistically significant （P〈0. 000 1） ; [Conclusions] The improvement of the lung function of children with allergic asthma,the score of the day night time asthma symptom and the score of C-ACT in experimental group are better than the control group. The IgG4 value is increased significantly year by year in the specific immunotherapy of sublingual dust mite for two years. Dermatophagoides Farinae Drops is a safe and effective treatment of allergic asthma in children-specific immunosuppressive drugs.