舌下含服粉尘螨滴剂治疗单一和多重过敏变应性鼻炎患者的临床疗效评估

Efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in monosensitized and polysensifized patients with allergic rhinitis

目的评估标准化粉尘螨滴剂舌下特异性免疫治疗（sublingual immunotherapy，SLIT）对单一过敏和多重过敏的变应性鼻炎（allergic rhinitis，AR）患者的疗效。方法回顾性分析69例接受粉尘螨滴剂SLIT治疗1．5～2．0年且随访资料完整的AR患者资料。根据皮肤点刺试验结果将患者分为单一过敏组和多重过敏组。在治疗前、治疗半年、1．0年和1．5～2．0年后，评估两组患者的鼻部症状评分（total nasal symptoms score，TNSS）和药物评分（total medication score，TMS）的变化。以SPSS20．0统计软件进行数据分析。结果SLIT半年和1．0年时，单一过敏组患者的TNSS（2．00[1．00；3．00]、0．00[0．00；1．00]分）低于多重过敏组（3．00[2．00；4．00]、2．00[0．00；3．00]分），差异有统计学意义（Z值为-2．851、-2．590，P均〈0．05）；SLIT治疗1．5—2．0年后，单一过敏组患者（0．00[0．00；1．00]分）与多重过敏组患者（0．00[0．00；2．00]分）的TNSS差异无统计学意义（Z=-1．461，P〉0．05）。SLIT治疗半年、1．0年、1．5—2．0年后，单一过敏组和多重过敏组的TMS差异无统计学意义（Z值为-0．777、-0．944、-0．907，P均〉0．05）。结论舌下含服粉尘螨滴剂对单一过敏和多重过敏（含尘螨）的AR患者均有疗效。经过1．5—2．0年的SLIT治疗后，多重过敏患者也可以达到单一尘螨过敏AR患者的治疗效果。

Objective To compare the efficacy of sublingual immunotherapy （SLIT） with standardized Dermatophagoides farinae drops in monosensitized and polysensitized patients with allergic rhinitis. Methods The efficacy of SLIT in 69 patients who were sensitized to house dust mites and treated with Dermatophagoides farinae drops for 1.5 -2. 0 year with complete clinical data were analyzed retrospectively. These patients had been divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total medication score （TMS） and the total nasal symptoms score （TNSS） were evaluated before and half an year, 1.0 year and 1.5 -2. 0 years after SLIT treatment. Results After SLIT treatment for half an year, the TNSS in the monoallergen sensitized group （2. 00 [ 1.00; 3.00]） was significantly lower than that in the polyallergen sensitized group （3.00 [ 2.00 ;4. 00 ], Z = -2. 851, P 〈 0. 05 ）, this significant difference of TNSS between the two groups was also found after SLIT treatment for 1.0 year （ 0. 00 [ 0. 00 ; 1.00 ], 2.00 [ 0. 00 ; 3.00 ], Z = - 2. 590, P〈0. 05）. Whereas, there was no significant difference between the two groups after 1.5 -2.0 years＇ treatment refer to the TNSS （ 0.00 [ 0. 00 ; 1.00 ], 0.00 [ 0.00 ; 2. 00 ], Z = - 1. 461, P 〉 0.05 ）. Half an year, 1.0 year and 1.5 -2. 0 years after SLIT treatment, the TMS in both groups reduced significantly, with no significant difference between two groups （ Z value was - 0. 777, - 0. 944, - 0. 907, all P 〉 0. 05）. Conclusions SLIT with Dermatophagoides farinae drops is effective in monosensitized and polysensitized patients with allergic rhinitis. And equivalent efficacy could be achieved after 1.5 -2. 0 years.