舌下特异性免疫治疗在慢性荨麻疹中的应用研究

Observation on the Effect of Sublingual Immunotherapy in Chronic Urticaria

目的探讨慢性荨麻疹患者舌下特异性免疫治疗(SLIT)的临床疗效。方法选取2011年1月至2012年9月于佛山市顺德区慢性病防治中心门诊就治的慢性荨麻疹患者100例。通过病史询问、体格检查、自体血清皮肤试验(ASST)、变应原皮肤点刺试验(SPT)、Unicap方法检测血清特异性IgE(sIgE)等途径,将粉尘螨SPT阳性,且粉尘螨sIgE≥1级,ASST阴性者纳入研究。所有患者随机分为两组,试验组50例给予粉尘螨舌下特异性免疫治疗结合基础的抗组胺药治疗,对照组50例仅给予抗组胺药对症治疗。分别于治疗前、治疗后0.5年、1.0年、1.5年对两组进行病情评估。结果治疗0.5年、1.0年、1.5年,试验组的有效率依次为64%、72%、82%,对照组依次为52%、58%、64%。治疗0.5年和1年时,两组疗效差异无统计学意义(Z=-1.031,-1.122,P>0.05)。治疗1.5年,两组疗效比较差异有统计学意义(Z=-2.129,P<0.05)。结论 SLIT在已确定变应原的慢性荨麻疹患者中,能针对病因治疗,改善临床症状,减少疾病复发,值得推荐。

Objective To assess the effect of sublingnal immunotherapy （SLIT） in Chronic urticaria. Methods On the basis of clinical history, physical examination and autologous serum skin test（ ASST）, 100 patients with chronic urticaria from Shunde District Center for Prevention and Cure of Chronic Disease during January 2011 and September 2012 were screened out by skin prick test（SPT） and serum level of soluble IgE （sIgE） against dermatophagoides fafinae. The patients who had an allergy to dermatophagoides farinae （ posi- tive SPT and slgE≥ 1 grade）and negative ASST were randomly divided into two groups. Observation group consisted of 50 cases were treated with SLIT and regular antihistamines heteropathy. Control group consisted of 50 cases were only treated with regular antihistamines heteropathy. Results The effective rate was 64%, 72% ,82% in observation group and 52% ,58% ,64% in control group at 0.5 year,1 year and 1.5 year after treatment, respectively. The effective rate of two groups showed statistically significant difference（ Z = - 2. 129, P 〈 0.05 ） at 1.5 year after treatment but no significant difference at 0.5 year and 1 year after treatment （Z= - 1.031, - 1. 122, P 〉 0. 05 ）. Conclusion SLIT is effective for chronic urticaria with identified allergens, which can treat targeting at the etiology,improve the clinical symtoms, and reduce the reccurrence, thus is worth recommending.