特异性免疫疗法治疗对粉尘螨过敏的54例慢性荨麻疹临床观察

Clinical Observation of Specific Immunotherapy in Treatment of 54 Patients with Chronic Urticaria Sensitive to Dermatophagoides Farinae

目的观察舌下含服标准化粉尘螨滴剂特异性免疫疗法治疗对粉尘螨过敏的慢性荨麻疹患者的临床疗效及安全性。方法将入选的108例对粉尘螨过敏的慢性荨麻疹患者随机分为两组,各54例。治疗组采用标准化粉尘螨滴剂舌下含服免疫治疗,从低剂量起逐步递增至维持剂量,并根据荨麻疹症状控制情况予以咪唑斯叮口服治疗;对照组仅根据荨麻疹症状控制情况予以咪唑斯叮口服治疗。每3个月随访1次,共4次。结果 1年后治疗组有效率(81.48%)优于对照组(53.70%);治疗组服用抗组胺药物评分(0.420±0.189)低于对照组(0.620±0.174),即治疗组较对照组在使用更少的口服抗组胺药的前提下,可以获得更好的症状改善;治疗组的症状改善、服用抗组胺药物及整体满意程度主观评价均明显优于对照组;以上差异均有统计学意义(P均<0.05)。治疗组有部分患者出现腹泻、头晕、夜间咳嗽、舌下发麻症状,均未影响治疗。结论特异性免疫疗法对粉尘螨过敏的慢性荨麻疹疗效显著,但治疗期间的不良事件应给予充分关注,其疗效及安全性尚需进一步研究。

Objective To evaluate the clinical efficacy and safety of sublingual immunotherapy with standardized der matophagoides farinae drops for the treatment of chronic urticaria sensitive to dermatophagoides farinae. Methods One hundred and eight chronic urticaria patients sensitive to dermatophagoides farinae were ran domly allocated into treatment group and control group. The 54 patients in treatment group were treated with standardized dermatophagoides farinae drops from low dosage to maintenance dosage and mizolasfine accord ing to the symptoms improvements of urticaria. The 54 patients in control group were treated with mizolastine according to the symptoms improvements of urticaria only. All of the patients were visited four times once ev ery three months. Results After one year treatment, the effective rate in treatment group （81.48% ）was bet ter than in control group（53.70% ）. The taking antihistamine drug score in treatment group（0. 420 ± 0. 189） was lower than in control group （0.620 ± 0. 174）, namely the symptoms improvements in treatment group was better than in control group by taking less of antihistamine drug. The subjective evaluation of the＇~symlbtoms improvements, taking antihistamine drug and overall satisfaction in treatment group were better than in control group. They had significant difference between the two groups （ P 〈 0.05 ）. Some patients of the treatment group appeared diarrhea, dizzy, cough in night and numb under the tongue, it had no affection on treatment. Conclusion Specific immunotherapy is effective to treat chronic urticaria sensitive to denatophagoides fari nae. Enough attention should be paid to the adverse events during treatment. It needs further research still for efficacy and safety.