舌下变应原免疫疗法治疗儿童支气管哮喘伴变应性鼻炎的临床评价

Clinical evaluation of sublingual allergen specific immunotherapy in treatment to children with bronchial asthma and allergic rhinitis

目的 探讨舌下变应原特异性免疫疗法（SLIT）治疗支气管哮喘伴变应性鼻炎的疗效及安全性。方法 选取5~14岁的哮喘伴变应性鼻炎患儿120例，随机分成SLIT治疗组（舌下含服粉尘螨滴剂）和常规治疗组，每组60例。记录两组患儿治疗前后哮喘控制问卷（ACQ）评分、鼻炎症状评分、月均用药情况和不良反应，检测血清粉尘螨特异性IgE （SIgE）值。结果 治疗1年后，SLIT治疗组和常规治疗组的ACQ评分、鼻炎症状评分、治疗哮喘月均用药评分及血清粉尘螨SIgE值均有所下降，且SLIT治疗组下降程度明显高于常规治疗组，差异有统计学意义（P〈0.01）。SLIT治疗组与用药相关的皮疹、鼻咽痒和哮喘发作不良反应发生率为13.3%，未出现严重不良反应。结论 SLIT治疗儿童哮喘伴变应性鼻炎安全有效，比常规治疗效果更佳。

Objective To explore the therapeutic effect and safety of sublingual allergen specific immunotherapy （SLIT） for the treatment of bronchial asthma with allergic rhinitis. Methods One hundred and twenty children from 5 to 14 years old with asthma and allergic rhinitis were selected and randomly divided into the SLIT treatment group （sublingual administration of the dermatophagoides farinae drop） and conventional treatment group. Each group had 60 patients. Scores of asthma control questionnaire （ACQ）, rhinitis symptoms, monthly medication and adverse reactions were recorded. The specific IgE （SIgE） value of serum dermatophagoides farinae was measured. Results After treatment for one year, the scores of ACQ, rhinitis symptom, and monthly asthmatic medicine and the SIgE value of serum dermatophagoides farinae of the SLIT treatment group and conventional treatment group were decreased. The decrease of the SLIT treatment group was significantly more than that of the conventional treatment group. The differences were statistically significant （P〈0.01）. The incidence of side effects （including skin rash, nasopharyngeal itch, and asthma attack） relevant to immunotherapy was 13.3% and no serious side effects happened. Conclusion SLIT can safely and effectively treat children with bronchial asthma and allergic rhinitis and is better than the conventional therapy.