卡介菌多糖核酸治疗常年性变应性鼻炎临床研究

Clinical efficacy of BCG-PSN in perennial allergic rhinitis and its therapeutic mechanism

目的观察卡介菌多糖核酸(polysaccharide nucleic acid fraction of bacillus Calmette-Guerin,BCGPSN)治疗常年性变应性鼻炎的临床疗效,并探讨其治疗机理。方法对60例常年性变应性鼻炎患者采用BCG-PSN注射液0.5mg(1ml)肌肉注射,隔日1次,疗程为6周。其中37例于治疗前和治疗6周后行结核菌素(purified protein derivative of tuberculin,PPD)皮内试验、鼻分泌物嗜酸粒细胞(EOS)计数。对照组给予酮替芬1mg口服,每日2次,疗程相同。结果①BCG—PSN治疗6周后,临床近期疗效与对照组相比差异无统计学意义(P>0.05)。随访6个月后评判远期疗效,BCG—PSN治疗组的显效率为38.3%,明显优于对照组(P<O.05);②BCG—PSN治疗6周后,PPD反应与治疗前相比明显增强(P<0.001),而鼻分泌物EOS计数显著减少(P<0.001)。结论 BCG—PSN对常年性变应性鼻炎具有良好的临床疗效。其治疗机理可能为通过诱导患者体内的Th1型免疫反应,调节Th1/Th2平衡,减少鼻粘膜嗜酸粒细胞浸润,从而控制变应性鼻炎的发生和发展。

Purpose To evaluate the clinical efficacy of BCG-PSN (polysaccharide nucleic aicd fraction of BCG) in the treatment of perennial allergic rhinitis, and to discuss its therapeutic mechanism. Methods Among 60 patients with perennial allergic rhinitis, BCG-PSN injection was administered intramuscularly in dose of 0.5 mg(1 ml) every 2 days for 6 weeks. Purified protein derivative (PPD) intracutaneous test and nasal secretion eosinophil(EOS) count were applied to 37 patients before and 6 weeks after BCG-PSN administration. Ketotifen tablets were taken in dose of 1 mg twice a day for the same duration as a control. Results ①After 6 weeks of treatment, the clinical efficacy showed no statistic difference between the 2 groups( P > 0.05), while in the follow-up after 6 months, the rating of obvious efiect was obtained in 38.3% of the patients in BCG-PSN group, which was significantly higher than that of the control( P < 0.05). ②After BCG-PSN administration, a significantly enhancement of PPD skin reaction was observed( P < 0.001). Meanwhile, the number of EOS in nasal secretion turned to be reduced significantly than before treatment (P <0.001) .Conclusion BCG-PSN had a superior clinical efficacy in combating perennial allergic rhinitis.Base on the results,a possibility was suggested that BCG-PSN administration could regulate Th1/Th2 balance through inducing Th1-type immune response, and reduce EOS accumulation in the nasal mucosa, so as to control the paroxysm and development of allergic rhinitis.