粉尘螨滴剂特异性免疫治疗螨过敏性哮喘患儿的长期疗效观察

Long-term efficacy of Dermatophagoides farina drop specific immunotherapy on children with acarid allergic asthma

目的:观察舌下含服粉尘螨滴剂特异性免疫治疗螨过敏性哮喘患儿的临床疗效。方法:选择于四川省内江市隆昌县人民医院就诊的非急性爆发期的螨过敏性哮喘患儿102例,用随机数字表法随机分成对照组(51例)和治疗组(51例)。对照组接受常规治疗;治疗组在常规治疗的基础上增加舌下含服粉尘螨滴剂进行特异性免疫治疗。定期随访,随访期均为36个月。检测指标为呼气峰值流速(peak expiratory flow,PEF)、第1秒用力呼气容积占预计值的百分比(FEV1%)、血清尘螨特异性IgG4和sIgE水平。观察日间和夜间哮喘症状,做儿童哮喘控制测试(children asthma control test,C-ACT)评分,比较两组疗效指标的差异,并观察不良反应的发生情况。结果:治疗36个月时,治疗组患儿的PEF、FEV1%、日间和夜间哮喘症状评分均优于对照组(P<0.05),sIgE和IgG4显著升高(P<0.05),C-ACT评分达到完全控制级别。结论:舌下含服粉尘螨滴剂特异性免疫治疗螨过敏性哮喘患儿能改善肺功能,有效缓解哮喘症状。

Objective： To observe the clinical efficacy of sublingual Dermatophagoides farina drop specific immunotherapy on children with acarid allergic asthma. Methods： One hundred and two asthma child patients with non-acute exacerbation were selected as research subjects. They were randomly divided into the treatment group （n = 51） and the control group （n： 51）. The children in the control group received only routine treatment, while the children in the treatment group were sublingually given Derrnatophagoides farina drop, in addition to routine treatment. Peak expiratory flow （FEF）, percentage of forced expir- atory volume in one second （FEV 1% ）, serum levels of sIgE and IgG4 were detected as indicators. Symptoms of asthma during the day and at night were closely observed, and scores of children asthma control tests （C ACT） were made to compare differ- ences in therapeutic effects between the 2 groups. At the same time, adverse drug reactions of the 2 groups were also observed closely. Results： After treatment of 36 months, the scores of PEF, FEV 1% and asthma symptoms during the day and at night for the child patients of the treatment group were all superior to those of the control group （P〈0.05）. Serum levels of sIgE and IgG4 were significantly elevated （P〈0.05）, and scores of C-ACT for the treatment group almost reached the level of com- plete control of asthma symptoms. Conclusion： Sublingual Derrnatophagoides farina drop could effectively improve the lung function and alleviate the symptoms of acarid allergic asthma in children.