标准化粉尘螨滴剂舌下含服治疗特应性皮炎的有效性和安全性

Efficacy and safety of sublingual immunotherapy with standardized dermatophagoides farinae drops on atopic dermatitis

目的:评价标准化粉尘螨滴剂对特应性皮炎(atopic dermatitis,AD)患者舌下特异性免疫治疗(sublingual immunotherapy,SLIT)的疗效及安全性。方法:选取46例粉尘螨过敏的AD患者,随机分为对照组和SLIT组,对照组给予依巴斯汀口服同时外用丙酸氟替卡松乳膏治疗,SLIT组在对照组基础上加用舌下含服粉尘螨滴剂。治疗半年后,对两组患者治疗前后SCORAD积分和日均用药评分进行比较分析,评价AD患者SLIT的有效率及对症用药情况。并记录两组患者治疗过程中的不良反应。结果:治疗半年后,SLIT组有效率显著高于对照组(69.56%vs 34.78%,P<0.05)。从治疗后第3个月至第6个月,SLIT组日均用药评分[分别为(0.43±0.18)、(0.34±0.17)、(0.24±0.15)、(0.14±0.12)分]均显著低于对照组[分别为(0.59±0.25)、(0.48±0.21)、(0.40±0.20)、(0.32±0.18)分],差异具有统计学意义(P<0.05)。此外,SLIT组AD患者均未出现严重不良反应,仅部分患者表现出轻微局部不适感。结论:舌下含服标准化粉尘螨滴剂是一种治疗特应性皮炎安全且有效的方法。

Objective： To evaluate the efficacy and safety of sublingual immunotherary （SLIT） with standardized dermatophagoides farinae drops on patients with atopic dermatitis （AD）. Methods： A total of 46 AD patients sensitive to dust mites were randomly assigned to control group and SLIT group. The control group was given pharmacotherapy included ebastine and fluticasone propionate cream treatment, while the SLIT group received dermatophagoides farinae drops plus the above-mentioned pharmacotherapy. Efficacy rate, drug scores and adverse drug reactions were recorded for 6 months between the two groups. Results： After 6-month treatment, the total effective rate of SLIT group （69.56%） was significantly higher than that of the control group （34.78%） （P 〈 0.05）. Meanwhile, after 3 months treatment, the average daily drug scores of the SLIT group （0.43 ± 0.18, 0.34 ± 0.17, 0.24 ± 0.15, 0.14 ± 0.12, respectively） decreased significantly compared with the control group （0.59 ± 0.25, 0.48 ± 0.21, 0.40 ± 0.20, 0.32 ± 0.18, respectively） （P 〈 0.05）. No severe adverse events occurred. Conclusion： Sublingual immunotherapy with standardized dermatophagoides farinae drops is effective and safe in the treatment of atopic dermatitis.