皮下免疫和舌下免疫治疗变应性鼻炎的疗效及安全性对比观察

Comparative study of the efficacy and safety of subcutaneous and sublingual immunotherapy for patients with allergic rhinitis

目的探讨皮下免疫和舌下免疫治疗变应性鼻炎(AR)的疗效及安全性。方法 156例对尘螨过敏的成人变应性鼻炎患者随机分为皮下特异性免疫治疗(SCIT)组(78例)和舌下特异性免疫治疗(SLIT)组(78例),分别接受标准化屋尘螨变应原制剂皮下注射治疗和标准化粉尘螨变应原滴剂舌下含服治疗,对比观察两组疗效及不良反应发生情况。结果两组治疗后鼻部症状均改善明显,VAS评分较治疗前均明显降低,治疗前后比较差异有统计意义(P<0.05),但治疗后VAS评分组间比较差异无统计学意义(P>0.05)。SCIT组总有效率为89.7%,SLIT组总有效率为84.6%,组间比较差异无统计学意义(P>0.05)。SCIT组不良反应发生率为39.7%(31/78),SLIT组不良反应发生率为8.9%(7/78),两组间不良反应率比较差异有统计学意义(P<0.05)。结论两种方法对AR都能取得良好的疗效,而舌下特异性免疫治疗不良反应发生率相对较低,临床应用更为安全。

Objective To investigate the efficacy and safety of subcutaneous and sublingual immunotherapy for patients with allergic rhinitis（AR）. Methods 156 adult AR patients were randomly divided into subcutaneous specific immunotherapy （sub- cutaneous immunotherapy, SCIT） group （78 cases） and sublingual specific immunotherapy （sublingual immunotherapy, SLIT） group （78 cases ） to be treated by standardized dust mite extract. The efficacy and adverse events of both groups were observed and compared. Results After treatment, the nasal symptoms of both groups were improved significantly and the VAS scores were significantly lower than before treatment, and the difference between before and after treatment were statistically significant （P 〈 0.05）, but the VAS scores between the two groups after treatment had no statistically significant difference （ P 〉 0.05 ）. The total effective rate of SCIT was 89.7% and SLIT group was 84.6%, and the difference was not statistically significant （P 〉 0.05）. The adverse reaction rate of SCIT group was 39.7% （31/78） and SLIT group was 8.9% （7/78）, and the difference was statistically significant （P 〈 0.05 ）. Conclusion Two treatments for AR can achieve good results, but SLIT has a relatively low incidence of adverse reactions.