舌下含服粉尘螨滴剂治疗儿童变应性鼻炎的临床疗效

Curative effect of the dust mites drops sublingual immunotherapy in pediatric allergic rhinitis

目的评估标准化粉尘螨滴剂舌下特异性免疫治疗(SLIT)变应性鼻炎(AR)患者的疗效,同时比较其对单一过敏与多种过敏儿童的免疫治疗效果。方法收集150例AR患者作为实验组,并按过敏原数量分为单一螨过敏组(61例)与多重过敏组(89例)。选择同期行药物治疗的32例AR患儿作为对照组。记录各组的症状评分(TNSS)、药物评分(TMS)和视觉模拟评分(VAS)。结果治疗6个月时实验组TNSS与VAS评分稍高于对照组,1年及2年时评分两组差异无统计学意义;而TMS评分在各时间点与对照组比较有明显改善。除TMS评分半年时稍低于多种过敏组外,单一过敏组的各种指标评分与多种过敏组差异无统计学意义。结论舌下含服粉尘螨滴剂对螨虫引起的儿童变应性鼻炎有较好的治疗效果,对单一螨虫过敏与合并多重过敏的儿童免疫治疗效果相似。尘螨血清特异性IgG4的升高可以作为免疫治疗有效的预测指标。

Objective To compare the curative effect of sublingual immunotherapy （SLIT） with standardized dermatophagoides farina drops in monosensitized and polysensitized children with allergic. Methods A total of 150 pediatric allergic rhinitis patients were enrolled as desensitization group and were allocated into monosensitized group （61 cases） and polysensitized group （89 cases） according to the number of coexisting allergens. Meanwhile 32 allergic rhinitis children treated by pharmacotherapy during the same period were collected as control group. The symptom scores （TNSS）, drug scores （TMS） and visual analogue scale（VAS） were assessed at the beginning,6 months,1 year and 2 years of the treatment. Re- sults The scores of TNSS and VAS in desensitization were slightly higher than those in the control after 6 months treat- ment,but without difference at 1 year and 2 years;The score of TMS had significant improvement in desensitization com- pared with the corresponding points in control. All the parameters in monosensitized group were equivalent with polysensiti- zend group,except the score of TMS was slightly lower than the polysensitizend group at 6 months. Conclusions Dust mites under the SLIT can significantly improve nasal symptoms of the monoallergen sensitized and polyallergen sensitized al- lergic children, reduce the symptomatic drug use, and two groups have similar curative effects. The rise of dust mites specific IgG4 can be used as immunotherapy effective predictors.