舌下含服粉尘螨滴剂治疗儿童变应性鼻炎的长期疗效及安全性观察

Long-term clinical effect and safety observation of sublingual dermatophagoides farinae drop in preschool and school-age children with allergic rhinitis

目的:评估标准化粉尘螨滴剂舌下含服特异性免疫治疗(SLIT)对儿童变应性鼻炎(AR)的长期疗效及安全性。方法:收集能坚持治疗并定期随访的50例学龄前组(≤6岁)和52例学龄期组(>6岁)患儿的资料,所有患儿均对尘螨过敏,随机分为SLIT加药物治疗组及单纯药物治疗组。SLIT加药物治疗组以标准化粉尘螨滴剂舌下含服免疫治疗,辅以对症药物治疗;单纯药物治疗组以糠酸莫米松鼻喷剂及地氯雷他定片口服对症治疗。每3个月随访1次,共随访2年。观察并记录治疗后症状得分、药物评分。治疗2年后、停药2年后综合评价患儿的主观症状、用药及治疗满意度情况。结果:SLIT加药物治疗组治疗2年后的症状得分(1.13±1.05)和药物评分(0.07±0.04)改善情况均明显高于单纯药物治疗组(4.68±3.09、0.36±0.25),差异有统计学意义(均P<0.01);SLIT加药物治疗组患儿主观症状评价,用药及治疗满意度亦明显高于单纯药物治疗组。学龄前组主观症状、用药及治疗满意度与学龄期组相同,停药2年后,学龄期组主观症状评价、用药及治疗满意度优于学龄前组。结论:尘螨过敏的不同年龄患儿采用SLIT进行2年特异性免疫治疗均能获得良好效果,但停药2年后,学龄期组在症状得分、药物评价、主观满意度方面优于学龄前组。

Objective：To evaluate the efficacy of specific sublingual immunotherapy（SLIT）with Dermatophagoides farinae drops on preschool and school age children with allergic rhinitis.Method：Fifty preschool children（≤6year）,and 52 school age children（6year）,who suffered from dust mite induced allergic rhinitis,were randomly divided into subingual immunotherapy（SLIT）＋ drug group and drug group.SLIT ＋drug group was treated with a standardized subingual immunotherapy drops of Dermatophagoides farinae and combined with symptomatic therapy,drug group was treated with mometasone furoate nasal spray and dseloratdine tablets as symptomatic treatment.These children were followed up for 2years with one visit in every 3months.Symptom scores and medication scores were record at each visit.Comprehensive evaluation of symptom,medication,and patients＇ degree of satisfaction were used.Result：Two years after SLIT finished,symptom scores（SLIT ＋drug group：1.13±1.05;drug group：4.68±3.09）,medication scores（SLIT ＋drug group：0.07±0.04;drug group：0.36±0.25）of SLIT ＋drug group were significantly lower than those in drug group respectively,all P0.01.The subjective assessment of patient＇symptom,medication,and treatment satisfaction in SLIT ＋drug group was significantly lower than those in drug group.Subjective assessment symptoms,medication,and treatment satisfaction in preschool group was the same as in school age group.After SLIT ended for 2years,subjective assessment and treatment satisfaction in the school age group was better than those in preschool group in medication score.Conclusion：SLIT demonstrated clinical improvement in children of different ages during 2years treatment.the symptom scores,medication scores and subjective satisfaction in school age group are better than those in preschool group.