舌下特异性免疫治疗对尘螨过敏致儿童变应性咳嗽的临床疗效及安全性研究

Clinical Effect and Safety of Sublingual Immunotherapy on Allergic Cough in Children Caused by Dust Mites Allergy

目的探讨舌下特异性免疫治疗对尘螨过敏致儿童变应性咳嗽(AC)的临床疗效及安全性。方法选取2017年11月—2018年5月昆明市儿童医院呼吸与危重症科门诊收治的尘螨过敏致AC患儿72例,随机分为对照组37例和观察组35例。对照组患儿采用常规药物治疗,观察组患儿在对照组基础上给予舌下特异性免疫治疗。比较两组患儿治疗前及治疗后1、4、12个月视觉模拟评分法(VAS)评分、咳嗽症状积分,治疗初及治疗后4、12个月用药评分,治疗前及治疗后4个月第1秒用力呼气容积(FEV1)、血清总免疫球蛋白E(IgE)及嗜酸粒细胞分数,治疗后4、12个月复发情况及不良反应发生情况。结果两组患儿治疗前及治疗后1个月VAS评分、咳嗽症状积分比较,差异无统计学意义(P>0.05);观察组患儿治疗后4、12个月VAS评分、咳嗽症状积分低于对照组(P<0.05)。两组患儿治疗初始用药评分比较,差异无统计学意义(P>0.05);观察组患儿治疗后4、12个月用药评分低于对照组(P<0.05)。两组患儿治疗前FEV1、血清总IgE水平、嗜酸粒细胞分数及治疗后4个月FEV1比较,差异无统计学意义(P>0.05);观察组患儿治疗后4个月血清总IgE水平、嗜酸粒细胞分数低于对照组(P<0.05)。观察组患儿治疗后4、12个月复发率低于对照组(P<0.05)。两组患儿均未出现严重不良反应。结论舌下特异性免疫治疗能有效缓解尘螨过敏致AC患儿的咳嗽症状,减轻炎性反应,降低疾病复发率,减少用药,且安全性良好。

Objective To explore the clinical effect and safety of sublingual immunotherapy(SLIT)on allergic cough(AC)in children caused by dust mites allergy.Methods 72 cases of AC children caused by dust mites allergy were selected in Outpatient Department of Respiratory and Critical Care,Kunming Children's Hospital from November 2017 to May 2018,and they were randomly divided into control group(n=37)and observation group(n=35).Children in control group were treated with conventional drugs,children in observation group were treated with SLIT on the basis of the control group.Visual analogue scale(VAS)score,cough symptom score before treatment and 1,4,12 months after treatment,medication score at initial treatment and 4,12 months after treatment,forced expiratory volume in one second(FEV1),serum total immunoglobulin E(IgE),eosinophils percentage before treatment and 4 months after treatment,recurrence rate 4,12 months after treatment,incidence of adverse reaction were compared between the two groups.Results No significant difference of VAS score and cough symptoms score before treatment and at 1 month after treatment was found between the two groups(P>0.05);VAS score and cough symptoms score in observation group were lower than those in control group at 4,12 months after treatment(P<0.05).No significant difference of medication score was found between the two groups at initial treatment(P>0.05);medication score in observation group was lower than that in control group at 4,12 months after treatment(P<0.05).No significant difference of FEV1,serum total IgE and eosinophils percentage before treatment and FEV1 at 4 months after treatment was found between the two groups(P>0.05);serum total IgE and eosinophils percentage in observation group were lower than those in control group at 4 months after treatment(P<0.05).Recurrence rate at 4,12 months after treatment in observation group were lower than that in control group(P<0.05).There was no serious adverse reactions in the two groups.Conclusion SLIT can effectively relief the cough symptoms of AC children caused by dust mites allergy,reduce inflammatory reactions,reduce the recurrence rate of disease,reduce the types of drugs and has high safety.