皮下免疫与舌下免疫治疗变应性鼻炎的临床疗效分析

An Analysis of the Clinical Effect of Subcutaneous Immunity and Sublingual Immunity in the Treatment of Allergic Rhinitis

目的探讨皮下免疫(SCIT)与舌下免疫(SLIT)治疗变应性鼻炎的临床疗效及安全性。方法2012年3月至2016年3月期间,在我科门诊行变应性鼻炎免疫治疗患者92例,随机分为两组:SCIT组46例,SLIT组46例。两组治疗疗程为2年,均分剂量累加阶段和剂量维持阶段。分别观察两组患者1年后,2年后的治疗疗效、症状改善情况、不良反应情况。结果治疗1年后:SCIT组有效率60.86%,鼻部症状评分(四种症状评分之和平均分值,以下同)为:4.68±0.89,不良反应发生率21.74%;SLIT组有效率56.21%,鼻部症状评分为:4.36±0.66,不良反应发生率8.69%。两组患者治疗的有效率及鼻部症状评分比较,差异无统计学意义(P>0.05);不良反应发生率SLIT组明显较低,差异有统计学意义(P<0.05)。治疗2年后:SCIT组有效率76.08%,鼻部症状评分为:2.99±0.86,不良反应发生率为28.26%。SLIT组有效率71.74%,鼻部症状评分为:2.76±0.65,不良反应发生率为:13.04%。两组患者的有效率及鼻部症状评分比较,差异无统计学意义(P>0.05);不良反应发生率SLIT组明显较低,差异有统计学意义(P<0.05)。两组患者治疗1年后及2年后的有效率及鼻部各种症状评分比较,差异有统计学意义(P<0.05)。结论皮下免疫与舌下免疫治疗变应性鼻炎的疗效相当;两组免疫治疗的时间周期越长,疗效越好;SLIT治疗变应性鼻炎安全性更好,值得推广。

Objective To explore the clinical effect of subcutaneous immunity(SCIT)and sublingual immunity(SLIT)in the treatment of allergic rhinitis,Methods From March,2012 to March,2016,92 patients with allergic rhinitis received immunotherapy in our outpatient department were selected for the study.These patients were randomly divided into groups as following:the SCIT group with 46 cases and the SLIT group with 46 cases.The treatment course of the two groups was 2 years,and they were divided into dose accumulation stage and dose maintenance stage.The therapeutic effect,symptom improvement and adverse reactions of both groups were observed at time points of 1 year later and 2 years later.Results One year after the treatment,the results were as following:the effective rate of SCIT group was 60.86%;the nasal symptom score(the average score of the sum of four symptom scores,the same below)was 4.68±0.89;the incidence of adverse reactions was 21.74%;the effective rate of the SLIT group was 56.21%,the nasal symptom score was 4.36±0.66,and the incidence of adverse reactions was 8.69%.There was no significant difference between the two groups in treatment efficiency and nasal symptom scores(P>0.05).The incidence of adverse reactions in the SLIT group was significantly lower(P<0.05).Two years after the treatment,the results were as following:the effective rate of SCIT group was 76.08%;the score of nasal symptoms was 2.99±0.86;and the incidence of adverse reactions was 28.26%;Also,in the SLIT group,the effective rate was 71.74%,the nasal symptom score was 2.75±0.65,and the incidence of adverse reactions was 13.04%.There was no significant difference between the two groups in effective rate and nasal symptom score(P>0.05).The incidence of adverse reactions in the SLIT group was significantly lower(P<0.05).There were significant differences between the two groups in the effective rate and nasal symptom scores after 1 and 2 years of treatment(P<0.05).Conclusion Subcutaneous immunity and sublingual immunity have the same therapeutic effect on allergic rhinitis.The longer the cycle of immunotherapy,the better the curative effect can be.SLIT has a better safety in the treatment of allergic rhinitis and is worth popularizing.