舌下免疫治疗对变应性鼻结膜炎患者新致敏原预防作用及生活质量影响的研究

Effect of sublingual immunotherapy on preventing new allergens and improving quality of life in allergic rhinoconjunctivitis patients

目的:评估舌下特异性免疫治疗(SLIT)对变应性鼻结膜炎(ARC)患者新致敏原预防作用、生活质量影响及临床疗效。方法:对116例18~55岁ARC患者的临床资料进行回顾性分析,根据患者意愿分为对照组(58例)和SLIT组(58例)。对照组给予糠酸莫米松鼻喷剂+氯雷他定片+盐酸奥洛他定滴眼液对症治疗,SLIT组在对照组基础上给予粉尘螨滴剂SLIT,进行2年的随访观察。分析比较两组患者治疗前后的过敏原检查结果、鼻结膜炎生活质量问卷(RQLQ)、鼻炎症状总评分(TNSS)、结膜炎症状总评分(TCSS)、药物评分(TMS)以及视觉模拟量表(VAS)评分。结果:治疗2年后,对照组中有19例患者(32.76%)出现了新致敏原,而SLIT组仅有4例(6.90%)(χ^2=12.20,P<0.05);致敏原减少的情况仅在出现在SLIT组中,有6例(10.34%)。与基线相比,治疗2年后SLIT组患者的RQLQ、TNSS、TCSS、TMS和VAS评分均显著降低(P<0.05),而对照组除日常活动评分方面差异不显著(P>0.05),其他均显著降低(P<0.05)。经过2年治疗后,SLIT组的RQLQ、TNSS、TCSS、TMS和VAS评分均显著低于对照组(P<0.05)。结论:采用粉尘螨滴剂对尘螨致敏的ARC患者进行2年SLIT比单纯药物治疗更为显著,生活质量也明显改善,并且SLIT能够预防新致敏原的产生。

Objective:To evaluate the prevention of new allergens,improvement of quality of life and clinical efficacy of sublingual immunotherapy(SLIT)on patient with allergic rhinoconjunctivitis(ARC).Methods:A cohort of 116 patients with ARC between 18-55 years old were analyzed retrospectively and be divided into control group(58 patients)and SLIT group(58 patients)according to their wishes.Control group was treated with mometasone furoate nasal spray+desloratadine tablets+olopatadine hydrochloride eye drops,while SLIT group was added SLIT with dermatophagoides farina drops on basic drug therapy and the 2 groups were observed and followed up for 2 years.The allergen test results,RQLQ,TNSS,TCSS,TMS and VAS score were evaluated before and after treatment.Results:After 2 years of treatment,19 patients(32.76%)appeared new allergens in the control group,whereas there was only 4 patients(6.90%)in SLIT group(χ^2=12.20,P<0.05).6 patients with reduction of allergens only observed in SLIT group(10.34%).The RQLQ score,TNSS,TCSS,TMS and VAS score had improved significantly after treatment for 2 years in SLIT group compared with the baseline(P<0.05),and the control group also had all improvement except for daily activity score.After 2 years of treatment,the RQLQ score,TNSS,TCSS,TMS and VAS score in SLIT group had significantly lower than the control group(P<0.05).Conclusion:These results support the hypothesis that,compared with drug therapy alone,SLIT can prevent the generation of new allergens,improve the quality of life and show effective clinical outcomes.