粉尘螨滴剂联合维生素D滴剂辅助治疗儿童哮喘伴过敏性鼻炎临床观察

Clinical Observation of Dermatophagoides Farinae Drops Combined with Vitamin D Drops in the Adjuvant Treatment of Pediatric Asthma Complicated with Allergic Rhinitis

目的探讨粉尘螨滴剂联合维生素D滴剂辅助治疗儿童哮喘伴过敏性鼻炎的临床疗效。方法选取江苏省徐州市儿童医院2019年1月至2021年1月收治的哮喘伴过敏性鼻炎患儿112例,按随机数字表法分为对照组和观察组,各56例。两组患儿均予氯雷他定颗粒口服,观察组患儿加用粉尘螨滴剂联合维生素D滴剂(胶囊型)治疗。两组均持续治疗6个月。结果观察组患儿近期总有效率为73.21%,与对照组的67.86%相当(P>0.05);观察组患儿远期总有效率为91.07%,显著高于对照组的71.43%(P<0.05)。两组患儿治疗3个月、6个月喘息、鼻塞、喷嚏、鼻痒评分均显著降低,肺功能指标(用力肺活量,第1秒用力呼气容积,呼气峰流速,用力呼出25%、50%、75%肺活量的呼气流速,以及最大呼气中段流量占预计值百分比)均显著升高,且观察组患儿治疗6个月的喷嚏、鼻痒评分及肺功能指标均改善更显著(P<0.05)。观察组患儿治疗6个月的血清白细胞介素4、白细胞介素5、白细胞介素12及肿瘤坏死因子-α水平均显著低于对照组(P<0.05)。两组患儿均无严重不良反应,血、尿等常规均未检出异常;仅对照组中2例患儿出现喉部不适,3 d后自行缓解。结论粉尘螨滴剂联合维生素D滴剂辅助治疗儿童哮喘伴过敏性鼻炎,可缓解患儿的临床症状,并改善其肺功能。

Objective To investigate the clinical efficacy of Dermatophagoides Farinae Drops combined with Vitamin D Drops in the adjuvant treatment of pediatric asthma complicated with allergic rhinitis.Methods A total of 112 children with asthma and allergic rhinitis admitted to the Xuzhou Children′s Hospital from January 2019 to January 2021 were selected and divided into the control group and the observation group by the random number table method,with 56 cases in each group.The children in the two groups were given oral Loratadine Granules,on this basis,the children in the observation group were given Dermatophagoides Farinae Drops combined with Vitamin D Drops(capsules).Both groups were treated continuously for six months.Results The short-term total effective rate in the observation group was 73.21%,which was similar to 67.86%in the control group(P>0.05).The long-term total effective rate in the observation group was 91.07%,which was significantly higher than 71.43%in the control group(P<0.05).After three and six months of treatment,the wheezing,nasal obstruction,sneezing and nasal itching scores in the two groups significantly decreased;the lung function-related indexes[percentages of forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),forced expiratory flow at 25%,50%and 75%of FVC(FEF25,FEF50,FEF75),maximum mid-expiratory flow(MMEF)to expected values]significantly increased;the sneezing,nasal itching scores,and lung function-related indexes in the observation group were significantly better after six months of treatment(P<0.05).After six months of treatment,the serum interleukin-4(IL-4),interleukin-5(IL-5),interleukin-12(IL-12)and tumor necrosis factor-α(TNF-α)levels were significantly lower than those in the control group(P<0.05).There was no serious adverse reaction in the two groups,and there was no abnormality in the blood and urine routine tests;only two children in the control group experienced discomfort in the throat,which relieved spontaneously after 3 d.Conclusion The adjuvant treatment of Dermatophagoides Farinae Drops combined with Vitamin D Drops can relieve the clinical symptoms and improve the lung function in children with asthma and allergic rhinitis.