舌下含服粉尘螨滴剂对变应性鼻炎伴哮喘患者的疗效及其经济性分析

王鹛嵩; 吴海涛; 黄学彬; 钟莉莉; 柳海珠; 黄秋菊

doi:10.13201/j.issn.1001-1781.2016.07.008

舌下含服粉尘螨滴剂对变应性鼻炎伴哮喘患者的疗效及其经济性分析

- 海南省人民医院(耳鼻咽喉头颈外科医院) (海口, 570311)
基金项目:
海南省卫生计生行业科研项目（No：14A200059）

详细信息

通讯作者: 王鹛嵩,E-mail:meisongwang@126.com

中图分类号: R765.21

收稿日期: 2015-10-21

Efficacy and economic evaluation of sublingual immunotherapy with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma

- Hospital of Otolaryngology Head and Neck Surgery, Hainan General Hospital, Haikou, 570311, China

More Information

Corresponding author: WANG Meisong, E-mail: meisongwang@126.com

Received Date: 21 October 2015

摘要

摘要: 目的：评估舌下含服标准化粉尘螨滴剂治疗变应性鼻炎（AR）伴过敏性哮喘的疗效及其经济性。方法：回顾性分析203例4~60岁尘螨过敏的AR伴过敏性哮喘患者的资料。203例患者中，86例接受标准化粉尘螨滴剂的舌下含服特异性免疫治疗（SLIT）和药物治疗（SLIT组）；117例患者仅采用标准化药物治疗（单纯药物组）。每3个月随访1次，共随访2年。观察并记录患者治疗期间的鼻部症状评分、鼻炎药物评分、哮喘日间症状评分、哮喘夜间症状评分、哮喘药物评分以及治疗费用，并进行经济性分析。结果：2组患者治疗前鼻部症状评分、鼻部药物评分、哮喘日间症状评分、哮喘夜间症状评分、哮喘药物评分比较差异均无统计学意义（均P>0.05）。分别完成1年和2年的疗程后，SLIT组患者鼻部症状评分、鼻炎药物评分、哮喘日间症状评分、哮喘夜间症状评分、哮喘药物评分均显著低于单纯药物组，差异均有统计学意义（均P<0.01）。与治疗前比较，SLIT组患者治疗1年和治疗2年症状评分和药物评分显著降低，差异均有统计学意义（均P<0.01）。治疗费用方面，尽管SLIT组的直接费用稍高于单纯药物组，但其间接费用明显低于单纯药物组，差异有统计学意义（P<0.01）。结论：舌下含服粉尘螨滴剂对AR伴过敏性哮喘具有良好的疗效，且能够降低患者的间接治疗费用。
- 鼻炎,变应性 /
- 哮喘 /
- 免疫疗法 /
- 治疗效果
Abstract: Objective: To evaluate the efficacy and economics of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma.Method: Two hundred and three patients(aged 4-60 yr) with allergic rhinitis and allergic asthma induced by house dust mites were retrospectively analyzed. Eighty-six patients were treated by SLIT with standardized Dermatophagoides farina drops and pharmacotherapy(SLIT group), while 117 patients were treated by standardized pharmacotherapy(drug group). Patients were followed up for 2 years with one visit in every 3 months. Total nasal syptom score(TNSS), total rhinitis medicine score(TRMS), daytime asthma syptom score(DASS), nighttime asthma syptom score(NASS), total asthma medicine score(TAMS) and treatment charge were recorded at each visit.Result: There was no significant difference between two groups in TNSS, TRMS, DASS, NASS, TAMS before treatment(all P>0.05). After 1-year or 2-year duration, there were significant differences between the SLIT group and drug group in TNSS, TMSS, DASS,NASS, TAMS(all P<0.01). After 1-year or 2-year duration, the symptom scores and medication scores of SLIT group significantly decreased compared with those before treatment(all P<0.01). In terms of treatment charge, although direct cost of SLIT group was a little higher than that of drug group, the indirect cost of SLIT group was remarkably lower than that of drug group, showing significant difference(P<0.01).Conclusion: SLIT with Dermatophagoides farinae drops is effective in patients with allergic rhinitis and allergic asthma, which may also reduce indirect cost.
- rhinitis, allergic /
- asthma /
- immunotherapy /
- treatment effectiveness

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参考文献(18)

[1]	LI J,SUN B,HUANG Y,et al.A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China[J].Allergy,2009,64:1083-1092.
[2]	BOUSQUET J,LOCKEY R,MALLING H J.Allergen immunotherapy:therapeutic vaccines for allergic diseases.A WHO position paper[J].J Allergy Clin Immunol,1998,102(4Pt 1):558-562.
[3]	崔珑,王智楠,徐忠强.舌下特异性免疫治疗不同年龄组儿童变应性鼻炎的长期疗效及安全性观察[J].中华耳鼻咽喉头颈外科杂志,2013,48(1):17-21.
[4]	李胜兰,陶泽璋.变应原特异性免疫治疗变应性鼻炎的药物经济学[J].中华耳鼻咽喉头颈外科杂志,2015,50(4):347-349.
[5]	EIFAN A O,AKKOC T,YILDIZ A,etal.Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy inasthmatic/rhinitis children sensitized to house dust mite:an open randomized controlled trial[J].Clin Exp Allergy,2010,40:922-932.
[6]	TAHAMILER R,SARITZALI G,CANAKCIOGLU S.Long-term efficacy of sublingual immunotherapy in patients with perennial rhinitis[J].Laryngoscope,2007,117:965-969.
[7]	顾之燕,董震.变应性鼻炎的诊治原则和推荐方案(2004年,兰州)[J].中华耳鼻咽喉头颈外科杂志,2005,40(3):166-167.
[8]	中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南[J].中华结核和呼吸杂志,2008,31(3):177-185.
[9]	ANTUNEZ C,MAYORGA C,CORZO J L,et al.Two year follow-up of immunological response in mite-allergic children treated with sublingual immunotherapy.Comparison with subcutaneous administration[J].Pediatric Allergy Immunology,2008,19:210-218.
[10]	POTTER P C.Update on sublingual immunotherapy[J].Ann Allergy Asthma Immunol,2006,96(2Suppl1):S22-25.
[11]	中华耳鼻咽喉头颈外科杂志编委会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎特异性免疫治疗专家共识[J].中华耳鼻咽喉头颈外科杂志,2011,46(12):876-980.
[12]	陈实,王灵,陈冰,等.海南儿童哮喘常见吸入性变应原的调查[J].临床儿科杂志,2011,29(6):552-555.
[13]	HALLOY J L.[Sublingual hyposensitization] [J].Rev Med Brux,2004,25:A256-258.
[14]	PENAGOS M,COMPALATI E,TARANTINI F,et al.Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3to 18years of age:a meta-analysis of randomized,placebocontrolled,double-blind trials[J].Ann Allergy Asthma Immunol,2006,97:141-148.
[15]	温赤君,朱明风,任文美,等.舌下粉尘螨滴剂治疗儿童支气管哮喘伴变应性鼻炎的有效性和安全性[J].中华耳鼻咽喉头颈外科杂志,2011,46(5):393-396.
[16]	陈建军,孔维佳,项济生,等.变应性鼻炎伴哮喘患者特异性免疫治疗的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2010,24(3):57-59.
[17]	BERTO P,PASSALACQUA G,CRIMI N,et al.Economic evaluation of sublingual immunotherapy vs symptomatic treatment in adults with pollen-induced respiratory allergy:the Sublingual Immunotherapy Pollen Allergy Italy(SPAI)study[J].Ann Allergy Asthma Immunol,2006,97:615-621.
[18]	ARIANO R,BERTO P,INCORVAIA C,et al.Economic evaluation of sublingual immunotherapy vs symptomatic treatment in allergic asthma[J].Ann Allergy Asthma Immunol,2009,103:254-259.