Efficacy and safety of immunotherapy in dust mites and alternaria multi-sensitized allergic rhinitis patients
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摘要: 目的: 探讨尘螨及交链孢霉多重致敏的变应性鼻炎患者进行免疫治疗的有效性和安全性。方法: 采用开放、随机、平行对照临床研究,将纳入的60例变应性鼻炎患者随机分为免疫治疗组(过敏原注射液)和药物治疗组(可选药物包括鼻用糖皮质激素、口服二代抗组胺药、白三烯受体拮抗剂),评估及比较2组患者治疗前后各项评分(症状评分、药物评分、联合评分)、血清特异性IgE水平、生活质量评分的变化。同时观察记录免疫治疗过程中出现的不良反应。结果: 经过24个月的治疗,免疫治疗组、药物治疗组各项评分(症状评分、药物评分、联合评分及生活质量评分)均较治疗前显著降低,而免疫治疗组评分也显著低于药物治疗组。免疫治疗过程中仅出现局部不良反应,未出现全身不良反应及严重不良反应。结论: 在尘螨和交链孢霉多重致敏的变应性鼻炎患者中,使用尘螨和交链孢霉联合免疫治疗安全、有效,比单纯使用药物治疗效果更佳。Abstract: Objective: The aim of this study is to evaluate the efficacy and safety of immunosuppression in patients with allergic rhinitis with multiple sensitization of dust mites and AlternariaMethod: An open, label random parallel controlled clinical study was conducted. Sixty dust mites and alternaria multi-sensitized allergic rhinitis patients were enrolled and randomized into immunotherapy group and medication group. Evaluation indicators included symptom scores, medication scores, symptom medication combined scores, RQLQ and serum allergen-specific IgE. In immunotherapy group, side effects were also observed and recorded.Result: After 24 months of treatment, all the scores were significantly lower than baseline, in both immunotherapy group and medication group. The scores of immunotherapy group were significantly lower than those of the medication group. Only local side effects were observed in immunotherapy group, without any systemic side effects and anaphylaxis.Conclusion: Mixed immunotherapy with dust mites and alternaria was effective and safe in allergic rhinitis patients and it had better curative effect than medication.
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Key words:
- rhinitis /
- allergic /
- immunotherapy /
- dust mite /
- alternaria
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[1] 王成硕, 王向东, 张伟, 等.变应性鼻炎屋尘螨过敏原皮下免疫治疗的远期疗效研究[J].中华耳鼻咽喉头颈外科杂志, 2012, 47 (10):804-808.
[2] TAHAMILER R, SARITZALI G, CANAKCIOGLUS, et al.Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis[J].ORL J Otorhinolaryngol Relat Spec, 2008, 70:144-150.
[3] KUNA P, KACZMAREK J, KUPCZYK M.Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children[J].J Allergy Clin Immunol, 2011, 127:502-508.
[4] TABAR A I, LIZASO M T, GARCIA B E, et al.Double-blind, placebo-controlled study of Alternaria alternata immunotherapy:clinical efficacy and safety[J].Pediatr Allergy Immunol, 2008, 19:67-75.
[5] WANG J, WU Y, LI J, et al.Eight aeroallergen skin extracts may be the optimal panel for allergic rhinitis patients in Central China[J].Int Arch Allergy Immunol, 2017, 173:193-198.
[6] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.变应性鼻炎诊断和治疗指南 (2015年, 天津)[J].中华耳鼻咽喉头颈外科杂志, 2016, 51 (1):6-24.
[7] JUTEL M, AGACHE I, BONINI S, et al.International consensus on allergy immunotherapy[J].J Allergy Clin Immunol, 2015, 136:556-568.
[8] 程雷, 吴海燕, 田慧琴.维生素D在变应性鼻炎发病中的作用[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (9):675-677.
[9] 王成硕, 张罗, 韩德民, 等.标准化尘螨过敏原疫苗治疗应性鼻炎一年的疗效和安全性研究[J].首都医科大学学报, 2005, 14 (3):246-248.
[10] VARNEY V A, TABBAH K, MAVROLEON G, et al.Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite:a double-blind, randomized, placebo-controlled trial[J].Clin Exp Allergy, 2003, 33:1076-1082.
[11] 陈建军, 项济生, 孔维佳, 等.阿罗格脱敏治疗变应性鼻炎的安全性研究[J].临床耳鼻咽喉科杂志, 2006, 20 (5):208-209.
[12] 骆伟华.阿罗格脱敏治疗儿童哮喘的安全性研究[J].实用医学杂志, 2008, 24 (9):1620-1621.
[13] 符徵, 蔡飞, 孙亮, 等.安脱达标准疫苗免疫治疗的安全性[J].临床耳鼻咽喉头颈外科杂志, 2009, 23 (18):856-856.
[14] 朱亮, 陆纪红, 谢青, 等.皮下免疫和舌下免疫治疗尘螨变应性鼻炎的安全性及依从性分析[J].中华耳鼻咽喉头颈外科杂志, 2010, 45 (6):444-449.
[15] 邱前辉.变应性鼻炎免疫治疗的现状和未来[J].临床耳鼻咽喉头颈外科杂志, 2017, 31 (1):9-12.
[16] SHAMJI M H, KAPPEN J H, AKDIS M, et al.Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma:an EAACI Position Paper[J].Allergy, 2017, 72:1156-1173.
[17] QI S, CHEN H, HUANG N, et al.Early intervention improves clinical responses to house dust mite immunotherapy in allergic rhinitis patients[J].Int Arch Allergy Immunol, 2016, 171:234-240.
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