评估粉尘螨舌下特异性免疫治疗对成人变应性哮喘伴鼻炎控制水平及肺功能的影响

刘维; 江洪; 蒲红; 皮静婷; 龙宇; 张应龙

doi:10.13201/j.issn.1001-1781.2019.09.013

评估粉尘螨舌下特异性免疫治疗对成人变应性哮喘伴鼻炎控制水平及肺功能的影响

- 重庆医科大学附属永川医院耳鼻咽喉头颈外科(重庆永川, 402160)
基金项目:
永川区自然基金计划项目(No:Ycstc,2018nb0227)

详细信息

通讯作者: 张应龙,E-mail:8527179@qq.com

中图分类号: R765.21

收稿日期: 2019-01-24

An assessment of the sublingual immunotherapy with Dermatophagoides farinae on asthma control level and pulmonary function of allergic asthma and rhinitis in adult patient

- Department of Otolaryngology Head and Neck Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China

More Information

Corresponding author: ZHANG Yinglong, E-mail: 8527179@qq.com

Received Date: 24 January 2019

摘要

摘要: 目的:评估舌下特异性免疫治疗(SLIT)成人变应性哮喘伴鼻炎患者的临床疗效及对哮喘控制水平和肺功能的影响。方法:回顾性分析182例18~60岁变应性哮喘伴鼻炎患者的临床资料,根据患者意愿分为药物组(66例)和SLIT组(116例)。药物组以小至中等剂量的吸入性糖皮质激素+长效β2受体激动剂及糠酸莫米松鼻喷剂+氯雷他定片对症治疗;SLIT组在此基础上给予粉尘螨滴剂进行SLIT。随访观察3年,评估两组患者治疗前后的哮喘控制测试(ACT)评分、呼气峰值流速占正常预计值的百分率(PEF%)、哮喘日间症状评分(DASS)、哮喘夜间症状评分(NASS)、鼻炎的症状评分(TNSS)以及药物评分(TMS)。结果:与治疗前比较,两组患者在治疗1年、2年、3年后的ACT、PEF%、DASS、NASS、TNSS和TMS均有显著变化,差异有统计学意义(均P<0.05);与治疗1年比较,治疗2年后SLIT组患者的ACT、PEF%、DASS、NASS、TNSS和TMS均进一步降低(均P<0.05),而药物组仅DASS、TMS显著降低(均P<0.05);治疗3年后仅SLIT组的DASS、TMS持续得到显著改善(均P<0.05)。治疗1年、2年和3年后,SLIT组的ACT、PEF%、DASS、NASS和TMS均显著优于药物组(均P<0.05);而TNSS在治疗2年和3年后才显著低于药物组(P<0.05)。结论:采用粉尘螨滴剂对尘螨致敏的成人哮喘伴鼻炎患者进行3年SLIT能获得比单纯药物治疗更显著的疗效,哮喘控制和肺功能改善也更显著。
- 舌下特异性免疫治疗 /
- 哮喘 /
- 鼻炎 /
- 成人 /
- 肺功能
Abstract: Objective: To evaluate the efficacy, asthma control level and pulmonary function of sublingual immunotherapy on allergic asthma and rhinitis in adult patient. Method: This retrospective analysis of 182 cases of adult patient from 18-60 years with allergic asthma and rhinitis, according to the patients' wishes they were divided into drug group(66 patients) and SLIT group(116 patients). Drug group patients were treated with low to moderate doses of inhaled corticosteroids+long-acting β2 receptor agonists and mometasone furoate nasal spray+desloratadine tablets as symptomatic treatment. SLIT group was treated by SLIT with Dermatophagoides farina drops on this basis. Before treatment and 1 year, 2 year and 3 years after treatment, the ACT, PEF%, DASS, NASS, TNSS and TMS were evaluated. Result: The ACT, PEF%, DASS, NASS, TNSS and TMS had continuously improved significantly 1 year, 2 year and 3 years after treatment in both groups comparing with baseline(P<0.05). Compared with 1 year after treatment, SLIT group had lower ACT, PEF%, DASS, NASS, TNSS and TMS in 2 years after treatment(all P<0.05), whereas drug group had lower TMS and DASS(all P<0.05). In 3 years of treatment, only SLIT group resulted in significant continuous improvement in DASS and TMS(all P<0.05). After 1 year, 2 and 3 years of treatment, SLIT group resulted in significantly better ACT, PEF%, DASS, NASS and TMS than drug group(all P<0.05). After 2 and 3 years of treatment, TNSS of SLIT group were significantly lower than in drug group(P<0.05). Conclusion: Sublingual immunotherapy for 3 years with Dermatophagoides farinae drops in adult patient with allergic asthma and rhinitis was more effective than drug therapy alone, and asthma control and lung function improved significantly.
- sublingual immunotherapy /
- asthma /
- rhinitis /
- adult /
- pulmonary function

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