Preliminary study on life quality assessment of adult allergic rhinitis in immunotherapy, drug guidance and supervised treatment
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摘要: 目的 应用鼻-结膜炎相关生活质量问卷(RQLQ)评估药物或免疫治疗对成人变应性鼻炎(AR)患者生活质量的影响。方法 共纳入142例患者，其中接受特异性免疫治疗(SIT)的患者37例(SIT组); 其余105例患者均接受规范化药物治疗，根据是否接受过药物应用的指导分为接受药物应用指导组(A1组)87例和未接受药物应用指导组(A2组)18例; 根据是否接受过药物应用的监督分为接受药物应用监督组(B1组)33例和未接受药物应用监督组(B2组)72例。采用电话随访，应用RQLQ评估患者日常活动、睡眠、非鼻-眼症状、鼻部症状、眼部症状、实际问题及情感7大方向，共计28个小项的调查。研究数据用SPSS 17.0软件进行分析处理。结果 文化程度越高的AR患者生活质量评分越高(P < 0.05)。AR患者性别对心理情感障碍的影响无统计学意义(P>0.05)。免疫治疗后对于鼻部症状、眼部症状的改善较治疗前明显(P < 0.01)。SIT组和A1组治疗后鼻部症状的改善程度更为明显(P < 0.05)。A1组和B1组治疗后生活质量均较治疗前明显改善(P < 0.01)。接受治疗后A1组较A2组在生活质量上有明显改善(P < 0.01或P < 0.05);B1组较B2组在生活质量上有明显改善(P < 0.05或P < 0.01)。结论 AR患者无论接受单纯药物治疗还是免疫治疗，其生活质量均可得到一定程度的改善，SIT较药物治疗具有更好的疗效。加强用药指导和宣传教育可提高AR患者的生活质量。Abstract: Objective Effects of drugs or immunotherapy on the quality of life of adult patients with allergic rhinitis(AR) were assessed using the rhinoconjunctivitis quality of life questionnaire(RQLQ).Method A total of 142 patients were included, including 37 patients receiving specific immunotherapy(SIT)(SIT group). The remaining 105 patients received standardized drug treatment, and were divided into 87 cases in the receiving drug application instruction group(A1 group) and 18 cases in the non-receiving drug application instruction group(A2 group) according to whether or not receiving the drug application guidance group. According to whether or not receiving supervision of drug applications, they were divided into 33 cases of receiving drug application supervision group(B1 group) and 72 cases of non-receiving drug application supervision group(B2 group). Using telephone follow-up, RQLQ was used to evaluate the patients 'daily activities, sleep, non-nasal-eye symptoms, nasal symptoms, eye symptoms, practical problems, and emotional 7 major directions, a total of 28 small surveys. Research data was analyzed and processed by SPSS 17.0 software.Result The higher the education level, the higher the quality of life score of patients with allergic rhinitis(P < 0.05). There was no statistically significant effect of gender on psychomotor disorder in AR patients(P>0.05). Immunotherapy improved nasal and ocular symptoms and possess statistical significance(P < 0.01). The improvement of nasal symptoms was more pronounced in SIT group and A1 group(P < 0.05). The quality of life of A1 group and B1 group improved significantly after treatment(P < 0.01). After treatment, A1 group had a significant improvement in quality of life compared to A2 group(P < 0.01 or P < 0.05); The B1 group had a significant improvement in the quality of life compared to the B2 group(P < 0.05 or P < 0.01).Conclusion Life quality of AR patients can be improved to a certain extent, with simple drug therapy or immunotherapy, and SIT is more effective than drug therapy. The quality of life of AR patients can be improved by improving medication guidance and publicity.
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Key words:
- rhinitis, allergic /
- specific immunotherapy /
- quality of life /
- drugs therapy /
- drugs supervision
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表 1 A1组患者治疗前后生活质量评分比较
x±s 治疗前 治疗后 Z P 日常活动 3.94±4.97 2.77±3.79 -3.596 < 0.01 睡眠 4.97±4.85 2.38±3.25 -5.033 < 0.01 非鼻-眼症状 8.87±8.62 4.70±6.09 -5.053 < 0.01 实际问题 6.49±5.04 3.69±3.47 -5.043 < 0.01 鼻部症状 10.27±4.30 6.03±4.11 -6.433 < 0.01 眼部症状 5.32±5.06 2.74±3.56 -5.886 < 0.01 情感 4.79±5.03 2.90±3.49 -3.513 < 0.01 
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表 2 B1组患者治疗前后生活质量评分比较
x±s 治疗前 治疗后 Z P 日常活动 4.06±5.51 2.42±3.82 -2.854 < 0.01 睡眠 5.70±4.95 1.67±2.01 -4.004 < 0.01 非鼻-眼症状 8.61±8.30 3.61±5.31 -3.265 < 0.01 实际问题 7.09±4.93 3.00±3.04 -3.919 < 0.01 鼻部症状 9.91±3.84 4.58±4.26 -4.367 < 0.01 眼部症状 6.00±5.25 2.03±3.08 -4.165 < 0.01 情感 4.64±4.94 2.12±2.60 -2.563 < 0.05
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表 3 SIT组患者在治疗前后生活质量评分比较
x±s 治疗前 治疗后 Z P 鼻部症状 11.11±1.88 7.41±3.17 -4.868 < 0.01 眼部症状 3.41±3.31 1.73±2.57 -3.755 < 0.01
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表 4 A1组和A2组患者治疗后生活质量评分比较
x±s A1组 A2组 Z P 日常活动 2.80±3.84 5.91±3.68 -2.854 < 0.01 睡眠 2.41±3.31 4.59±3.92 -4.004 < 0.01 非鼻-眼症状 4.84±6.19 7.41±6.46 -3.265 < 0.01 实际问题 3.72±3.55 6.68±3.27 -3.919 < 0.01 鼻部症状 6.14±4.18 8.41±4.20 -4.367 < 0.01 眼部症状 2.76±3.63 4.91±4.07 -4.165 < 0.01 情感 2.98±3.55 5.91±4.53 -2.563 < 0.05
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表 5 B1组和B2组患者治疗后生活质量评分比较
x±s B1组 B2组 Z P 日常活动 2.42±3.82 3.92±4.01 -2.087 < 0.05 睡眠 1.67±2.01 3.40±3.95 -2.134 < 0.05 非鼻-眼症状 3.61±5.31 6.17±6.60 -2.188 < 0.05 实际问题 3.00±3.04 4.79±3.81 -2.301 < 0.05 鼻部症状 4.58±4.26 7.42±4.03 -4.007 < 0.01 眼部症状 2.03±3.08 3.75±4.01 -2.483 < 0.05 情感 2.12±2.60 4.19±4.20 -2.207 < 0.05
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表 6 SIT组和A1组患者治疗前后生活质量评分比较
x±s SIT组 A1组 Z P 鼻部症状 治疗前 11.11±1.88 10.28±4.30 -1.208 >0.05 治疗后 3.41±3.31 5.32±5.06 -2.388 < 0.05 眼部症状 治疗前 7.41±3.17 6.03±4.11 -1.842 >0.05 治疗后 1.73±2.57 2.74±3.56 -1.573 >0.05
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表 7 A1组和B1组患者治疗后生活质量评分比较
x±s A1组 B1组 Z P 日常活动 2.77±3.79 2.42±3.83 -0.651 >0.05 睡眠 2.38±3.25 1.67±2.01 -0.810 >0.05 非鼻-眼症状 4.70±6.09 3.61±5.32 -1.052 >0.05 实际问题 3.69±3.47 3.00±3.04 -0.991 >0.05 鼻部症状 6.03±4.11 4.58±4.27 -2.443 < 0.05 眼部症状 2.74±3.56 2.03±3.08 -1.267 >0.05 情感 2.90±3.49 2.12±2.60 -0.691 >0.05
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[1] Schatz M, Zeiger RS, Chen W, et al. A comparison of the psychometric properties of the Mini-Rhinitis Quality of Life Questionnaire and the Rhinitis Control Assessment Test[J]. Am J Rhinol Allergy, 2012, 26(2): 127-133. doi: 10.2500/ajra.2012.26.3744
[2] Baiardini I, Bousquet PJ, Brzoza Z, et al. Recommendations for assessing patient-reported outcomes and health-related quality of life in clinical trials on allergy: a GA(2) LEN taskforce position paper[J]. Allergy, 2010, 65(3): 290-295. doi: 10.1111/j.1398-9995.2009.02263.x
[3] Juniper EF. Measuring health-related quality of life in rhinitis[J]. J Allergy Clin Immunol, 1997, 99(2): S742-749. doi: 10.1016/S0091-6749(97)90000-2
[4] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 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. doi: 10.3760/cma.j.issn.1673-0860.2016.01.004
[5] Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis[J]. Clin Exp Allergy, 1991, 21(1): 77-83. doi: 10.1111/j.1365-2222.1991.tb00807.x
[6] Leong KP, Chan SP, Tang CY, et al. Quality of life of patients with perennial allergic rhinitis: preliminaryvalidation of the Rhinoconjunctivitis Quality of Life Questionnaire in Singapore[J]. Asian Pac J Allergy Immunol, 1999, 17(3): 163-167.
[7] Nascimento Silva M, Naspitz C, Solé D. Evaluation of quality of life in children and teenagers with allergic rhinitis: adaptation and validation of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ)[J]. Allergol Immunopathol(Madr), 2001, 29(4): 111-118. doi: 10.1016/S0301-0546(01)79042-8
[8] Soler R, De La Hoz B, Badia X, et al. Validation of the Spanish version of the Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)[J]. Rev Clin Esp, 2004, 204(3): 131-138. doi: 10.1016/S0014-2565(04)71417-4
[9] Okuda M, Ohkubo K, Goto M, et al. Comparative study of two Japanese rhinoconjunctivitis quality-of-lifequestionnaires[J]. Acta Otolaryngol, 2005, 125(7): 736-744. doi: 10.1080/00016480510026944
[10] Di Lorenzo G, Pacor ML, Amodio E, et al. Differences and similarities between allergic and nonallergic rhinitis in a large sample of adult patients with rhinitis symptoms[J]. Int Arch Allergy Immunol, 2011, 155(3): 263-270. doi: 10.1159/000320050
[11] 刘晓玲, 罗鸿, 余晔, 等. 三级预防健康教育管理与生活方式干预在变应性鼻炎治疗中的作用研究[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(17): 783-788. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201217008.htm
[12] Bunnag C, Leurmarnkul W, Jareoncharsri P, et al. Quality of life assessment in Thai patients with allergic rhinoconjunctivitis using the SF-36 questionnaire(Thai version)[J]. Rhinology, 2005, 43(2): 99-103.
[13] Okubo K, Gotoh M, Shimada K, et al. Fexofenadine improves the quality of life and work productivity in Japanese patients with seasonal allergic rhinitis during the peak cedar pollinosis season[J]. Int Arch Allergy Immunol, 2005, 136(2): 148-154. doi: 10.1159/000083322
[14] Peng GC, Hsu CH. The efficacy and safety of heat-killedLactobacillus paracasei for treatment of perennial allergic rhinitisinduced by house-dust mite[J]. Pediatr Allergy Immunol, 2005, 16(5): 433-438. doi: 10.1111/j.1399-3038.2005.00284.x
[15] Walter Canonica G, Bousquet J, Van Hammée G, et al. Levocetirizine improves health-related quality of life and healthstatus in persistent allergic rhinitis[J]. Respir Med, 2006, 100(10): 1706-1715. doi: 10.1016/j.rmed.2006.03.039
[16] 刘晓玲, 罗鸿, 张建斌, 等. 成人变应性眼患者治疗前后生活质量评估及其影响因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(5): 392-395. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201505003.htm
[17] 王向东, 张罗, 赵岩, 等. 成人持续性变应性鼻炎生活质量评价和相关性分析[J]. 中国耳鼻咽喉头颈外科, 2007, 14(1): 667-669. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT200711020.htm
[18] 张薇, 尤易文, 顾苗, 等. 80例成人持续性变应性鼻炎治疗前后生活质量评估[J]. 重庆医学, 2013, 42(31): 3776-3778. doi: 10.3969/j.issn.1671-8348.2013.31.019
[19] 张念武, 董曦文, 王利霞, 等. 变应性鼻炎患者的生活质量状况及影响因素[J]. 山东医药, 2014, 54(13): 78-79. doi: 10.3969/j.issn.1002-266X.2014.13.035
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