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目的:观察卡介菌多糖核酸(BCGPSN)治疗常年性变应性鼻炎(PAR)的临床疗效,并讨论其免疫学机制。方法:将100例年龄≥10岁PAR患者分为3组,第1组注射BCGPSN28例;第2组注射BCGPSN加吸入激素37例;第3组单纯吸入激素35例。观察用药6周后血清总IgE,结核菌素皮肤试验(PPD)及临床疗效的变化。结果:第1、2组治疗后总IgE比治疗前有显著降低,第3组则无变化。治疗前3组PPD阳性率仅为21%,治疗后应用BCGPSN的第1、2组阳转率分别为30.4%及32.1%,两组总阳转率为31.4%。评定3组疗效,第1组治疗总有效率71.4%,第3组为97.1%,第2组则可达100%。结论:BCGPSN对常年性变应性鼻炎具有一定的治疗效果,对控制复发亦有较好效果。其治疗机制可能为抑制患者体内Th2反应,并促使Th亚群向Th1转化,从而阻止Ⅰ型变态反应的发病。
Objective: To observe the clinical efficacy of BCGPSN for the treatment of perennial allergic rhinitis (PAR) and to discuss its immunological mechanism. Methods: One hundred patients with PAR ≥10 years old were divided into three groups. Group 1 received BCGPSN in 28 cases. Group 2 received BCGPSN plus inhaled steroid in 37 cases. Group 3 received inhaled steroid alone in 35 cases. The changes of total serum IgE, tuberculin skin test (PPD) and clinical efficacy were observed after 6 weeks of treatment. Results: The total IgE after treatment in groups 1 and 2 was significantly lower than that before treatment, while in group 3 there was no change. The positive rate of PPD in the three groups before treatment was only 21%. After the treatment, the positive rates of BCGPSN in groups 1 and 2 were 30.4% and 32.1% respectively, and the total positive conversion rate was 31.4% in both groups. The efficacy of the three groups was evaluated. The total effective rate of the first group was 71.4%, that of the third group was 97.1%, and that of the second group was 100%. Conclusion: BCGPSN has certain therapeutic effect on perennial allergic rhinitis and also has good effect on controlling recurrence. The therapeutic mechanism may be to inhibit Th2 response in patients and promote Th subtype transformation to Th1, thereby preventing the onset of type I allergic reactions.