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目的:观察变应原舌下特异性免疫(SLIT)治疗变应性鼻炎的疗效及安全性。方法:选择在我院确诊的尘螨相关性变应性鼻炎不伴哮喘280例,随机分为观察组132例和对照组148例。对照组根据鼻部症状控制情况采用常规对症治疗,轻度症状者使用氯雷他定片,中度或重度症状者根据病情需要联合应用丙酸氟替卡松鼻喷剂喷鼻;观察组在对照组基础上加用变应原SLIT治疗,将粉尘螨滴剂(1~5号)滴于舌下,含1~3min后吞咽,每天睡前用药。向所有入组病例发放记录卡,记录每天对症用药情况、鼻炎症状评分、疗效评估和不良反应发生情况。治疗6个月后,比较两组上述指标。结果:(1)观察组对症用药得分(0.29±0.17)分,非常显著低于对照组的(0.91±0.21)分(P<0.01)。(2)两组治疗后鼻炎症状评分均较治疗前非常显著下降(P<0.01),其中,观察组较对照组下降更显著(P<0.01)。(3)观察组鼻炎症状消失96例,占72.7%;对照组鼻炎症状消失56例,占37.8%;两组比较,差异非常显著(P<0.01)。观察组总体有效率93.9%(124/132),对照组为48.7%(72/148);两组比较,差异非常显著(P<0.01)。观察组发作严重程度改善率93.2%(123/132),发作频率改善率90.2%(119/132);对照组发作严重程度改善率40.0%(59/148),发作频率改善率40.5%(60/148);两组比较,均差异非常显著(P<0.01)。(4)观察组中1例初用5号滴剂时出现轻度口、眼发痒,未做特殊处理,1周后症状消失。两组均无一例发生中、重度及严重全身不良反应。结论:变应原SLIT治疗尘螨相关性变应性鼻炎,疗效满意,且较安全。
Objective: To observe the efficacy and safety of allergen sublingual immunotherapy (SLIT) in the treatment of allergic rhinitis. Methods: Two hundred and eighty cases of allergic rhinitis without dust associated with dust mite were selected and randomly divided into observation group (132 cases) and control group (148 cases). The control group according to the nasal symptom control using conventional symptomatic treatment, mild symptoms of loratadine tablets, moderate or severe symptoms according to the needs of the disease combined with fluticasone propionate nasal spray nasal spray; observation group in the control group based On the addition of allergen SLIT treatment, the dust mite drops (1 to 5) drops sublingually, containing 1 ~ 3min swallowing, medication before bedtime. Record cards were distributed to all enrolled patients and symptomatic drug use, rhinitis symptom score, efficacy evaluation and adverse reactions were recorded daily. After 6 months of treatment, the above two indicators were compared. Results: (1) The score of symptomatic medication in the observation group (0.29 ± 0.17) was significantly lower than that of the control group (0.91 ± 0.21) (P <0.01). (2) The symptom score of rhinitis in both groups after treatment was significantly lower than that before treatment (P <0.01), in which the observation group decreased more significantly than the control group (P <0.01). (3) The symptoms of rhinitis in observation group disappeared in 96 cases, accounting for 72.7%. The symptoms of rhinitis in control group disappeared in 56 cases, accounting for 37.8%. The differences between the two groups were significant (P <0.01). The overall effective rate was 93.9% (124/132) in the observation group and 48.7% (72/148) in the control group. The difference between the two groups was significant (P <0.01). The improvement rate of seizure frequency in the observation group was 93.2% (123/132), seizure frequency improvement rate was 90.2% (119/132), the control group seizure severity improvement rate was 40.0% (59/148) and seizure frequency improvement rate was 40.5% (60) / 148). The differences between the two groups were significant (P <0.01). (4) In the observation group, 1 patient initially had slight mouth and itchy eyes with No. 5 drops, without special treatment, the symptoms disappeared after 1 week. None of the two groups had any moderate, severe or severe systemic adverse reactions. Conclusion: Allergen SLIT can treat dust mite-associated allergic rhinitis with satisfactory curative effect and safety.