CAJ | 학술논문

目的探讨舌下含服粉尘螨滴剂1～4号舌下特异性免疫治疗(SLIT)对儿童持续性变态反应性哮喘的临床疗效.方法选取2011年1月至2011年8月于本院儿科门诊接受舌下粉尘螨滴剂含服治疗并随访26周的78例轻-中度持续性变态反应性哮喘患儿为研究对象.将其按照就诊顺序随机分为SLIT组(n=40)和对照组(n=38).持续性变态反应性哮喘的诊断标准参照《儿童支气管哮喘诊断与防治指南》.两组患儿性别、平均年龄、病程及病情严重度等比较,差异无统计学意义(P＞0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与其签署临床研究知情同意书).SLIT组患儿舌下含服粉尘螨滴剂1～4号联合吸入糖皮质激素(ICS)布地奈德气雾剂治疗,对照组仅给予布地奈德气雾剂吸入治疗(剂量与治疗组相同).比较两组患儿哮喘控制测试(ACT)评分、布地奈德气雾剂吸入剂量、呼气流速峰值(PEFR)占预计值百分比(％)及不良反应发生情况.结果与对照组比较,SLIT组在治疗结束26周时,ACT评分高、布地奈德气雾剂吸入剂量小、PEFR占预计值的百分比高,且差异均有统计学意义(P＜0.05).两组均无重度全身不良反应发生.结论 SLIT能明显改善持续性变态反应性哮喘患儿的临床症状,减少布地奈德气雾剂吸入量,提高患儿的生活质量.
목적 탐토설하함복분진만적제1～4호설하특이성면역치료(SLIT)대인동지속성변태반응성효천적림상료효.방법 선취2011년1월지2011년8월우본원인과문진접수설하분진만적제함복치료병수방26주적78례경-중도지속성변태반응성효천환인위연구대상.장기안조취진순서수궤분위SLIT조(n=40)화대조조(n=38).지속성변태반응성효천적진단표준삼조《인동지기관효천진단여방치지남》.량조환인성별、평균년령、병정급병정엄중도등비교,차이무통계학의의(P＞0.05)(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상감호인적지정동의,병여기첨서림상연구지정동의서).SLIT조환인설하함복분진만적제1～4호연합흡입당피질격소(ICS)포지내덕기무제치료,대조조부급여포지내덕기무제흡입치료(제량여치료조상동).비교량조환인효천공제측시(ACT)평분、포지내덕기무제흡입제량、호기류속봉치(PEFR)점예계치백분비(％)급불량반응발생정황.결과 여대조조비교,SLIT조재치료결속26주시,ACT평분고、포지내덕기무제흡입제량소、PEFR점예계치적백분비고,차차이균유통계학의의(P＜0.05).량조균무중도전신불량반응발생.결론 SLIT능명현개선지속성변태반응성효천환인적림상증상,감소포지내덕기무제흡입량,제고환인적생활질량.
Objective To investigate the effects of sublingual Dermatophagoides Farinae drops 1-4 by sublingual specific immunotherapy ( SLIT ) in children with persistent allergic asthma.Methods The clinical data of 78 patients with mild to moderate persistent allergic asthmatic who had been treated by sublingual Dermatophagoides Farinae drops from January to August,2011 in the department of pediatrics in Guangdong Women and Children's Hospital and received 26 weeks of follow-up.They were randomly divided into SLIT group (n=40) and control group (n =38) according to visiting sequence. Persistent allergic asthma diagnostic criteria was Children Bronchial Asthma Diagnosis and Prevention Guide.There had no significance difference between two groups among gender,average age,course and severity of persistent allergic asthma (P＞0.05).Informed consent was obtained from the parents of each participating child.Treatment projects of SLIT group and control group were sublingual Dermatophagoides Farinae drops 1-4 combined with an inhaled corticosteroid (ICS) budesonide aerosol,and an inhaled ICS budesonide aerosol (the same dosage as SLIT group) only,respectively.Analysis of asthma control test (ACT) score,dosage of budesonide aerosol,peak expiratory flow rate (PEFR) in predicted percentage (％),and severe adverse events in two groups.Results After 26 weeks of the end of treatment,there had significance difference between two groups among ACT score, dosage of budesonide aerosol,PEFR in predicted percentage (P＜0.05). There were no severe adverse events in both groups. Conclusions SLIT can obviously improve the clinical symptoms of children with persistent allergic asthma,decrease of ICS content,improve the quality of life of children.