中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
12期
986-991
,共6页
朱亮%朱鲁平%陈若希%陶绮蕾%陆纪红%程雷
硃亮%硃魯平%陳若希%陶綺蕾%陸紀紅%程雷
주량%주로평%진약희%도기뢰%륙기홍%정뢰
鼻炎,变应性,常年性%免疫治疗%注射,皮下%投药,舌下%治疗结果
鼻炎,變應性,常年性%免疫治療%註射,皮下%投藥,舌下%治療結果
비염,변응성,상년성%면역치료%주사,피하%투약,설하%치료결과
Rhinitis,allergic,perennial%Immunotherapy%Injections,subcutaneous%Administration,sublingnal%Treatment outcome
目的 评价标准化尘螨变应原疫苗皮下免疫治疗(subcutaneous immunotherapy,SCIT)和舌下免疫治疗(sublingual immunotherapy,SLIT)对中-重度持续性变应性鼻炎(allergic rhinitis,AR)的临床效果.方法 98例中-重度持续性AR患者纳入本项开放性对照研究,分别采用SCIT和SLIT治疗方案.所有患者均对屋尘螨和粉尘螨过敏,完成2年的特异性免疫治疗.其中,SCIT组40例,年龄7～57岁,平均(x-±s,以下同)年龄为(19.0±2.7)岁；SLIT组58例,年龄6～ 50岁,平均年龄(17.7±3.2)岁.应用记分法和视觉模拟量表(visual analogue scale,VAS)进行鼻部症状评分.采用治疗前后对照,分别比较SCIT和SLIT两组患者治疗2年后鼻部症状评分的变化,并对两种治疗方法作一疗效比较.应用SAS 9.1.3软件对数据进行统计学分析.结果 免疫治疗2年后,SCIT组和SLIT组患者的喷嚏、流涕、鼻塞和鼻痒症状评分以及鼻部症状总评分(包括记分法和VAS)均明显下降,差异有统计学意义(Z值分别为-3.14、-3.76、-3.09、-3.48、-4.13;-3.63、-3.21、-2.48、-3.56、-3.98,P值均＜0.05).对两组患者治疗2年后的鼻部4个症状评分以及总评分(记分法)与治疗前相应各项评分(基线值)的差值进行比较,组间差异无统计学意义(Z值分别为-0.97、-0.67、-0.36、-0.04、-0.67,P值均＞0.05).然而,对两组患者免疫治疗前后鼻部症状VAS评分的差值进行比较,结果显示:治疗2年后SCIT组患者鼻塞VAS评分的下降更为显著,与SLIT组相比差异有统计学意义(t=-2.21,P=0.032)；但两组其余鼻部症状以及症状整体改善程度相似,差异无统计学意义(t值分别为-0.57、-1.93、-1.73、-0.99,P值均＞0.05).结论 尘螨过敏的中-重度持续性AR患者采用SCIT或SLIT进行2年特异性免疫治疗均能获得良好效果.SCIT可能对鼻塞症状的改善尤为显著,但两种治疗方式的总体疗效未见明显差别.
目的 評價標準化塵螨變應原疫苗皮下免疫治療(subcutaneous immunotherapy,SCIT)和舌下免疫治療(sublingual immunotherapy,SLIT)對中-重度持續性變應性鼻炎(allergic rhinitis,AR)的臨床效果.方法 98例中-重度持續性AR患者納入本項開放性對照研究,分彆採用SCIT和SLIT治療方案.所有患者均對屋塵螨和粉塵螨過敏,完成2年的特異性免疫治療.其中,SCIT組40例,年齡7～57歲,平均(x-±s,以下同)年齡為(19.0±2.7)歲；SLIT組58例,年齡6～ 50歲,平均年齡(17.7±3.2)歲.應用記分法和視覺模擬量錶(visual analogue scale,VAS)進行鼻部癥狀評分.採用治療前後對照,分彆比較SCIT和SLIT兩組患者治療2年後鼻部癥狀評分的變化,併對兩種治療方法作一療效比較.應用SAS 9.1.3軟件對數據進行統計學分析.結果 免疫治療2年後,SCIT組和SLIT組患者的噴嚏、流涕、鼻塞和鼻癢癥狀評分以及鼻部癥狀總評分(包括記分法和VAS)均明顯下降,差異有統計學意義(Z值分彆為-3.14、-3.76、-3.09、-3.48、-4.13;-3.63、-3.21、-2.48、-3.56、-3.98,P值均＜0.05).對兩組患者治療2年後的鼻部4箇癥狀評分以及總評分(記分法)與治療前相應各項評分(基線值)的差值進行比較,組間差異無統計學意義(Z值分彆為-0.97、-0.67、-0.36、-0.04、-0.67,P值均＞0.05).然而,對兩組患者免疫治療前後鼻部癥狀VAS評分的差值進行比較,結果顯示:治療2年後SCIT組患者鼻塞VAS評分的下降更為顯著,與SLIT組相比差異有統計學意義(t=-2.21,P=0.032)；但兩組其餘鼻部癥狀以及癥狀整體改善程度相似,差異無統計學意義(t值分彆為-0.57、-1.93、-1.73、-0.99,P值均＞0.05).結論 塵螨過敏的中-重度持續性AR患者採用SCIT或SLIT進行2年特異性免疫治療均能穫得良好效果.SCIT可能對鼻塞癥狀的改善尤為顯著,但兩種治療方式的總體療效未見明顯差彆.
목적 평개표준화진만변응원역묘피하면역치료(subcutaneous immunotherapy,SCIT)화설하면역치료(sublingual immunotherapy,SLIT)대중-중도지속성변응성비염(allergic rhinitis,AR)적림상효과.방법 98례중-중도지속성AR환자납입본항개방성대조연구,분별채용SCIT화SLIT치료방안.소유환자균대옥진만화분진만과민,완성2년적특이성면역치료.기중,SCIT조40례,년령7～57세,평균(x-±s,이하동)년령위(19.0±2.7)세；SLIT조58례,년령6～ 50세,평균년령(17.7±3.2)세.응용기분법화시각모의량표(visual analogue scale,VAS)진행비부증상평분.채용치료전후대조,분별비교SCIT화SLIT량조환자치료2년후비부증상평분적변화,병대량충치료방법작일료효비교.응용SAS 9.1.3연건대수거진행통계학분석.결과 면역치료2년후,SCIT조화SLIT조환자적분체、류체、비새화비양증상평분이급비부증상총평분(포괄기분법화VAS)균명현하강,차이유통계학의의(Z치분별위-3.14、-3.76、-3.09、-3.48、-4.13;-3.63、-3.21、-2.48、-3.56、-3.98,P치균＜0.05).대량조환자치료2년후적비부4개증상평분이급총평분(기분법)여치료전상응각항평분(기선치)적차치진행비교,조간차이무통계학의의(Z치분별위-0.97、-0.67、-0.36、-0.04、-0.67,P치균＞0.05).연이,대량조환자면역치료전후비부증상VAS평분적차치진행비교,결과현시:치료2년후SCIT조환자비새VAS평분적하강경위현저,여SLIT조상비차이유통계학의의(t=-2.21,P=0.032)；단량조기여비부증상이급증상정체개선정도상사,차이무통계학의의(t치분별위-0.57、-1.93、-1.73、-0.99,P치균＞0.05).결론 진만과민적중-중도지속성AR환자채용SCIT혹SLIT진행2년특이성면역치료균능획득량호효과.SCIT가능대비새증상적개선우위현저,단량충치료방식적총체료효미견명현차별.
Objective To investigate the clinical efficacy of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT)with standardized house dust mite(HDM)extract for persistent allergic rhinitis(PER).Methods Ninety-eight patients with moderate to severe PER caused by HDM and who completed SCIT(Alutard SQ,ALK-Abelló)or SLIT(Chanllergen-Df drops,Wolwo Pharma)regimen for two years were enrolled in this open-label controlled study.The patients were divided into two groups:SCIT group consisted of 40 patients aged 7 to 57 years old[(19.0 ± 2.7)years,(x-)± s],and SLIT group consisted of 58 patients aged 6 to 50 years old[(17.7 ± 3.2)years].The nasal symptoms(sneezing,rhinorrhea,nasal obstruction and pruritus)were evaluated using a four-point rating scale(from 0 =absent to 3 =severe)as well as 10 cm-visual analogue scale(VAS).Efficacy of SCIT and SLIT was assessed as the mean change from baseline in nasal symptom scores after 2-year course of immunotherapy,and the results were compared.SAS software version 9.1.3 was applied for statistical analysis.Results Both SCIT and SLIT significantly reduced the individual symptom score of sneezing,rhinorrhea,nasal obstruction and pruritus,and the total nasal symptom scores(including 4-point scale and VAS)after 2-year treatment when compared with the baseline(Z value were-3.14,-3.76,-3.09,-3.48,-4.13 ;-3.63,-3.21,-2.48,-3.56,-3.98,respectively,all P ＜ 0.05).There was no significant difference in decreased mean score of the individual and total nasal symptoms(4-point scale)between SCIT and SLIT groups(Z value were-0.97,-0.67,-0.36,-0.04,-0.67,respectively,all P ＞ 0.05).However,a significant reduction of VAS score of nasal obstruction was found in SCIT group after 2-year treatment,compared with SLIT group(t =-2.21,P =0.032).There was no significant difference in decreased VAS score of three other nasal symptoms as well as global rhinitis severity between two immunotherapy groups(t value were-0.57,-1.93,-1.73,-0.99,repectively,all P＞0.05).Conclusions Both SCIT and SLIT demonstrated clinical improvement in moderate to severe PER patients sensitized to HDM after two years treatment.It is suggested that SCIT may relieve nasal obstruction significantly; however,the overall clinical efficacy is consistent with SCIT and SLIT.
