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
2015年
2期
105-109
,共5页
罗志红%李彬%万浪%彭聪
囉誌紅%李彬%萬浪%彭聰
라지홍%리빈%만랑%팽총
鼻炎,变应性,常年性%脱敏法,免疫%治疗结果%问卷调查
鼻炎,變應性,常年性%脫敏法,免疫%治療結果%問捲調查
비염,변응성,상년성%탈민법,면역%치료결과%문권조사
Rhinitis,allergic,perennial%Desensitization,immunologic%Treatment outcome%Questionnaires
目的 观察并比较应用标准化尘螨变应原集群免疫治疗和常规免疫治疗变应性鼻炎(allergic rhinitis,AR)之间的临床疗效及安全性.方法 接受免疫治疗的中-重度持续性螨过敏AR患者共110例,采用随机数字表法分为2组,分别接受常规免疫治疗A组(57例)及集群免疫治疗B组(53例),A组失访7例,脱落率12.28％,B组失访1例,脱落率1.89％,比较两组在治疗7周、15周、1.0年、1.5年、2.0年时的鼻部症状评分、药物评分、迷你型鼻结膜炎生活质量调查问卷(Mini RQLQ)评分、临床疗效等,同时观察治疗2年过程中局部不良反应和全身不良反应发生率.以SPSS19.0软件进行统计学分析.结果 2组鼻部症状评分、药物评分、Mini RQLQ评分均较治疗前降低(P值均＜0.05).在7周和2.0年时集群免疫治疗组鼻部症状评分[(0.55 ±0.21)、(0.57 ±0.27)分]、5项Mini RQLQ评分及临床有效率(86.5％、94.2％)均优于常规治疗组[鼻部症状:(1.41±0.65)、(0.83 ±0.30)分,t值分别为11.344、5.649,P值均＜0.05;Mini RQLQ评分:P值均＜0.05;临床有效率:60.0％、80.0％,x2值分别为9.224、4.642,P值均＜0.05].在7周时集群免疫治疗组药物评分[(0.11 ±0.04)分]低于常规治疗组[(0.47±0.11)分,t=27.665,P＜0.05].局部和全身不良反应发生率在剂量累加阶段和剂量维持阶段集群免疫治疗组与常规免疫治疗组相比,差异均无统计学意义(P＞0.05).结论 对中-重度持续性螨过敏的AR,集群免疫治疗是一种安全的治疗方法,较常规免疫治疗更有效且起效更迅速.
目的 觀察併比較應用標準化塵螨變應原集群免疫治療和常規免疫治療變應性鼻炎(allergic rhinitis,AR)之間的臨床療效及安全性.方法 接受免疫治療的中-重度持續性螨過敏AR患者共110例,採用隨機數字錶法分為2組,分彆接受常規免疫治療A組(57例)及集群免疫治療B組(53例),A組失訪7例,脫落率12.28％,B組失訪1例,脫落率1.89％,比較兩組在治療7週、15週、1.0年、1.5年、2.0年時的鼻部癥狀評分、藥物評分、迷妳型鼻結膜炎生活質量調查問捲(Mini RQLQ)評分、臨床療效等,同時觀察治療2年過程中跼部不良反應和全身不良反應髮生率.以SPSS19.0軟件進行統計學分析.結果 2組鼻部癥狀評分、藥物評分、Mini RQLQ評分均較治療前降低(P值均＜0.05).在7週和2.0年時集群免疫治療組鼻部癥狀評分[(0.55 ±0.21)、(0.57 ±0.27)分]、5項Mini RQLQ評分及臨床有效率(86.5％、94.2％)均優于常規治療組[鼻部癥狀:(1.41±0.65)、(0.83 ±0.30)分,t值分彆為11.344、5.649,P值均＜0.05;Mini RQLQ評分:P值均＜0.05;臨床有效率:60.0％、80.0％,x2值分彆為9.224、4.642,P值均＜0.05].在7週時集群免疫治療組藥物評分[(0.11 ±0.04)分]低于常規治療組[(0.47±0.11)分,t=27.665,P＜0.05].跼部和全身不良反應髮生率在劑量纍加階段和劑量維持階段集群免疫治療組與常規免疫治療組相比,差異均無統計學意義(P＞0.05).結論 對中-重度持續性螨過敏的AR,集群免疫治療是一種安全的治療方法,較常規免疫治療更有效且起效更迅速.
목적 관찰병비교응용표준화진만변응원집군면역치료화상규면역치료변응성비염(allergic rhinitis,AR)지간적림상료효급안전성.방법 접수면역치료적중-중도지속성만과민AR환자공110례,채용수궤수자표법분위2조,분별접수상규면역치료A조(57례)급집군면역치료B조(53례),A조실방7례,탈락솔12.28％,B조실방1례,탈락솔1.89％,비교량조재치료7주、15주、1.0년、1.5년、2.0년시적비부증상평분、약물평분、미니형비결막염생활질량조사문권(Mini RQLQ)평분、림상료효등,동시관찰치료2년과정중국부불량반응화전신불량반응발생솔.이SPSS19.0연건진행통계학분석.결과 2조비부증상평분、약물평분、Mini RQLQ평분균교치료전강저(P치균＜0.05).재7주화2.0년시집군면역치료조비부증상평분[(0.55 ±0.21)、(0.57 ±0.27)분]、5항Mini RQLQ평분급림상유효솔(86.5％、94.2％)균우우상규치료조[비부증상:(1.41±0.65)、(0.83 ±0.30)분,t치분별위11.344、5.649,P치균＜0.05;Mini RQLQ평분:P치균＜0.05;림상유효솔:60.0％、80.0％,x2치분별위9.224、4.642,P치균＜0.05].재7주시집군면역치료조약물평분[(0.11 ±0.04)분]저우상규치료조[(0.47±0.11)분,t=27.665,P＜0.05].국부화전신불량반응발생솔재제량루가계단화제량유지계단집군면역치료조여상규면역치료조상비,차이균무통계학의의(P＞0.05).결론 대중-중도지속성만과민적AR,집군면역치료시일충안전적치료방법,교상규면역치료경유효차기효경신속.
Objective To compare the efficacy and safety of subcutaneous immunotherapy with dermatophagoides pteronyssinus standardized extract given in conventional and cluster immunotherapy schedules for persistent allergic rhinitis.Methods One hundred and ten patients with moderate to severe allergic rhinitis caused by dust mites,in accordance with the immunotherapy inclusion criteria,were allocated to receive conventional immunotherapy as group A (n =57) or cluster immunotherapy as group B (n =53).In group A,7 cases were lost to follow-up,the expulsion rate of group A was 12.28％ ; in group B,1 case was lost to follow-up,the expulsion rate of group B was 1.89％.Nasal symptom scores,medicine scores and mini rhinoconjunctivitis quality of life questionnaire (Mini RQLQ) were recorded and compared before and after 7 weeks,15 weeks,1.0 year,1.5 years,2.0 years.All the scores were assessed to evaluate the clinical efficacy,and also the incidence of local and systemic adverse reactions were registered to evaluate the safety.SPSS 19.0 software was used to analyze the data.Results Nasal symptom scores,medicine scores and Mini RQLQ of both groups were significant lower than those before the treatment (all P ＜ 0.05).Mini RQLQ and nasal symptom scores in cluster group (0.55 ± 0.21,0.57 ± 0.27) were more significantly declined than the conventional group after 7 weeks and 2.0 years of observation (all PMini RQLQ ＜ 0.05 ; nasal symptom scores:1.41 ± 0.65,0.83 ± 0.30,t value was 11.344,5.649,both P ＜ 0.05).The clinical efficiency rate in cluster group (86.5％,94.2％) were more significantly highter than those (60.0％,80.0％) in the conventional group after 7 weeks and 2 years of observation(x2 value was 9.224,4.642,both P ＜ 0.05).The medicine scores in cluster group (0.11 ± 0.04) was more significantly declined than conventional group (0.47 ± 0.11) after 7 weeks (t =27.665,P ＜ 0.05).The incidence of local and systemic adverse reactions during the incremental-dose phase and maintenance-dose phase compared with conventional immunotherapy were not significantly different (P ＞ 0.05).Conclusion The cluster immunotherapy is a safe treatment method which is more effective and faster than conventional immunotherapy to the dust mites caused allergic rhinitis.
