舌下免疫治疗在过敏性鼻炎中的应用效果(1)
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[摘要] 目的 探讨舌下抗原特异性免疫在过敏性鼻炎中的应用效果。方法 过敏性鼻炎患者120例，随机分为观察组与对照组各60例，对照组予对症治疗，观察组在此基础上加舌下免疫治疗。对比两组疗效评价观察组安全性。结果 观察组总有效率显著高于对照组(P<0.05)；两组AR评分及用药评分均较前显著改善(P<0.05)，治疗后观察组显著低于对照组(P<0.05)；患者疗效自我评价显示，观察组总有效率显著高于对照组(P<0.05)；治疗后嗜酸细胞计数呈下降趋势；观察组无严重不良反应出现。结论 SLIT治疗AR疗效肯定，不良反应少，可达到根治目的。
[关键词] 舌下；抗原；特异性免疫；过敏性鼻炎
[中图分类号] R765.21 [文献标识码] B [文章编号] 1673-9701(2011)33-28-02
The Effect of the Sublingual Immunotherapy Application on Allergic Rhinitis
LV Jingyao
Department of Otorhinolaryngology，the Affiliated Taizhou City Hospital of Taizhou University of Medicine，Taizhou 318000，China
[Abstract] Objective To disscuss the effect of sublingual immunotherapy on allergic rhinitis. Methods All of 120 patients with AR were randomly divided into two groups， patients in the control group were given symptomatic treatment，observation group was given symptomatic treatment and sublingual immunotherapy. Results The total effective rate in the observation group was significantly higher than control group(P<0.05)；The symptom score and drug using score were improved significantly after treatment in both groups(P<0.05)，the observation group was significantly lower than control group(P<0.05)；The self-assessment of effcacy in observation group was significantly higher than control group(P<0.05). EOS account was reduced after treatment. There was no serious adverse reactions. Conclusion SLIT is effective and safty on patients with AR.
[Key words] Sublingual；Antigen；Specific immune；Allergic rhinitis
过敏性鼻炎(AR)多因接触变应原诱发，治疗主要包括远离变应原、药物对症及免疫治疗(SIT)等。有报道称，SIT可从源头上对AR进行治疗[1]。笔者应用变应原舌下含服免疫治疗(SLIT)60例AR患者，现报道如下。
1 资料与方法
1.1 一般资料
收集我院2010年2～12月AR患者120例，男68例，女52例，平均年龄(43.2±12.8)岁。均符合2004年AR诊断标准[2]，且经吸入性变应原皮肤点刺检测粉尘螨强阳性。随机分为观察组与对照组各60例，两组在性别、年龄、病程、变应原、鼻炎症状评分等方面无显著差异(P>0.05)，具可比性。
1.2 方法
1.2.1 变应原检查 抗原点刺溶液由浙江我武生物科技有限公司提供，用14种抗原配成皮试液，加阴性对照液(生理盐水)、阳性对照液(组胺)共16份，于患者前臂外侧各做8个点刺点，间距≥2cm，20min后观察反应结果。阳性标准：①风团直径为阳性对照的1/2，周围有红斑反应带为+；②风团直径与阳性对照相同，周围红斑反应带宽度≥10mm为++；③皮丘直径>15mm，或红斑形状不规则，周围红斑宽度≥2倍阳性对照反应带为+++；④局部反应同+++，同时出现周身皮痒、皮肤潮红、憋气、哮喘等为++++。+++和++++为强阳性反应。
1.2.2 治疗方法 ①对照组：轻者口服氯雷他定片(开瑞坦，上海先灵葆雅制药有限公司)，儿童5mg/d，成人10mg/d；重者联用布地奈德喷剂 ......
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