儿童过敏性鼻炎舌下免疫治疗的效果分析及显效时间判断

doi:10.11958/20230138

摘要/Abstract

摘要：

目的探讨舌下免疫治疗（SLIT）对儿童螨过敏性鼻炎（AR）的疗效，并判断其显效时间。方法纳入螨AR患儿64例，按疗程每日1次舌下含服对应粉尘螨滴剂，同时按需使用对症药物。按学龄分为≤6岁组和>6岁组，对2组间以及组内SLIT治疗前、治疗半年、1年后的鼻部症状总评分（TNSS）、药物总评分（TMS）及视觉模拟量表（VAS）评分进行比较。结果 64例AR患儿经SLIT半年后的TNSS、TMS、VAS评分均明显低于治疗前，治疗1年后进一步降低（均P<0.05）。≤6岁组和>6岁组间治疗前、治疗半年及1年后TNSS、TMS、VAS评分差异均无统计学意义（均P>0.05）；2组内治疗半年后各项评分均低于治疗前，治疗1年后评分进一步降低（均P<0.05）。结论 AR患儿接受SLIT后显示良好临床效果，应尽早开展SLIT以减少远期并发症的发生。

关键词: 鼻炎，过敏性, 舌下免疫疗法, 儿童, 评分, 显效时间

Abstract:

Objective To investigate the efficacy of sublingual immunotherapy (SLIT) in children with mite allergic rhinitis (AR) and to determine the time to efficacy. Methods Sixty-four children with mite AR were recruited and treated with sublingual corresponding dust mite drops once daily according to the treatment schedule, along with symptomatic medication as needed. The patients were divided into the ≤6 years old group and the >6 years old group according to school age. The TNSS, TMS and VAS scores were compared before, half a year, and one year after SLIT treatment between the two groups and within the groups. Results Compared with pre-treatment, TNSS, TMS and VAS scores were significantly reduced in 64 AR children after half a year of SLIT treatment, and scores further reduced after one year of treatment (P<0.05). There were no significant differences in TNSS, TMS and VAS scores before treatment, half a year and one year after treatment between the ≤6 years old group and the >6 years old group (P>0.05). All scores were significantly lower after half a year of treatment than those before treatment in the two groups, and scores were further reduced after one year treatment (P<0.05). Conclusion Children with AR have shown good clinical results after SLIT, and should be initiated as early as possible to reduce the occurrence of long-term complications.

Key words: rhinitis, allergic, sublingual immunotherapy, child, score, time to efficacy

中图分类号:

R765.213

图/表 2

参考文献 16

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时间	TNSS	TMS	VAS
治疗前	8.0（8.0，8.0）	3.0（3.0，3.0）	8.0（8.0，8.0）
治疗半年	2.0（2.0，2.0）^a	2.0（2.0，2.0）^a	5.0（5.0，5.0）^a
治疗1年	1.0（1.0，1.0）^ab	0.0（0.0，0.0）^ab	3.0（3.0，3.0）^ab
χ²	126.095^＊＊	124.097^＊＊	128.000^＊＊

时间	TNSS	TMS	VAS
治疗前	8.0（8.0，8.0）	3.0（3.0，3.0）	8.0（8.0，8.0）
治疗半年	2.0（2.0，2.0）^a	2.0（2.0，2.0）^a	5.0（5.0，5.0）^a
治疗1年	1.0（1.0，1.0）^ab	0.0（0.0，0.0）^ab	3.0（3.0，3.0）^ab
χ²	126.095^＊＊	124.097^＊＊	128.000^＊＊

组别		n	TNSS
组别		n	治疗前	治疗半年		治疗1年		χ²
≤6岁组		21	8（7，8）	2.0（2.0，2.0）^a		1.0（1.0，1.5）^ab		41.073^＊＊
>6岁组		43	8（8，8）	2.0（2.0，2.0）^a		1.0（1.0，1.0）^ab		85.035^＊＊
Z			0.371	0.181		0.464
组别	TMS
组别	治疗前				治疗半年		治疗1年		χ²
≤6岁组	3.0（3.0，3.0）				2.0（2.0，2.0）^a		0.0（0.0，0.5）^ab		40.519^＊＊
>6岁组	3.0（3.0，3.0）				2.0（2.0，2.0）^a		0.0（0.0，0.5）^ab		83.725^＊＊
Z	0.878				0.499		1.250
组别	VAS
组别	治疗前				治疗半年		治疗1年		χ²
≤6岁组	8.0（8.0，8.0）				5.0（5.0，5.0）^a		3.0（3.0，3.0）^ab		42.000^＊＊
>6岁组	8.0（8.0，8.0）				5.0（5.0，5.0）^a		3.0（3.0，3.0）^ab		86.000^＊＊
Z	0.035				0.113		1.287

组别		n	TNSS
组别		n	治疗前	治疗半年		治疗1年		χ²
≤6岁组		21	8（7，8）	2.0（2.0，2.0）^a		1.0（1.0，1.5）^ab		41.073^＊＊
>6岁组		43	8（8，8）	2.0（2.0，2.0）^a		1.0（1.0，1.0）^ab		85.035^＊＊
Z			0.371	0.181		0.464
组别	TMS
组别	治疗前				治疗半年		治疗1年		χ²
≤6岁组	3.0（3.0，3.0）				2.0（2.0，2.0）^a		0.0（0.0，0.5）^ab		40.519^＊＊
>6岁组	3.0（3.0，3.0）				2.0（2.0，2.0）^a		0.0（0.0，0.5）^ab		83.725^＊＊
Z	0.878				0.499		1.250
组别	VAS
组别	治疗前				治疗半年		治疗1年		χ²
≤6岁组	8.0（8.0，8.0）				5.0（5.0，5.0）^a		3.0（3.0，3.0）^ab		42.000^＊＊
>6岁组	8.0（8.0，8.0）				5.0（5.0，5.0）^a		3.0（3.0，3.0）^ab		86.000^＊＊
Z	0.035				0.113		1.287