儿童过敏性鼻炎粉尘螨特异性舌下免疫治疗短期疗效评估

doi:10.6040/j.issn.1673-3770.0.2021.117

摘要/Abstract

摘要： 目的评估尘螨过敏的过敏性鼻炎患儿进行舌下免疫治疗的短期疗效。方法回顾性分析2019年至2020年就诊于首都儿科研究所附属儿童医院耳鼻咽喉头颈外科,应用粉尘螨舌下特异性免疫治疗满6个月的患儿,分析其治疗前后的视觉模拟量表评分(VAS)、鼻部总症状评分(TNSS)、总用药评分(TMS)、症状药物联合评分(CSMS)。结果共纳入50例过敏性鼻炎患儿,平均(7.7±2.7)岁。治疗前VAS、TNSS、TMS、CSMS评分分别为(5.5±1.6)分、(5.5±2.2)分、(3.0±0.1)分、(4.3±0.6)分,治疗后6个月上述评分分别为(2.5±1.4)分、(2.2±1.6)分、(0.6±1.1)分、(1.2±1.2)分,治疗后较治疗前各评分均有下降(P<0.05)。结论粉尘螨舌下免疫治疗对于尘螨过敏性鼻炎的患儿短期疗效较好。

关键词: 过敏性鼻炎, 尘螨, 舌下免疫治疗

Abstract: Objective To evaluate the short-term effect of Dermatophagoides farinae specific sublingual immunotherapy for children with allergic rhinitis. Methods Children attended in the department of otorhinolaryngology head and neck surgery, Capital Institute of Pediatrics affiliated Children's Hospital and received Dermatophagoides farinae specific sublingual immunotherapy for 6 months were enrolled from 2019 to 2020. Visual analogue scale(VAS), total nasal symptoms score(TNSS), total medication score(TMS), and combined symptom and medication score(CSMS)before and after immunotherapy were collected. Results In total 50 children with allergic rhinitis were enrolled, with an average age of(7.7±2.7)years old. Before immunotherapy, VAS, TNSS, TMS and CSMS was(5.5±1.6)score,(5.5±2.2)score,(3.0±0.1)score,(4.3±0.6)score, respectively. And after immunotherapy for 6 months, VAS, TNSS, TMS and CSMS was(2.5±1.4)score,(2.2±1.6)score,(0.6±1.1)score,(1.2±1.2)score, respectively. The scores were all decreased significantly after immunotherapy(P<0.05). Conclusion Short term efficacy of Dermatophagoides farinae specific sublingual immunotherapy is good for children with allergic rhinitis.

Key words: Allergic rhinitis, Dermatophagoides farinae, Sublingual immunotherapy

中图分类号:

R765

庞冲,边赛男,张冰,尹旭,陆颖霞,叶鹏飞,王湛,赵晶,高彦,关凯. 儿童过敏性鼻炎粉尘螨特异性舌下免疫治疗短期疗效评估[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 70-74.

PANG Chong, BIAN Sainan, ZHANG Bing, YIN Xu, LU Yingxia, YE Pengfei, WANG Zhan, ZHAO Jing, GAO Yan, GUAN Kai. Short-term effect of Dermatophagoides farinae specific sublingual immunotherapy for children with allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 70-74.

参考文献

[1] Greiner AN, Hellings PW, Rotiroti G, et al. Allergic rhinitis. Lancet[J] , 2011,378(9809):2112-2122. doi: 10.1016/S0140-6736(11)60130-X.
[2] Schuler Iv CF, Montejo JM. Allergic rhinitis in children and adolescents[J]. Pediatr Clin N Am, 2019, 66(5): 981-993. doi:10.1016/j.pcl.2019.06.004.
[3] Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: Allergic rhinitis[J]. Otolaryngol Head Neck Surg, 2015, 152(1 Suppl): S1-S43. doi:10.1177/0194599814561600.
[4] Pfaar O, Agache I, de Blay F, et al. Perspectives in allergen immunotherapy: 2019 and beyond[J]. Allergy, 2019, 74(Suppl 108): 3-25. doi:10.1111/all.14077.
[5] Roberts G, Pfaar O, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: allergic rhinoconjunctivitis[J]. Allergy, 2018, 73(4): 765-798. doi:10.1111/all.13317.
[6] Jutel M, Agache I, Bonini S, et al. International consensus on allergy immunotherapy[J]. J Allergy Clin Immunol, 2015, 136(3): 556-568. doi:10.1016/j.jaci.2015.04.047.
[7] Wheatley LM, Togias A. Clinical practice. Allergic rhinitis[J]. N Engl J Med, 2015, 372(5): 456-463. doi: 10.1056/NEJMcp1412282.
[8] Halken S, Larenas-Linnemann D, Roberts G, et al. EAACI guidelines on allergen immunotherapy: Prevention of allergy[J]. Pediatr Allergy Immunol, 2017, 28(8): 728-745. doi:10.1111/pai.12807.
[9] Durham SR, Penagos M. Sublingual or subcutaneous immunotherapy for allergic rhinitis? [J]. J Allergy Clin Immunol, 2016, 137(2): 339-349.e10. doi:10.1016/j.jaci.2015.12.1298.
[10] Vita D, Caminiti L, Ruggeri P, et al. Sublingual immunotherapy: adherence based on timing and monitoring control visits[J]. Allergy, 2010, 65(5): 668-669. doi:10.1111/j.1398-9995.2009.02223.x.
[11] Vogelberg C, Brüggenjürgen B, Richter H, et al. Real-world adherence and evidence of subcutaneous and sublingual immunotherapy in grass and tree pollen-induced allergic rhinitis and asthma[J]. Patient Prefer Adherence, 2020, 14: 817-827. doi:10.2147/PPA.S242957.
[12] Manzotti G, Riario-Sforza GG, Dimatteo M, et al. Comparing the compliance to a short schedule of subcutaneous immunotherapy and to sublingual immunotherapy during three years of treatment[J]. Eur Ann Allergy Clin Immunol, 2016, 48(6): 224-227.
[13] 刘湘, 楼响瑜, 高月秋, 等. 变应性鼻炎患者变应原谱及舌下免疫治疗分析[J]. 中国耳鼻咽喉头颈外科, 2019, 26(9): 491-494. doi:10.16066/j.1672-7002.2019.09.007. LIU Xiang, LOU Xiangyu, GAO Yueqiu, et al. Allergen spectrum and sublingual specific immunotherapy analysis in allergic thinitis patients[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2019, 26(9): 491-494. doi:10.16066/j.1672-7002.2019.09.007.
[14] Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis[J]. Cochrane Database Syst Rev, 2003(2): CD002893. doi:10.1002/14651858.cd002893.
[15] Nolte H, Bernstein DI, Nelson HS, et al. Efficacy of house dust mite sublingual immunotherapy tablet in North American adolescents and adults in a randomized, placebo-controlled trial[J]. J Allergy Clin Immunol, 2016, 138(6): 1631-1638. doi:10.1016/j.jaci.2016.06.044.
[16] Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial[J]. J Allergy Clin Immunol, 2016, 137(2): 444-451.e8. doi:10.1016/j.jaci.2015.06.036.
[17] Okubo K, Masuyama K, Imai T, et al. Efficacy and safety of the SQ house dust mite sublingual immunotherapy tablet in Japanese adults and adolescents with house dust mite-induced allergic rhinitis[J]. J Allergy Clin Immunol, 2017, 139(6): 1840-1848.e10. doi:10.1016/j.jaci.2016.09.043.
[18] Dhami S, Nurmatov U, Arasi S, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis[J]. Allergy, 2017, 72(11): 1597-1631. doi:10.1111/all.13201.
[19] Hoseini RF, Jabbari F, Rezaee A, et al. House dust mite sublingual-swallow immunotherapy in perennial rhinitis: a double-blind, placebo-controlled Iranian study[J]. J Biol Regul Homeost Agents, 2018, 32(1): 83-88.
[20] 王丰, 张虹婷, 孟娟. 皮下免疫与舌下免疫治疗变应性鼻炎的疗效比较[J]. 重庆医学, 2017, 46(21): 2906-2908. doi:10.3969/j.issn.1671-8348.2017.21.008. WANG Feng, ZHANG Hongting, MENG Juan. Comparison of efficacy of subcutaneous immunotherapy and sublingual immunotherapy for treating allergic rhinitis[J]. Chongqing Medicine, 2017, 46(21): 2906-2908. doi:10.3969/j.issn.1671-8348.2017.21.008.
[21] Bergmann KC, Demoly P, Worm M, et al. Efficacy and safety of sublingual tablets of house dust mite allergen extracts in adults with allergic rhinitis[J]. J Allergy Clin Immunol, 2014, 133(6): 1608-1614.e6. doi:10.1016/j.jaci.2013.11.012.
[22] Mosbech H, Canonica GW, Backer V, et al. SQ house dust mite sublingually administered immunotherapy tablet(ALK)improves allergic rhinitis in patients with house dust mite allergic asthma and rhinitis symptoms[J]. Ann Allergy Asthma Immunol, 2015, 114(2): 134-140. doi:10.1016/j.anai.2014.11.015.
[23] Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update[J]. World Allergy Organ J, 2014, 7(1): 6. doi:10.1186/1939-4551-7-6.
[24] Calderon MA, Casale TB, Nelson HS, et al. An evidence-based analysis of house dust mite allergen immunotherapy: a call for more rigorous clinical studies[J]. J Allergy Clin Immunol, 2013, 132(6): 1322-1336. doi:10.1016/j.jaci.2013.09.004.
[25] de Bot CM, Moed H, Berger MY, et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care[J]. Pediatr Allergy Immunol, 2012, 23(2): 150-158. doi:10.1111/j.1399-3038.2011.01219.x.

相关文章 15

[1]	李孟辉,郅莉莉,戚凯文,王珊珊,高倩,步美玲,姜荷云,冯绛楠,王金荣. 皮下免疫治疗对单一尘螨和合并霉菌过敏儿童哮喘的临床研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 75-80.
[2]	王鑫,刘巧平,闫占峰,刘思溟,朱雅静,丁倩,张莹,田媛,张京然. 基于网络药理学探究小青龙汤治疗过敏性鼻炎的作用机制[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 46-55.
[3]	王宇婷综述王嘉玺审校. microRNA在过敏性鼻炎发病机制中的研究进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 98-104.
[4]	李化静,郝润梅,戴皓,张令,申震,权芳,邵渊. 儿茶素抑制卵清蛋白诱导的过敏性鼻炎小鼠模型炎症反应的机制研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 1-7.
[5]	林兴,沈翎,林宗通,杨中婕. 儿童鼻腔异物与过敏性鼻炎关系的初步研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 101-104.
[6]	徐海侠,崔晓波,刘佳荣,李欣,刘佳宜,刘晓玲. 内蒙古呼和浩特城区气传致敏花粉流行情况调查[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 106-109.
[7]	张贵阳,黄河,冼志,张汉文,谢桂彩. 粉尘螨滴剂舌下含服免疫治疗对不同年龄段变应性鼻炎患者的临床效果评估[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 60-65.
[8]	钱俊俊,周文成,吴中飞,卜冬云,汪李琴,陆美萍,程雷. 苏皖地区变应性鼻炎患者吸入性变应原谱分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 147-151.
[9]	邱昌余,周俊,庄德恩,杨晴,陆美萍,程雷. 人工智能技术在辅助耳鼻咽喉科医师了解过敏性鼻炎患者需求中的应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 88-94.
[10]	曹成,许昱. 变应性鼻炎患者舌下免疫治疗的临床依从性192例分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 114-118.
[11]	洪冬冬,刘元献,邹练强,翁镌凌,邓文娴. 变应性鼻炎患者粉尘螨皮肤点刺试验阳性764例结果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 119-123.
[12]	吴湘萍. 患者管理方式对变应性鼻炎舌下含服粉尘螨滴剂疗效的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 68-72.
[13]	屠燕怡,史丽,赵莉,金鹏,訾晓雪,李昂,金义炫,郅莉莉. 尘螨疫苗皮下注射治疗变应性鼻炎的疗效和安全性评估[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 50-55.
[14]	顾晓,陈彦林. 舌下免疫治疗变应性鼻炎的疗效分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 17-20.
[15]	谢晓红, 胡志邦, 宋盼盼, 戴艳红, 陈峰, 俞晨杰, 高下. 舌下含服粉尘螨滴剂联合鼻用激素治疗变应性鼻炎疗效观察[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 34-37.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed