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[粉尘螨滴剂对过敏性哮喘和变应性鼻炎舌下免疫治疗的临床评价]

[Clinical evaluation for sublingual immunotherapy of allergic asthma and atopic rhinitis with Dermatophagoides Farinae Drops].

作者信息

Cao Lan-Fang, Lu Quan, Gu Hong-Liang, Chen Yan-Ping, Zhang Yuan, Lu Min, Qian Yao-Qin, Li Lan, Xu Yi-Ping

机构信息

Department of Pediatrics, Renji Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200001, China.

出版信息

Zhonghua Er Ke Za Zhi. 2007 Oct;45(10):736-41.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of sublingual immunotherapy with 'Dermatophagoides Farinae Drops' in D. farinae allergic asthma and/or rhinitis patients.

METHODS

A 25-week double-blind, placebo-controlled, multi-centered trail was conducted in 278 children (aged 4 - 18 yr) with mite-induced asthma and/or rhinitis. Patients were randomly assigned to receive sublingual immunotherapy (SLIT) with 'Dermatophagoides Farinae Drops' (n = 139) or placebo (n = 139) for 25 weeks and the dosage and administration strictly followed the manufacturer's instructions. At the beginning of the 2nd, 3rd, 4th, 6th, 10th, 14th, 18th, 22nd week of the treatment, the patients were asked to accept follow-up visit, during the clinical trial all patients and parents were asked to keep a daily record of their asthma symptom scores, rescue medicine use, rhinitis symptom scores, morning and evening peak expiratory flow. Asthma symptom scores, reduction in use of rescue medicine, rhinitis symptom scores, lung function tests, skin sensitivity to mite, mite-specific immunoglobulin (Ig) E and IgG4, and quality of life and adverse effect were assessed during the study.

RESULT

(1) Of the 278 children, 27 dropped out before the study completion. (2) After 25 weeks of treatment, the median variability of PEFR was -1.38 for SLIT group and -0.90 for the placebo (P < 0.05). (3) Besides, the mean variability of medicine score of asthma was -0.08 for SLIT group and 0.52 for the plcebo (P < 0.05). (4) The median variability of rhinitis symptom score was -1.96 for SLIT group and -1.03 for the placebo (P < 0.01). (5) The rescue medicine usage of SLIT reduced but did not show significant differences between SLIT and placebo. (6) After 25 weeks treatment, the increase of D. farinae specific IgE antibody of two groups were similar, while specific IgG4 increased significantly in SLIT compared to the patients in control one (P < 0.01); (7) No severe adverse events happened in the trial and the most-likely adverse events were mild asthma and local rash.

CONCLUSION

Dermatophagoides Farinae Drops is safe and effective in treating allergic asthma and atopic rhinitis.

摘要

目的

评估舌下含服“粉尘螨滴剂”对粉尘螨过敏性哮喘和/或鼻炎患者的安全性和有效性。

方法

对278名(年龄4 - 18岁)由螨虫引起的哮喘和/或鼻炎患儿进行了一项为期25周的双盲、安慰剂对照、多中心试验。患者被随机分配接受舌下免疫疗法(SLIT),使用“粉尘螨滴剂”(n = 139)或安慰剂(n = 139),为期25周,剂量和用法严格遵循制造商的说明。在治疗的第2、3、4、6、10、14、18、22周开始时,患者接受随访,在临床试验期间,要求所有患者及其家长每天记录哮喘症状评分、急救药物使用情况、鼻炎症状评分、早晚呼气峰值流速。在研究期间评估哮喘症状评分、急救药物使用减少情况、鼻炎症状评分、肺功能测试、对螨虫的皮肤敏感性、螨虫特异性免疫球蛋白(Ig)E和IgG4,以及生活质量和不良反应。

结果

(1)278名儿童中,27名在研究完成前退出。(2)治疗25周后,SLIT组PEFR的中位数变异性为-1.38,安慰剂组为-0.90(P < 0.05)。(3)此外,SLIT组哮喘药物评分的平均变异性为-0.08,安慰剂组为0.52(P < 0.05)。(4)SLIT组鼻炎症状评分的中位数变异性为-1.96,安慰剂组为-1.03(P < 0.01)。(5)SLIT组急救药物使用量减少,但SLIT组与安慰剂组之间无显著差异。(6)治疗25周后,两组粉尘螨特异性IgE抗体升高相似,而SLIT组特异性IgG4相比对照组患者显著升高(P < 0.01);(7)试验中未发生严重不良事件,最常见的不良事件为轻度哮喘和局部皮疹。

结论

粉尘螨滴剂治疗过敏性哮喘和变应性鼻炎安全有效。

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