Wu Yuan-yuan, Xie Xin-ming, Han Dong, Li Shao-jun, Liu Lu, Li Man-xiang
Respiratory Department, Institute of Respiratory Disease, the Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an 710004, China.
Respiratory Department, Institute of Respiratory Disease, the Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an 710004, China. Email:
Zhonghua Nei Ke Za Zhi. 2013 Oct;52(10):844-8.
To evaluate the efficacy and safety of sublingual immunotherapy(SLIT) in patients with allergic asthma in order to provide reliable evidence for clinical application of SLIT.
To search published articles of randomized controlled trials (RCTs) in allergic asthma from CNKI, WANFANG, Pubmed and Medline databases. The methodological quality of trials was assessed by Jadad-scale. The heterogeneity was examined by using Stata 11.0 software. Fixed effect model or random effect model was used to pool the data. The articles which could not be pooled were carried out by descriptive analysis. The Egger's and Begg's test were used to evaluate the publication bias.
There were total 6 RCTs included in this text. Compared with control group, SLIT could significantly reduce asthma symptom scores (SMD = -0.89, 95%CI -1.36--0.43, P = 0.000) and asthma medication scores (SMD = -4.53, 95%CI -6.97--2.08, P = 0.000), but not forced expiratory volume (FEV1) of lung function(SMD = 0.19, 95%CI -0.02-0.41, P = 0.078), neither serum sIgE levels (SMD = 0.05, 95%CI -0.58-0.69, P = 0.870). There were no obvious adverse events reported after treatment of SLIT. No publication bias were indicated by Egger's and Begg's tests.
SLIT significantly reduces asthma symptom scores and medication scores, suggesting that SLIT is a safe and effective approach of immunotherapy. However, it still needs more highly qualified studies of RCTs to prove.
评价舌下免疫疗法（SLIT）治疗过敏性哮喘的有效性和安全性，为SLIT临床应用提供可靠依据。
检索中国知网、万方、Pubmed及Medline数据库中关于过敏性哮喘的随机对照试验（RCT）发表文章。采用Jadad量表评估试验方法学质量。使用Stata 11.0软件检验异质性。采用固定效应模型或随机效应模型合并数据。无法合并的文章进行描述性分析。采用Egger检验和Begg检验评估发表偏倚。
本文共纳入6项RCT。与对照组相比，SLIT可显著降低哮喘症状评分（标准化均数差[SMD]=-0.89，95%可信区间[CI]-1.36-0.43，P=0.000）和哮喘药物评分（SMD=-4.53，95%CI-6.97-2.08，P=0.000），但对肺功能第一秒用力呼气容积（FEV1）无影响（SMD=0.19，95%CI-0.020.41，P=0.078），对血清特异性免疫球蛋白E（sIgE）水平也无影响（SMD=0.05，95%CI-0.580.69，P=0.870）。SLIT治疗后未报告明显不良事件。Egger检验和Begg检验未显示发表偏倚。
SLIT可显著降低哮喘症状评分和药物评分，提示SLIT是一种安全有效的免疫治疗方法。然而，仍需更多高质量的RCT研究加以证实。
