Luo Zhihong, Li Bin, Wan Lang, Peng Cong
Department of Otorhinolaryngology, Huangshi Central Hospital, Hubei Huangshi 435000, China.
Department of Otorhinolaryngology, Huangshi Central Hospital, Hubei Huangshi 435000, China. Email:
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Feb;50(2):105-9.
To compare the efficacy and safety of subcutaneous immunotherapy with dermatophagoides pteronyssinus standardized extract given in conventional and cluster immunotherapy schedules for persistent allergic rhinitis.
One hundred and ten patients with moderate to severe allergic rhinitis caused by dust mites, in accordance with the immunotherapy inclusion criteria, were allocated to receive conventional immunotherapy as group A (n = 57) or cluster immunotherapy as group B (n = 53). In group A, 7 cases were lost to follow-up, the expulsion rate of group A was 12.28%; in group B, 1 case was lost to follow-up, the expulsion rate of group B was 1.89%. Nasal symptom scores, medicine scores and mini rhinoconjunctivitis quality of life questionnaire (Mini RQLQ) were recorded and compared before and after 7 weeks, 15 weeks, 1.0 year, 1.5 years, 2.0 years. All the scores were assessed to evaluate the clinical efficacy, and also the incidence of local and systemic adverse reactions were registered to evaluate the safety. SPSS 19.0 software was used to analyze the data.
Nasal symptom scores, medicine scores and Mini RQLQ of both groups were significant lower than those before the treatment (all P < 0.05). Mini RQLQ and nasal symptom scores in cluster group (0.55 ± 0.21,0.57 ± 0.27) were more significantly declined than the conventional group after 7 weeks and 2.0 years of observation (all PMini RQLQ<0.05;nasal symptom scores: 1.41 ± 0.65, 0.83 ± 0.30, t value was 11.344, 5.649, both P < 0.05). The clinical efficiency rate in cluster group (86.5%, 94.2%) were more significantly highter than those (60.0%, 80.0%) in the conventional group after 7 weeks and 2 years of observation (χ(2) value was 9.224, 4.642, both P < 0.05). The medicine scores in cluster group (0.11 ± 0.04) was more significantly declined than conventional group (0.47 ± 0.11) after 7 weeks (t = 27.665, P < 0.05). The incidence of local and systemic adverse reactions during the incremental-dose phase and maintenance-dose phase compared with conventional immunotherapy were not significantly different (P > 0.05).
The cluster immunotherapy is a safe treatment method which is more effective and faster than conventional immunotherapy to the dust mites caused allergic rhinitis.
比较皮下免疫疗法使用尘螨标准化提取物以常规和集中免疫疗法方案治疗持续性变应性鼻炎的疗效和安全性。
110例由尘螨引起的中重度变应性鼻炎患者，符合免疫疗法纳入标准，被分配接受常规免疫疗法作为A组（n = 57）或集中免疫疗法作为B组（n = 53）。A组有7例失访，A组失访率为12.28%；B组有1例失访，B组失访率为1.89%。记录并比较7周、15周、1.0年、1.5年、2.0年后的鼻症状评分、药物评分和小型鼻结膜炎生活质量问卷（Mini RQLQ）。评估所有评分以评价临床疗效，同时记录局部和全身不良反应的发生率以评价安全性。使用SPSS 19.0软件分析数据。
两组的鼻症状评分、药物评分和Mini RQLQ均显著低于治疗前（均P < 0.05）。在观察7周和2.0年后，集中组的Mini RQLQ和鼻症状评分（0.55±0.21，0.57±0.27）比常规组下降更显著（Mini RQLQ均P<0.05；鼻症状评分：1.41±0.65，0.83±0.30，t值为ll.344，5.649，均P < 0.05）。在观察7周和2年后，集中组的临床有效率（86.5%，94.2%）比常规组（60.0%，80.0%）显著更高（χ(2)值为9.224，4.642，均P < 0.05）。在7周后，集中组的药物评分（0.11±0.04）比常规组（0.47±0.11）下降更显著（t = 27.665，P < 0.05）。与常规免疫疗法相比，递增剂量期和维持剂量期局部和全身不良反应的发生率无显著差异（P > 0.05）。
集中免疫疗法是一种安全的治疗方法，对于尘螨引起的变应性鼻炎比常规免疫疗法更有效且起效更快。
