Ai Tao, Wang Li, Luo Ronghua, Fan Yinghong, Liao Huiling, Xia Wanmin, Zhang Lei, Duan Yaping
Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Transl Pediatr. 2020 Oct;9(5):686-694. doi: 10.21037/tp-20-322.
Allergic asthma and allergic rhinitis are common chronic respiratory diseases in children. The prevalence rate of disease is increasing year by year. And avoid allergens, drug treatments and special immunotherapy (SIT) is the fundamental treatment for respiratory allergies diseases. But there are few comprehensive studies on the control level of asthma, improvement of lung function, and changes of exhaled nitric oxide (FeNO) after SLIT treatment in children with allergic asthma and rhinitis.
In all, 71 child asthma patients who received sublingual-specific immune therapy for 1 year or more were divided into an asthmatic rhinitis group (31 cases) and an asthma-alone group (40 cases). The two groups of patients were compared before and after treatment in terms of rhinitis symptom scores, daytime and nighttime asthma symptom scores, visual analog scale (VAS) score, drug score, pulmonary function, and exhaled nitric oxide level (FeNO).
After treatment, daytime symptom scores, VAS scores, drug scores, and FeNO levels of the asthma-alone group were all lower than before treatment, and the lung function was significantly improved (P<0.05), while the difference in night symptom scores before and after treatment was not statistically significant (P>0.05). The lung function and FeNO level of children in the asthmatic rhinitis group were lower after treatment than before treatment, with statistically significant differences (P<0.05). The scores of rhinitis and VAS in the asthmatic rhinitis group were higher than those in the asthma-alone group, and the differences were statistically significant. There was no significant difference in other scores between the two groups. There was no significant difference in lung function and FeNO level between the two groups.
SLIT for children with or without allergic asthma or with or without rhinitis has a significant effect, but its effect on children with asthma combined with rhinitis is not superior to that of children with asthma alone.
过敏性哮喘和过敏性鼻炎是儿童常见的慢性呼吸道疾病。疾病患病率逐年上升。避免接触过敏原、药物治疗和特异性免疫治疗(SIT)是呼吸道过敏性疾病的基本治疗方法。但关于舌下特异性免疫治疗(SLIT)对过敏性哮喘和鼻炎患儿哮喘控制水平、肺功能改善及呼出一氧化氮(FeNO)变化的综合研究较少。
选取71例接受舌下特异性免疫治疗1年及以上的儿童哮喘患者,分为哮喘合并鼻炎组(31例)和单纯哮喘组(40例)。比较两组患者治疗前后的鼻炎症状评分、白天和夜间哮喘症状评分、视觉模拟量表(VAS)评分、药物评分、肺功能及呼出一氧化氮水平(FeNO)。
治疗后,单纯哮喘组的白天症状评分、VAS评分、药物评分及FeNO水平均低于治疗前,肺功能显著改善(P<0.05),而夜间症状评分治疗前后差异无统计学意义(P>0.05)。哮喘合并鼻炎组患儿治疗后的肺功能和FeNO水平低于治疗前,差异有统计学意义(P<0.05)。哮喘合并鼻炎组的鼻炎和VAS评分高于单纯哮喘组,差异有统计学意义。两组其他评分差异无统计学意义。两组肺功能和FeNO水平差异无统计学意义。
SLIT对合并或不合并过敏性哮喘及合并或不合并鼻炎的儿童均有显著效果,但对哮喘合并鼻炎患儿的效果并不优于单纯哮喘患儿。