Yu D D, Liu Y, Zheng Z Y, Zhang J, Gao L, Zhang M, He C, Hao J L, Zhang K J, Feng Y
First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China.
Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan 030001, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Dec 6;57(12):1996-2001. doi: 10.3760/cma.j.cn112150-20230711-00002.
To study the efficacy and compliance analysis of pollen allergen drops in the treatment of allergic rhinitis. The method of single-center controlled was used to analyze the dates' results. From July 2021 to September 2021, 80 patients with seasonal allergic rhinitis were referred to the clinic of otorhinolaryngology in First Hospital of Shanxi Medical University.40 patients received sublingual immunotherapy (SLIT group), and the other 40 patients received symptomatic drug treatment as the control group. The total rhinoconjunctivitis symptom score (TRSS), the visual analogue scale(VAS), total medication score (TMS) and combined scores of medication and rhinoconjunctivitis symptoms (CSMRS) of the patient before the start of the treatment and after the first year of the treatment were compared to assess the efficacy of sublingual immunotherapy of Artemisia pollen. Follow the shedding during the study, the safety of the drug and the causes for compliance analysis were analyzed and recorded. The results of comparison with TRSS, VAS, TMS and CSMRS in two groups in the period of pretherapy were as follows: TRSS(12.393±3.023, 12.450±3.029, =-0.077, =0.939), VAS(8.357±1.026, 8.400±0.982, =-0.173, =0.862), TMS(3.214±0.568, 3.175±0.501, =0.301, =0.764), CSMRS (5.286±0.680, 5.253±0.677, =0.199, =0.843), there was no significant difference (>0.05); lower observed symptom scores were got in the post-treatment pollen peak SLIT group compared to the control group, TRSS(3.964±1.551, 7.750±2.169, =-7.918, P<0.05), VAS(2.893±0.956, 5.175±1.481, =-8.286, <0.05), TMS (1.821±0.863, 3.175±0.501, =-8.163, <0.05), CSMRS (2.489±0.921, 4.468±0.601, =-10.723, <0.05), and the differences between the groups were statistically significant (<0.05); the SLIT group significantly reduced all symptom scores at the first peak compared to the starting, TRSS(12.393±3.023, 3.964±1.551, =20.576, <0.05), VAS (8.357±1.026, 2.893±0.956, =30.070, <0.05), TMS (3.214±0.568, 1.821±0.863, =7.151, <0.05), CSMRS(5.286±0.680, 2.489±0.921, =14.533, <0.05) and there was statistical difference (<0.05). No significant adverse reactions occured during medication in the SLIT group. A total of 12 cases were shed in the SLIT group, so the compliance rate was 70%. The four reasons were that patients considered the course was long (4 cases, 33%); the drugs were expensive (3 cases, 25%); patients were busy with their work and life (3 cases, 25%); patients were affected by the outbreak (2 cases, 17%). In summary, Artemisia pollen sublingual drops may improve the symptoms of the patients who got allergic rhinitis caused by Artemisia pollen after the treatment for one year. However, due to the lack of sufficient understanding of immunotherapy or the difficulty in adhering to standardized medication, the compliance with sublingual immunotherapy is still poor, the compliance with sublingual immunotherapy needs to be further improved through patient education.
研究花粉变应原滴剂治疗变应性鼻炎的疗效及依从性分析。采用单中心对照方法分析数据结果。2021年7月至2021年9月,80例季节性变应性鼻炎患者被转诊至山西医科大学第一医院耳鼻咽喉科门诊。40例患者接受舌下免疫治疗(SLIT组),另外40例患者接受对症药物治疗作为对照组。比较治疗开始前及治疗1年后患者的鼻结膜炎总症状评分(TRSS)、视觉模拟评分(VAS)、总用药评分(TMS)以及用药与鼻结膜炎症状综合评分(CSMRS),以评估蒿属花粉舌下免疫治疗的疗效。随访研究期间的脱落情况,分析并记录药物安全性及依从性原因。两组治疗前TRSS、VAS、TMS和CSMRS的比较结果如下:TRSS(12.393±3.023,12.450±3.029,=-0.077,=0.939),VAS(8.357±1.026,8.400±0.982,=-0.173,=0.862),TMS(3.214±0.568,3.175±0.501,=0.301,=0.764),CSMRS(5.286±0.680,5.253±0.677,=0.199,=0.843),差异无统计学意义(>0.05);治疗后花粉高峰期SLIT组观察到的症状评分低于对照组,TRSS(3.964±1.551,7.750±2.169,=-7.918,P<0.05),VAS(2.893±0.956,5.175±1.481,=-8.286,<0.05),TMS(1.821±0.863,3.175±0.501,=-8.163,<0.05),CSMRS(2.489±0.921,4.468±0.601,=-10.723,<0.05),组间差异有统计学意义(<0.05);与开始时相比,SLIT组在第一个高峰期所有症状评分均显著降低,TRSS(12.393±3.023,3.964±1.551,=20.576,<0.05),VAS(8.357±1.026,2.893±0.956,=30.070,<0.05),TMS(3.214±0.568,1.821±0.863,=7.151,<0.05),CSMRS(5.286±0.680,2.489±0.921,=14.533,<0.05),差异有统计学意义(<0.05)。SLIT组用药期间未发生明显不良反应。SLIT组共脱落12例,依从率为70%。四个原因分别为患者认为疗程长(4例,33%);药物昂贵(3例,25%);患者工作生活繁忙(3例,25%);受疫情影响(2例,17%)。综上所述,蒿属花粉舌下滴剂治疗1年后可能改善蒿属花粉所致变应性鼻炎患者的症状。然而,由于对免疫治疗缺乏足够了解或难以坚持规范用药,舌下免疫治疗的依从性仍然较差,需要通过患者教育进一步提高舌下免疫治疗的依从性。