Hunt K J, Valentine M D, Sobotka A K, Benton A W, Amodio F J, Lichtenstein L M
N Engl J Med. 1978 Jul 27;299(4):157-61. doi: 10.1056/NEJM197807272990401.
Insect hypersensitivity is currently treated by immunization using whole-body extracts. We compared this regimen with immunotherapy using insect venoms or placebo in groups of 20 patients matched for history and sensitivity, as judged by venom skin test, histamine release and IgE antibody to venom. After six to 10 weeks of immunization, systemic reactions to stings occurred in seven of 12, seven of 11, and one of 18 patients treated with placebo, whole-body extract, and venom, respectively. Placebo and whole-body extract gave similar results and were significantly less effective than venom immunotherapy (P less than 0.01). The 14 patients with failure of treatment with whole-body extract and placebo were subsequently provided with venom immunotherapy; one reacted to a subsequent sting. We conclude that venom immunotherapy is clinically superior to therapy on whole-body extract or placebo.
目前，昆虫过敏症是通过使用全身体液提取物进行免疫治疗的。我们将这种治疗方案与使用昆虫毒液或安慰剂的免疫疗法进行了比较，研究对象为20组根据病史和敏感性匹配的患者，敏感性通过毒液皮肤试验、组胺释放以及针对毒液的IgE抗体来判断。免疫治疗6至10周后，接受安慰剂、全身体液提取物和毒液治疗的患者中，分别有12例中的7例、11例中的7例和18例中的1例出现了对叮咬的全身反应。安慰剂和全身体液提取物的效果相似，且明显不如毒液免疫疗法有效（P小于0.01）。接受全身体液提取物和安慰剂治疗无效的14名患者随后接受了毒液免疫疗法；其中1人在后续的叮咬中出现了反应。我们得出结论，毒液免疫疗法在临床上优于全身体液提取物或安慰剂治疗。
