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目的探讨舌下含服尘螨变应原疫苗对多种变应原过敏哮喘鼻炎儿童治疗的临床疗效。方法选291例年龄4～13岁哮喘缓解期伴变应性鼻炎患儿为免疫治疗对象,根据皮肤点刺试验结果分成尘螨过敏组(80例)、尘螨及蟑螂过敏组(71例)、尘螨及花粉过敏组(74例)、尘螨及狗毛过敏组(66例)共4组。全部病例完成包括尘螨在内的10种常见过敏原皮肤点刺实验,点刺试验后观察阳性反应。应用浙江我武生物科技有限公司提供的“粉尘螨滴剂”进行临床免疫治疗,记录治疗前后症状和体征评分以及不良反应。结果哮喘并变应性鼻炎完成1年免疫治疗的总有效率为62.5%,其中尘螨过敏组为53.8%,尘螨及蟑螂过敏组为66.2%,尘螨及花粉过敏组为70.3%,尘螨及狗毛过敏组为60.6%。各治疗组间有效率比较差异无统计学意义(x~2=5.107,P>0.05)。与用药有关的皮疹、鼻咽痒和哮喘发作的不良反应发生率为23.67%,未出现过敏性休克的严重副作用。结论舌下含服尘螨变应原疫苗对单一变应原和多种不同变应原混合过敏的哮喘和鼻炎儿童免疫治疗是安全有效的。
Objective To investigate the clinical efficacy of sublingual delivery of dust mite allergen vaccine in children with allergic rhinitis with multiple allergens. Methods A total of 291 asthmatic children with allergic rhinitis aged from 4 to 13 years were selected for immunotherapy. According to the results of skin prick test, the subjects were divided into dust mite allergy group (n = 80), dust mite and cockroach allergy group (n = 71) , Dust mite and pollen allergy group (74 cases), dust mites and dog hair allergy group (66 cases) were 4 groups. In all cases, 10 common allergens skin prick tests including dust mites were completed, and the positive reaction was observed after prick test. The clinical immunotherapy was performed using “Dust Mite Drops ” provided by Zhejiang Wuwu Biotechnology Co., Ltd. The symptoms and signs of the patients were recorded and the adverse reactions were recorded before and after treatment. Results The total effective rate of immunotherapy for asthma and allergic rhinitis was 62.5%, of which 53.8% for dust mite allergy group, 66.2% for dust mite and cockroach allergy group, 70.3% for dust mite and pollen allergy group, Mites and dog hair allergy group was 60.6%. There was no significant difference in the effective rates among the treatment groups (x ~ 2 = 5.107, P> 0.05). The incidence of adverse reactions to medication-related rashes, nasopharyngeal itch and asthma attacks was 23.67%, with no serious side effects of anaphylactic shock. Conclusion The sublingual immunization with dust mite allergen vaccine against asthma and rhinitis children allergic to single allergen and multiple allergens is safe and effective.