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目的系统评价皮下免疫(SCIT)与舌下免疫(SLIT)治疗尘螨变应性鼻炎的有效性、依从性与安全性。方法计算机检索Pub Med、Embase、Web of Science、Cochrane Library、万方数据、维普网、中国知网、中国生物医学文献数据库关于SCIT与SLIT治疗尘螨变应性鼻炎的随机对照研究或病例对照研究,参照英国牛津大学循证医学中心文献评价项目(Oxford CASP,2004)标准对文献进行质量评价、筛选和资料提取后,应用Review Manager5.2软件进行荟萃分析。结果最终纳入文献11篇(中文6篇,英文5篇),包括712例患者,荟萃分析结果显示:在改善鼻部症状评分方面,SCIT组与SLIT组差异无统计学意义(SMD=0.05;95%CI:-0.27~0.38)。在依从性方面,两治疗组差异无统计学意义(RR=1.11,95%CI:0.98~1.26)。在安全性方面,SCIT与SLIT均是安全有效的治疗方法,但荟萃分析中发现,SCIT组不良反应发生率高于SLIT组(RR=1.89,95%CI:1.00~3.60)。结论SCIT与SLIT均是治疗尘螨变应性鼻炎安全、有效的方法,但SCIT组不良反应发生率高于SLIT组。
Objective To systematically evaluate the efficacy, compliance and safety of subcutaneous (SCIT) and sublingual (SLIT) subcutaneous immunotherapy (SLIT) in the treatment of allergic rhinitis in dust mites. Methods A computer-controlled randomized controlled trial or case-control study of SCIT and SLIT in the treatment of allergic rhinitis in dust mites was carried out using PubMed, Embase, Web of Science, Cochrane Library, VIP, CNKI, CNKI, China Biomedical Literature Database According to Oxford CASP (2004), the quality assessment, screening and data extraction of the literature were conducted according to the Oxford University’s Evidence-based Medicine Center (Oxford CASP, 2004). The results were finally included in the literature of 11 articles (6 in English, 5 in English), including 712 patients. The meta-analysis showed that there was no significant difference between the SCIT group and the SLIT group in improving the nasal symptom score (SMD = 0.05; 95 % CI: -0.27 ~ 0.38). In compliance, there was no significant difference between the two treatment groups (RR = 1.11, 95% CI: 0.98 to 1.26). In terms of safety, both SCIT and SLIT are safe and effective treatments. However, the meta-analysis found that the incidence of adverse reactions in SCIT group was higher than that in SLIT group (RR = 1.89, 95% CI: 1.00-3.60). Conclusion Both SCIT and SLIT are safe and effective methods for the treatment of allergic rhinitis in dust mites. However, the incidence of adverse reactions in SCIT group is higher than that in SLIT group.