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目的探讨皮下注射免疫治疗(subcutaneous immunotherapy,SCIT)和舌下含服免疫治疗(sublingual immunotherapy,SLIT)对儿童变应性鼻炎患者的疗效、成本—效果比分析以及卫生经济学评价,为制定有效、经济、合理的治疗方案提供参考。方法专病门诊确诊尘螨过敏的中—重度持续性小儿变应性鼻炎患者78例,随机分为两组,分别接受舌下含服免疫治疗和皮下注射免疫治疗2年,随访对比分析患者生活质量改善程度、临床疗效和成本—效果比以及不良反应发生率等。结果两种治疗方案均取得了明显疗效;不良反应发生率均较低;SLIT组儿童依从性优于SCIT组;SCIT组治疗成本平均为425.00元/月,总有效率为94.57%,成本—效果比4.49;SLIT组治疗成本平均为266.80元/月,总有效率为82.85%,成本—效果比3.22;在对比相对高成本、高有效率与相对低成本、低有效率基础上,舌下免疫治疗成本—效果比优于皮内免疫治疗。结论在儿童变应性鼻炎患者中,SLIT组成本—效果优于SCIT组,且SLIT组具有良好的安全性和依从性,从经济学角度来说,舌下免疫治疗可以作为治疗尘螨过敏的儿童变应性鼻炎的优选方法,而SCIT组治疗期间,可以有效减少药物使用,临床上应针对不同类型患者进行治疗方案的选择。
Objective To investigate the curative effect, cost-benefit ratio analysis and health economics evaluation of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on children with allergic rhinitis. In order to develop an effective, Economic and reasonable treatment programs provide a reference. Methods 78 patients with moderate-severe chronic allergic rhinitis diagnosed with dust mite allergy were randomly divided into two groups, receiving sublingual immunotherapy and subcutaneous immunotherapy respectively for 2 years. Quality of improvement, clinical efficacy and cost-effectiveness ratio and the incidence of adverse reactions. Results The results showed that both treatment regimens were effective and the incidence of adverse reactions was low. The compliance of children in SLIT group was superior to that of SCIT group. The average cost of treatment in SCIT group was 425.00 yuan per month, the total effective rate was 94.57%. The cost-effectiveness The average cost of SLIT group was 266.80 yuan / month, the total effective rate was 82.85% and the cost-effective ratio was 3.22. On the basis of comparatively high cost, high efficiency, relatively low cost and low effective rate, sublingual immunization Cost-effectiveness is better than intradermal immunotherapy. CONCLUSIONS: In the pediatric patients with allergic rhinitis, the cost-effectiveness of SLIT is better than that of SCIT, and SLIT has good safety and compliance. From an economic point of view, sublingual immunotherapy can be used as an allergy to dust mites Children with allergic rhinitis, the preferred method, while the SCIT group during treatment, can effectively reduce the use of drugs, clinically different types of patients should be the choice of treatment options.