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目的探讨特异性变应原雾化吸入减敏防治过敏性支气管哮喘的临床效果、可行性及其优缺点。方法采用随机对照的方法,将40例未控制、尘螨阳性的过敏性支气管哮喘患者随机分为A组(常规治疗组,20例)和B组(吸入减敏组,20例)。两组接受相同的基础治疗,同时A组雾化吸入生理盐水5ml每周2次,B组雾化吸入特异性变应原每周2次持续6个月。治疗前后检测如下指标:(1)哮喘症状控制测试(ACT)评分;(2)肺功能及气道反应性测定;(3)皮肤过敏原测试;(4)平均每周使用万托林喷数。结果治疗后两组ACT评分较治疗前明显改善(P均<0.05);两组肺功能FEV1占预计值百分比较治疗前均有明显上升(P均<0.05);两组皮试强度反应性均较治疗前无明显变化(P均>0.05);两组使用万托林喷数明显较治疗前减少(P均<0.05)。支气管激发试验阴性率B组高于A组(80.0%vs 55.0%,P<0.05)。结论特异性变应原雾化吸入减敏可有效降低气道高反应,因此在防治过敏性支气管哮喘中具有临床价值。
Objective To investigate the clinical effects, feasibility, advantages and disadvantages of specific allergen inhalation desensitization in the prevention and treatment of allergic bronchial asthma. Methods 40 patients with allergic bronchial asthma who were not controlled by dust mite were randomly divided into group A (conventional treatment group, 20 cases) and group B (inhalation desensitization group, 20 cases). The two groups received the same basic treatment, while Group A inhaled saline 5ml twice a week, Group B inhaled specific allergens twice per week for 6 months. (1) Asthma Symptom Control Test (ACT) score; (2) Pulmonary function and airway reactivity test; (3) skin allergen test; (4) average weekly petotin spray count . Results The ACT scores of both groups were significantly improved after treatment (P <0.05). The percentages of FEV1 in both groups were significantly higher than those before treatment (all P <0.05) Compared with before treatment, there was no significant change (P> 0.05). The velveteen spray number in both groups decreased significantly (P <0.05). The negative rate of bronchial provocation test in group B was higher than that in group A (80.0% vs 55.0%, P <0.05). Conclusion Specific allergen inhalation desensitization can effectively reduce airway hyperresponsiveness, so it has clinical value in the prevention and treatment of allergic bronchial asthma.