目的 评价标准化粉尘螨变应原疫苗滴剂舌下含服治疗儿童变应性鼻炎的疗效并初步探索其免疫学机制.方法 选择粉尘螨阳性的儿童变应性鼻炎患者62例,随机分为2组:免疫治疗组31例,给予舌下含服标准化粉尘螨变应原疫苗滴剂脱敏治疗;药物治疗组31例,根据患者情况,给予适量抗组胺药口服,或鼻用类固醇激素局部喷鼻.治疗疗程为2年,治疗后观察患者症状、体征变化,采用视觉模拟量表(VAS)评定疗效,并比较治疗前后血清中总IgE、尘螨特异性IgE的水平.结果 免疫治疗组有效率为80.6%,药物治疗组有效率为64.5%,2组有效率比较差异有统计学意义(P<0.05);2组治疗前后症状评分差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05).免疫治疗组治疗前后血清总IgE、尘螨特异性IgE水平比较差异无统计学意义(P>0.05).结论 应用标准化粉尘螨变应原疫苗滴剂舌下含服对变应性鼻炎患者进行免疫治疗能够有效改善变应性鼻炎患儿的症状.%Objective To evaluate the curative effect of sublingual immunotherapy in children allergic rhinitis by standardized dermatophagoides farinae allergen vaccine drops and explore the immunological mechanisms. Methods 62 cases of children with allergic rhinitis whose test result was positive for dermatophagoides farinae were divided into two groups randomly:The sublingual immunotherapy group( 31 cases )which accepted standardized dermatophagoides farinae allergen vaccine drops sublingual immunotherapy and the control group( 31 cases ) which accepted antihistamine drug therapy or local nasal steroid spray. The course of treatment was two years. Evaluating the curative effect by the changes of symptoms and physical signs which were measured by VAS ( visual analogue scale ) and detecting the serum levels of total IgE, specific IgE levels of dermatophagoides farinae. Results The effective rate was 80.6％ in the sublingual immunotherapy group, and 64.5％ in the control group. Although the symptom score was statistically different after treatment it each group( P ＜ 0.01 ), there was no statistical difference between the two groups( P ＞ 0.05 ). Serum total Ig E and mite specific IgE showed no statistical difference( P ＞ 0.05 ) before and after sublingual immunotherapy treatment. Conclusion Application of standardized dermatophagoides farinae allergen vaccine drops in allergic rhinitis sublingual immunotherapy in children with allergic rhinitis can release symptoms and reduce drugs.
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