粉塵螨滴劑聯(lián)合氯雷他定治療兒童過(guò)敏性鼻炎的效果及對(duì)血清炎性因子水平的影響

高翔 王姝玥 李軍政

【摘要】 目的：探討粉塵螨滴劑聯(lián)合氯雷他定治療小兒過(guò)敏性鼻炎的臨床效果及其對(duì)血清炎性因子水平的影響。方法：選取本院2017年2月-2018年6月收治的過(guò)敏性鼻炎患兒86例，按照擲硬幣法分為對(duì)照組（n=42）及觀察組（n=44），對(duì)照組僅采用氯雷他定進(jìn)行治療，觀察組予以粉塵螨滴劑聯(lián)合氯雷他定治療。治療12個(gè)月后，比較兩組臨床療效、總藥物評(píng)分（TMS）、鼻部癥狀總評(píng)分（TNSS）及血清炎性因子。結(jié)果：觀察組治療總有效率高于對(duì)照組（P<0.05）。治療后，兩組TMS與TNSS評(píng)分均低于治療前（P<0.05）;治療后，觀察組TMS與TNSS評(píng)分均低于對(duì)照組（P<0.05）。治療后，兩組白細(xì)胞介素（IL）-4、IL-5及IL-6均低于治療前（P<0.05）;治療后，觀察組IL-4、IL-5及IL-6均低于對(duì)照組（P<0.05）。治療后，兩組IgG4與干擾素-γ（IFN-γ）均高于治療前，而腫瘤壞死因子-α（TNF-α）與IgE均低于治療前（P<0.05）;治療后，觀察組IgG4與IFN-γ均高于對(duì)照組，而TNF-α與IgE均低于對(duì)照組（P<0.05）。結(jié)論：粉塵螨滴劑聯(lián)合氯雷他定治療兒童過(guò)敏性鼻炎效果更好，可有效控制炎癥反應(yīng)、減弱變態(tài)反應(yīng)，有一定的臨床價(jià)值。

【關(guān)鍵詞】 粉塵螨滴劑 氯雷他定 過(guò)敏性鼻炎

[Abstract] Objective： To explore the clinical effects of Dermatophagoides Farinae Drops combined with Loratadine in children with allergic rhinitis and its effect on serum inflammatory factors. Method： A total of 86 children with allergic rhinitis in our hospital from February 2017 to June 2018 were selected. they were divided into control group （n=42） and observation group （n=44） according to the coin toss method. The control group was treated with Loratadine only， while the observation group was treated with Dermatophagoides Farinae Drops combined with Loratadine. After 12 months of treatment， the clinical efficacy， total medication scores （TMS）， total nasal symptoms scores （TNSS） and serum inflammatory factors were compared between the two groups. Result： The total effective rate in the observation group was higher than that in the control group （P<0.05）. After treatment， TMS and TNSS scores in the two groups were lower than those before treatment （P<0.05）. After treatment， TMS and TNSS scores in the observation group were lower than those in the control group （P<0.05）. After treatment， interleukin （IL）-4， IL-5 and IL-6 in the two groups were lower than those before treatment （P<0.05）. After treatment， IL-4， IL-5 and IL-6 in the observation group were lower than those in the control group （P<0.05）. After treatment， IgG4 and interferon-γ （IFN-γ） in the two groups were higher than those before treatment， while tumor necrosis factor-α （TNF-α） and IgE were lower than those before treatment （P<0.05）. After treatment， IgG4 and IFN-γ in the observation group were higher than those in the control group， while TNF-α and IgE were lower than those in the control group （P<0.05）. Conclusion： Dermatophagoides Farinae Drops combined with Loratadine in the treatment of allergic rhinitis in children has a better therapeutic effect， which can effectively control inflammatory reaction and reduce allergic reaction. It has certain clinical value.[Key words] Dermatophagoides Farinae Drops Loratadine Allergic rhinitisFirst-authors address： Dongguan Marina Bay Central Hospital， Dongguan 523000， China

過(guò)敏性鼻炎是常見的呼吸系統(tǒng)疾病，其誘發(fā)因素多種多樣，但近年研究表明，塵螨作為誘發(fā)因素之一，誘發(fā)率逐年上升[1-2]。過(guò)敏原接觸機(jī)體后誘發(fā)組胺釋放，多種免疫因子及炎癥因子參與反應(yīng)而引發(fā)此病。目前對(duì)于過(guò)敏性鼻炎的治療主要是過(guò)敏原特異免疫治療即脫敏療法，包括了皮下免疫、舌下免疫和氣管免疫，但皮下免疫操作復(fù)雜，對(duì)患兒來(lái)說(shuō)接受度較低，而舌下免疫操作簡(jiǎn)單、方便易于患兒及家屬接受[3-6]。孟魯司特是常用的抗過(guò)敏藥物，能有效阻礙組胺釋放，是臨床上常用的過(guò)敏性鼻炎治療藥物[7]。本研究以過(guò)敏性鼻炎患兒為研究對(duì)象，觀察粉塵螨滴劑聯(lián)合氯雷他定的治療效果，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料 選取本院2017年2月-2018年6月過(guò)敏性鼻炎患兒86例。納入標(biāo)準(zhǔn)：符合《兒童變應(yīng)性鼻炎診斷和治療指南》診斷標(biāo)準(zhǔn)[8];未使用過(guò)糖皮質(zhì)激素;變應(yīng)原皮試診斷陽(yáng)性。排除標(biāo)準(zhǔn)：合并有哮喘的患兒;合并有其他臟器疾病;患兒家屬不愿參與?！?br>