舌下免疫治疗联合鼻用激素对儿童尘螨变应性鼻炎鼻分泌物嗜酸性粒细胞及短期疗效的影响

Effect of Sublingual Immunotherapy Combined with Intranasal Corticosteroids on Nasal Secretion Eosinophils and Short-Term Efficacy in Children with Dust Mite Allergic Rhinitis

摘要: 目的：探讨8~15岁儿童尘螨变应性鼻炎(Dust Mite Allergic Rhinitis, DMAR)采用舌下免疫治疗(Sublingual Immunotherapy, SLIT)期间，对鼻分泌物嗜酸性粒细胞(Eosinophil, EOS)计数的短期影响，为临床疗效评估及治疗方案优化提供参考。方法：将我院DMAR患儿随机分为对照组和SLIT组。对照组仅给予糠酸莫米松鼻喷剂治疗，SLIT组在对照组基础上加用粉尘螨脱敏剂行舌下免疫治疗，在治疗前(T0)、治疗4周(T1)、治疗8周(T2)、治疗12周(T3)采集患儿鼻腔分泌物，检测EOS计数，同时记录患儿鼻炎症状评分(Total Nasal Symptom Score, TNSS)及药物不良反应发生情况，进行数据比较。结果：同期SLIT组EOS计数和TNSS评分均显著低于对照组，差异具有统计学意义(P < 0.05)。结论：8~15岁DMAR患儿采用SLIT联合糠酸莫米松鼻喷剂治疗可显著降低炎症指标，缓解临床症状，同时安全性较好。

Abstract: Objective: To investigate the short-term impact of sublingual immunotherapy (SLIT) on nasal secretion eosinophil (EOS) counts in children aged 8 - 15 years with dust mite allergic rhinitis (DMAR), and to provide a reference for clinical efficacy evaluation and treatment optimization. Methods: Children with DMAR were randomly assigned into a control group and a SLIT group. The control group received mometasone furoate nasal spray alone, while the SLIT group received SLIT with dust mite allergen extract in addition to the treatment used in the control group. Nasal secretions were collected at baseline (T0) and at 4 (T1), 8 (T2), and 12 weeks (T3) of treatment to measure EOS counts. The Total Nasal Symptom Score (TNSS) and the occurrence of adverse drug reactions were recorded and compared between the two groups. Results: At the corresponding time points post-treatment (T1, T2, and T3), both EOS counts and TNSS in the SLIT group were significantly lower than those in the control group, with the differences being statistically significant (P < 0.05). Conclusion: For children aged 8 - 15 with DMAR, SLIT combined with mometasone furoate nasal spray can significantly reduce inflammatory markers and alleviate clinical symptoms with a favorable safety profile.