Objective To evaluate the clinical efficacy and safety of specific immunotherapy( SIT )plus inhalant corticosteroid( ICS ) for patients with dust mite-induced allergic asthma. Methods 92 eligible patients were divided into two groups ,58 in the test group and 34 in the control one. The patients in test were treated with injection dermatophagoidei farini (dermatophagoides pteronyssinus ) plus budesonide inhalation for la , the former of which started gradually from 1st grade ( 50 TU · mL-1 )0.1 mL to 3rd grade( 5 000 TU · mL-1 )0.8 mL for maintaining treatment, and the average initial dosage of ICS was ( 430±200 ) μg · d-1. The patients in control were treated with budesonide in halation for 1 a, the average initial dosage of ICS was ( 420±205 ) μg · d-1. The ACT survey and lung function test were performed for all tested patients every 3 months. The dosage of ICS were reduced 50％ if the asthma were well controlled. The quality of life was assessed in all patients by AQLQ before and after the treatment. Adverse drug reactions were recorded during the entire study process. Results The asthma,lung function, AQLQ score and the daily ICS usage were significantly improved after treatment in both groups( P＜0.05 ). The asthma control rate in the test group was 93.1％, which was higher than that in the control group( 70.6％ )( P＜0.05 ). The average ICS usage in the test was ( 260±80 ) μg · d-1 ,which was lower than that in the control [ ( 350±160 ) μg · d-1 ] ( P＜ 0.05 ) . There were no significant differences appeared for the lung function and AQLQ score between the two groups after treatment( P＞0.05 ). The main adverse reactions of SIT were nodule, redness and swelling in the injection site and no severe side effects occured in the whole study. Conclusion The efficacy of SIT combined ICS is better than single ICS in the treatment of allergic asthma and the combined therapy has a good safety profile.%目的 评估比较特异性免疫治疗(specific immunotherapy,SIT)联合吸入性糖皮质激素(inhaled corticosteroids,ICS)和单用ICS治疗过敏性哮喘的疗效和安全性.方法 92例单纯尘螨过敏性哮喘患者分为治疗组58例和对照组34例.治疗组使用屋尘螨脱敏注射液和布地奈德干粉吸入剂联合治疗1 a,脱敏注射液起始用量为1级浓度(50 TU·mL-1)0.1 mL,逐渐增量至3级浓度(5 000 TU·mL-1)0.8 mL维持治疗,布地奈德平均起始剂量为(430±200) μg·d-1;对照组使用布地奈德干粉吸入剂1 a,平均起始剂量为(420±205) μg· d-1.所有受试者每3个月进行一次哮喘控制测试问卷(asthma control test,ACT)问卷评分和肺功能检查,哮喘控制良好者ICS用量减少50%.所有受试者在治疗前和治疗后分别用哮喘生命质量表(asthma-related quality of life questionnaire,AQLQ)进行生活质量评估.在整个研究过程中记录药物不良反应.结果 两组患者治疗后哮喘控制情况、肺功能、AQLQ评分和ICS用量均较治疗前有明显改善(P＜0.05).治疗组哮喘良好控制率(93.1%)高于对照组(70.6%,P＜0.05),治疗组平均ICS用量[(260±80) μg·d-1],低于对照组[(350±160) μg·d-1,P＜0.05],肺功能检查和AQLQ评分两组间差异无统计学意义(P＞0.05).SIT主要不良反应为注射部位红肿、风团和硬结,无严重不良反应发生.结论 SIT联合ICS能有效治疗过敏性哮喘,疗效优于单用ICS,且安全性好.
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