舌下含服塵螨滴劑治療變應性鼻炎療效的Meta分析_《中國循證醫學雜志》

作者：

崔瀟 , 田穎 , 于剛 ,  姜學鈞

中國醫科大學附屬第一醫院耳鼻咽喉科（沈陽 110001）;

關鍵詞：

塵螨變應性鼻炎免疫治療塵螨滴劑系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20130155

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目的　系統評價舌下含服塵螨滴劑對變應性鼻炎的療效。
方法　計算機檢索MEDLINE、EMbase、The Cochrane Library（2012年第10期）、CNKI、VIP、WanFang Data和CBM，收集有關舌下含服塵螨滴劑治療變應性鼻炎的隨機對照試驗（RCT），檢索時限均為從建庫至2012年10月。由2名研究者根據納入和排除標準獨立篩選文獻、提取資料，并評價納入研究的方法學質量后，采用 RevMan 5.1 軟件進行Meta分析。
結果　納入8個RCT，共788例患者。Meta分析結果顯示：舌下含服塵螨滴劑治療變應性鼻炎的總有效率與對照組比較無明顯差異［RR=1.15，95%CI（0.88，1.50），P=0.29］，但其在降低鼻癥狀評分［SMD= ?1.13，95%CI（?2.07，?0.20），P=0.02 ］和減少藥物使用［SMD= ?0.60，95%CI（?1.06，?0.15），P=0.009］方面優于對照組。
結論　舌下含服塵螨滴劑可改善變應性鼻炎患者的臨床癥狀，減少抗組胺、β受體阻滯劑及鼻噴激素的使用頻率。

引用本文： 崔瀟,田穎,于剛,姜學鈞. 舌下含服塵螨滴劑治療變應性鼻炎療效的Meta分析. 中國循證醫學雜志, 2013, 13(7): 885-889. doi: 10.7507/1672-2531.20130155 復制

1.	王成碩, 張羅, 韓德民, 等. 北京地區變應性鼻炎患者吸入變應原譜分析. 臨床耳鼻咽喉科雜志, 2006, 20(5): 204-206.
2.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
3.	Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
4.	陳建軍, 孔維佳, 項濟生, 等. 標準化粉塵螨滴劑治療變應性鼻炎的半年期療效濟安全性研究. 華中科技大學學報, 2008, 37(6): 823-827.
5.	de Bot CM, Moed H, Berger MY, et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care. Pediatric allery and immunology, 2012 23(2): 150-158.
6.	Guez S, Vatrinet C, Fadel R, et al. House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy, 2000, 55(4): 369-375.
7.	Passalacqua G, Pasquali M, Ariano R, et al. Randomized double-blind controlled study with sublingual carbamylated allergoid immunotherapy in mild rhinitis due to mites. Allergy, 2006, 61(7): 849-854.
8.	蘇芳, 謝景華, 孟慶翔. 粉塵螨疫苗治療過敏性鼻炎療效與個體化用藥. 河北醫學, 2011, 17(6): 772-774.
9.	Tseng SH, Fu LS, Nong BR, et al. Changes in serum specific IgG4 and IgG4/IgE ratio in mite-sensitized Taiwanese children with allergic rhinitis receiving short-term sublingual-swallow immunotherapy: a multicenter, randomized, placebo-controlled trial. Asian Pac J Allergy Immunol, 2008, 26(2-3): 105-112.
10.	謝永漢, 林福榮, 范振蘭. 舌下含服粉塵螨滴劑治療變應性鼻炎100例臨床分析. 臨床醫藥實踐, 2009, 18(6): 462-464.
11.	Yonekura S, Okamoto Y, Sakurai D, et al. Sublingual immunotherapy with house dust extract for house dust-mite allergic rhinitis in children. Allergol Int, 2010 59(4): 381-388.
12.	NOON L. Prophylactic inoculation against hay fever. Int Arch Allergy Appl Immunol, 1953, 4(4): 285-288.
13.	Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy, 2009 64(11): 1570-1579.
14.	Ippoliti F, De Sanctis W, Volterrani A, et al. Immunomodulation during sublingual therapy in allergic children. Pediatr Allergy Immunol, 2003, 14(3): 216-221.
15.	Lue KH, Lin YH, Sun HL, et al. Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized placebo-controlled study. Pediatr Allergy Immunol, 2006, 17(6): 408-415.
16.	Moingeon P, Batard T, Fadel R, et al. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy, 2006, 61(2): 151-165.
17.	Lu FM, Chou CC, Chiang BL, et al. Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels. Ann Allergy Asthma Immunol, 1998, 80(5): 419-423.
18.	Pajno GB. Sublingual immunotherapy: the optimism and the issues. J Allergy Clin Immunol, 2007, 119(4): 796-801.
19.	Passalacqua G, Durham SR. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol, 2007, 119(4): 881-891.
20.	Pfaar O, Klimek L. Efficacy and safety of specific immunotherapy with a high-dose sublingual grass pollen preparation: a double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol, 2008, 100(3): 256-263.

1. 王成碩, 張羅, 韓德民, 等. 北京地區變應性鼻炎患者吸入變應原譜分析. 臨床耳鼻咽喉科雜志, 2006, 20(5): 204-206.
2. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
3. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
4. 陳建軍, 孔維佳, 項濟生, 等. 標準化粉塵螨滴劑治療變應性鼻炎的半年期療效濟安全性研究. 華中科技大學學報, 2008, 37(6): 823-827.
5. de Bot CM, Moed H, Berger MY, et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care. Pediatric allery and immunology, 2012 23(2): 150-158.
6. Guez S, Vatrinet C, Fadel R, et al. House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy, 2000, 55(4): 369-375.
7. Passalacqua G, Pasquali M, Ariano R, et al. Randomized double-blind controlled study with sublingual carbamylated allergoid immunotherapy in mild rhinitis due to mites. Allergy, 2006, 61(7): 849-854.
8. 蘇芳, 謝景華, 孟慶翔. 粉塵螨疫苗治療過敏性鼻炎療效與個體化用藥. 河北醫學, 2011, 17(6): 772-774.
9. Tseng SH, Fu LS, Nong BR, et al. Changes in serum specific IgG4 and IgG4/IgE ratio in mite-sensitized Taiwanese children with allergic rhinitis receiving short-term sublingual-swallow immunotherapy: a multicenter, randomized, placebo-controlled trial. Asian Pac J Allergy Immunol, 2008, 26(2-3): 105-112.
10. 謝永漢, 林福榮, 范振蘭. 舌下含服粉塵螨滴劑治療變應性鼻炎100例臨床分析. 臨床醫藥實踐, 2009, 18(6): 462-464.
11. Yonekura S, Okamoto Y, Sakurai D, et al. Sublingual immunotherapy with house dust extract for house dust-mite allergic rhinitis in children. Allergol Int, 2010 59(4): 381-388.
12. NOON L. Prophylactic inoculation against hay fever. Int Arch Allergy Appl Immunol, 1953, 4(4): 285-288.
13. Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy, 2009 64(11): 1570-1579.
14. Ippoliti F, De Sanctis W, Volterrani A, et al. Immunomodulation during sublingual therapy in allergic children. Pediatr Allergy Immunol, 2003, 14(3): 216-221.
15. Lue KH, Lin YH, Sun HL, et al. Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized placebo-controlled study. Pediatr Allergy Immunol, 2006, 17(6): 408-415.
16. Moingeon P, Batard T, Fadel R, et al. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy, 2006, 61(2): 151-165.
17. Lu FM, Chou CC, Chiang BL, et al. Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels. Ann Allergy Asthma Immunol, 1998, 80(5): 419-423.
18. Pajno GB. Sublingual immunotherapy: the optimism and the issues. J Allergy Clin Immunol, 2007, 119(4): 796-801.
19. Passalacqua G, Durham SR. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol, 2007, 119(4): 881-891.
20. Pfaar O, Klimek L. Efficacy and safety of specific immunotherapy with a high-dose sublingual grass pollen preparation: a double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol, 2008, 100(3): 256-263.

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《中國循證醫學雜志》

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