The Efficacy And Satisfaction Survey Of Children With Allergic Rhinitis And Asthma In Combined Diagnostic And Therapeutic Mode

Objective To observe the efficacy of allergic rhinitis and asthmatic children after treatment in Combined Allergic Rhinitis and Asthma clinic （Combined Clinic）and to survey the parents’ satisfaction on the Combined Clinic.To explore the clinical efficacy and social influence in Combined Clinic.Method Under the combined diagnosis of otolaryngologist and pediatrician in the same clinic from2013September to2013December,59confirmed allergic rhinitis and asthmatic children from Combined Clinic,who were treated in Separate Otolaryngology Clinic and/or Pediatric Clinic (Separate Clinic) for more than three months before and weren’t content with the clinical efficiency, received standardized,individual treatment of combined upper and lower airway for three months. The comparison of nasal symptom visual analogue scale(VAS),pulmonary VAS,total nasal symptom score(TNSS),total pulmonary symptom score(TPSS), nasal signs,pulmonary signs,the levels of asthma control, lung function and fractional concentration of exhaled nitric oxide(FeNO) before and after the therapy were performed to evaluate the clinical efficacy. The diagnostic and therapeutic satisfaction of parents in Combined Clinic and Separate Clinic was compared by questionnaires. Telephone follow-up was used for the patient without subsequent visit on the scheduled time,the others by face-to-face method.Result After three months of treatment,42children returned to the doctor, among the older children(more than5years),12cases who successed to cooperate lung function performed lung function test and20who successed to cooperate FeNO performed FeNO test again.After treatment, the combined mode significantly decreased nasal VAS and pulmonary VAS of the children with allergic rhinitis and asthma（both P＜0.05）. For TNSS，26cases marked effectiveness,17cases effectivensss,the total effective rate was72.9%;for TPSS,31cases marked effectiveness,14cases effectivensss,the total effective rate was76.3%. The level of asthma control were improved significantly after treatment(P＜0.05).The pulmonary signs had significant difference （P＜0.05）, the difference of nasal signs was not statistically significant （P＞0.05） in42children. Forced expiratory flow in one second/predictive value（FEV1/pre）and forced expiratory flow at25%and75%of the pulmonary volume (FEF25-75%) of lung function and FeNO were significantly increased compared to that of pretreatment(all of the P＜0.05). Statistical significance of satisfaction in appointment and waiting time for the doctor, comprehensive cost, outpatient environment, the efficacy of nasal disease, asthma efficacy, health education and answering questions in the Combined Clinic and Separate Clinic (all of the P value＜0.05).The general satisfaction of Combined Clinic was also better than the Separate one (P＜0.05),and the consolidated expenses satisfaction didn’t show significance（P＞0.05）.Conclusion In the same consulting room,the otolaryngologist and pediatrician could treat the allergic rhinitis and asthmatic children together after the combined diagnosis;in combined diagnostic and therapeutic mode,by which way the effect of allergic rhinitis and asthma children was significant and the satisfaction of the parents was better than that of Separate Clinic.The combined mode which was effective,convenient and high-quality and could improve the clinal efficiency and parents’ satisfaction and didn’t increase the consolidated expenses, was worthy popularizing.