| Objective: To understand the effects of sublingual immunotherapy(SLIT)on symptom and medcation score(SMS),fractional exhaled nitric oxide(FeNO)levels,childhood asthma control test(C-ACT)scores,and lung function in children with asthma,asthma,and allergic rhinitis,for SLIT treatment of childhood asthma,asthma and rhinitis provide clinical evidence.Methods: The children who were diagnosed with bronchial asthma and allergic rhinitis diagnosed at the Children’s Respiratory Specialist Clinic of the Affiliated Hospital of Guizhou Medical University and the Department of Otorhinolaryngology were selected,skin prick tests or serum to detect dust mite allergen-specific positive(sIgE:++and above);treatment in Children’s respiratory specialist,otolaryngology department and diagnosed as bronchial asthma(BA),allergic rhinitis(AR)in children,91 children with bronchial asthma,54 children with bronchial asthma and rhinitis,skin prick test or serum-specific allergen test dust mite positive,drug therapy alone for the inhaled corticosteroid(ICS)group,with parental consent for drug treatment combined with SLIT treatment for the ICS+SLIT group;record the clinical manifestations of children,with or without acute asthma attack,β-2 receptor agonist use,children and parents to complete the C-ACT test,record scores,review nitric oxide,pulmonary function,according to the results of the upgrade or downgrade treatment,and recorded nasal symptoms and Otolaryngology clinic outpatient records.Independent sample t test was used for age comparison,and chi-square test was used for gender comparison.FeNO level,C-ACT score,SMS score and lung function were compared by anova at different time points in children with asthma and those with asthma with rhinitis,and LSD test was used for pairwise comparison.ICS group was compared with ICS+SLIT using independent sample t test.Results:(1)There was no significant difference in age and sex between ICS group and ICS+SLIT group(P>0.05).(2)SMS scores:The SMS scores of ICS group and ICS+SLIT group were lower than those before treatment,and the difference was statistically significant(P<0.05).Compared with ICS group,the score of SMS in children with ICS+SLIT group decreased significantly;The SMS score of asthma with rhinitis was higher than that of asthma children.(3)C-ACT scores :The C-ACT scores of children in ICS group and ICS+SLIT group were significantly higher than those before treatment(P<0.05).Compared with ICS group,children with ICS+SLIT group C-ACT scores increased significantly;The time required for C-ACT scores to reach complete control in children with asthma with rhinitis is longer than that in children with asthma alone.(4)4FeNO levels: FeNO levels in children with ICS and ICS+SLIT decreased compared with those before treatment,and FeNO levels decreased significantly in children with ICS+SLIT(P<0.05).There was no significant difference between the ICS group and the ICS+SLIT group in children with asthma,asthma with rhinitis(all P>0.05).The level of FeNO in children with asthma with rhinitis was higher than that in children with asthma alone.(5)Pulmonary function: The indexes of lung function in children with ICS and ICS+SLIT were improved compared with those before treatment.Compared with ICS group,the ICS+SLIT group had significant improvement in lung function FVC treatment for 9 months,and PEF treatment for 12 months were significant improvement,FEF25 treatment for 12 months was statistically significant(P<0.05).The lung function indexes of ICS group and ICS+SLIT group in asthma with rhinitis were improved compared with those before treatment.Compared with ICS group,the ICS+SLIT group of lung function index FVC for 9 months and treatment at 12 months had significant improvement.The difference was statistically significant.(P<0.05);The lung function index of lung function was significantly improved first;the lung function value of ICS+SLIT group was higher than that of ICS group in children with asthma,asthma and rhinitis.The index of lung function of asthmatic children was higher than that of asthmatic children with rhinitis.Conclusion:(1)ICS therapy can improve clinical symptoms,reduce drug use,reduce FeNO levels,and improve lung function;(2)ICS combined with SLIT treatment can significantly improve clinical symptoms,reduce drug use,reduce FeNO levels,and improve lung function;ICS+SLIT group scores better than SMS,C-ACT score,FeNO level,lung function and other indicators than ICS alone.(3)SLIT treatment is a safe and effective treatment.Long-term,adequate SLIT treatment can improve patients’ symptoms,better control disease progression and improve quality of life. |
