Clinical Efficacy And Safety Analysis Of Subcutaneous Specific Immunotherapy For Multiple Allergic Rhinitis

Objective To study the clinical efficacy and safety analysis of standardized subcutaneous specific immunotherapy(SCIT)for house dust mite(HDM)allergens in allergic rhinitis(AR)patients with different allergen profiles.Methods Retrospective study included patients who were diagnosed as allergic rhinitis(AR)induced by HDM and received standardized SCIT with dermatophagoides pteronyssinus allergen preparation for 3 years or more from January 2013 to January 2018,and the follow-up data were complete.According to age,the elderly group(> 14 years old)and the young group(≤14 years old);According to the allergen results,it was divided into single group(HDM group,only allergic to house dust mites)and multiple recombination(including house dust mites with two or more allergens),and multiple recombination was further divided into HDM+1 group,HDM+2 group,HDM+3 group,HDM+4 and above group.Patients’ files were established before SCIT treatment(T0 stage),after receiving SCIT treatment for one year(T1 stage)and three years(T2 stage),and the curative effect scores of patients were evaluated and recorded in the form of regular outpatient follow-up and telephone follow-up: Total nasal symptoms score(TNSS),Total non nasal symptoms score(TNNSS),Visual analogue scale(VAS),total medication score(TMS)and Rhinoconjunctivitis quality of life questionnaire(RQLQ).To evaluate the clinical efficacy of SCIT and compare the efficacy of patients with different allergen profiles and ages.The occurrence of local and systemic adverse reactions of patients during treatment was recorded and analyzed,and the safety of SCIT was analyzed.Results A total of 372 patients were included.After SCIT treatment,the scores of TNSS,TNNSS,TMS,VAS and RQLQ in T1 and T2 were significantly lower than those in T0,and the scores in T2 were significantly lower than those in T1,with statistical significance(P<0.05).In T1 and T2,compared with the elderly group,the clinical efficacy scores of the younger group were lower,and the differences were statistically significant(P<0.05).During T1 and T2 stage,the scores of TNSS,VAS and RQLQ of single group after SCIT treatment were lower than those of multiple recombination,and the difference was statistically significant(P<0.05),but there was no statistical difference in TMS(P>0.05).Further intra-group comparison showed that the improvement rates of TNSS in T2 HDM group,HDM+1 group,HDM+2 group and HDM+3 group had no statistical significance(P>0.005),and the improvement rates were 92.5%,90.3%,89.1% and 89.5%,respectively,which were different from those in HDM+4 and above groups.During the injection,122 patients had local adverse reactions,accounting for 32.8% of all cases.There were 759 times of adverse reactions(15,336 times in total),accounting for 4.95%.The main manifestations were swelling,redness,induration and itching,which could be relieved by taking antihistamines or within 2 hours.Two patients with local urticaria were treated with oral antihistamines,and their symptoms were relieved within one week.No serious adverse reactions occurred.Conclusions Standardized SCIT is a safe and effective treatment for AR patients,and The earlier the treatment,the better the effect.Allergen types may be one of the important factors affecting the efficacy of SCIT.SCIT is effective for AR patients with three or less allergens except house dust mite.