摘要
目的探讨特异性免疫治疗(SIT)联合盐酸哌甲酯控释片治疗中-重度持续性变应性鼻炎(AR)伴注意缺陷多动障碍(ADHD)患儿的临床效果。方法回顾性分析127例中-重度持续AR伴ADHD患儿的临床资料,按治疗方式分为哌甲酯组40例、SIT组43例和联合组44例。哌甲酯组给予口服盐酸哌甲酯控释片,SIT组给予常规尘螨变应原免疫治疗,联合组给予口服盐酸哌甲酯控释片和常规尘螨变应原免疫治疗。治疗前后比较3组患儿的鼻部症状评分、鼻结膜炎生活质量问卷(RQLQ)评分、ADHD症状评分,并评估AR、ADHD治疗效果。结果治疗后,3组的鼻部症状视觉模拟量表(VAS)评分、RQLQ各项评分(除哌甲酯组的鼻部症状外)均低于治疗前,且哌甲酯组、SIT组、联合组的鼻部症状VAS评分、RQLQ各项评分(除哌甲酯组的鼻部症状外)依次降低(均P<0.05);3组的ADHD症状评分低于治疗前(P<0.05),SIT组、哌甲酯组、联合组ADHD症状评分依次降低(均P<0.05)。联合组和SIT组的AR治疗总有效率大于哌甲酯组,联合组和哌甲酯组的ADHD治疗总有效率大于SIT组(均P<0.05)。结论对于合并ADHD的中-重度持续性AR患儿,SIT联合盐酸哌甲酯治疗能够更好地改善其鼻部症状、多动症状和生活质量,提高临床疗效。
Objective To investigate the clinical efficacy of specific immunotherapy(SIT) combined with Methylphenidate Hydrochloride Controlled-Release Tablets for the treatment of children with moderate-to-severe persistent allergic rhinitis(AR) accompanied by attention-deficit/hyperactivity disorder(ADHD). Methods The clinical data of 127 children with moderate-to-severe persistent AR accompanied by ADHD were retrospectively analyzed. They were divided into methylphenidate group(40 cases), SIT group(43 cases) and combination group(44 cases). The methylphenidate group was given oral Methylphenidate Hydrochloride Controlled-Release Tablets, the SIT group was given conventional immunotherapy of dust mite allergen, the combination group was given oral Methylphenidate Hydrochloride Controlled-Release Tablets and conventional immunotherapy of dust mite allergen. Nasal symptoms scores, Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ) scores and ADHD symptoms scores before and after treatment were compared among the there groups, and the therapeutic efficacy for AR and ADHD was evaluated. Results After treatment, the Visual Analogue Scale(VAS) scores for nasal symptoms, and the score for each RQLQ item(excluding nasal symptoms in the methylphenidate group) were lower in three groups compared with those before treatment, moreover, the scores for nasal symptoms and the score for each RQLQ item(excluding nasal symptoms in the methylphenidate group) decreased in sequence of the methylphenidate group, the SIT group and the combination group(all P<0.05);the scores for ADHD symptoms in the three groups were lower than those before treatment(P<0.05), the scores for ADHD symptoms decreased in sequence of the SIT group, the methylphenidate group and the combination group(all P<0.05). The total effective rate for AR treatment in the combination and SIT groups was greater than that in the methylphenidate group, and the total effective rate for ADHD treatment in the combination and methylphenidate groups was greater than that in the SIT group(all P<0.05). Conclusion For children with moderate-to-severe persistent AR complicated with ADHD, SIT combined with methylphenidate hydrochloride can better improve their nasal and hyperactivity symptoms, quality of life and clinical efficacy.
作者
岑瑞祥
彭聪
许昱
万浪
赵凯
CEN Rui-xiang;PENG Cong;XU Yu;WAN Lang;ZHAO Kai(Department of Otolaryngology,Head&Neck Surgery,Affiliated Hospital of Hubei Polytechnic University&Huangshi Central Hospital,Edong Healthcare Group,Huangshi 435000,China;Department of Otolaryngology,Head&Neck Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《广西医学》
CAS
2020年第6期661-664,702,共5页
Guangxi Medical Journal
基金
国家自然科学基金(81770986)。
关键词
变应性鼻炎
持续性
中-重度
注意缺陷与多动障碍
特异性免疫治疗
哌甲酯
联合治疗
症状改善
生活治疗
临床疗效
Allergic rhinitis
Persistent
Moderate-to-severe
Attention-deficit/hyperactivity disorder
Specific immunotherapy
Methylphenidate
Combination therapy
Symptom remission
Quality of life
Clinical efficacy
