Analysis Of Long-Term Efficacy And Influencing Factors Of Subcutaneous Specific Immunotherapy For Allergic Rhinitis

Objective:To explore the long-term effect of subcutaneous specific immunotherapy(SCIT)on allergic rhinitis,and to analyze the related factors that may affect the efficacy,so that otolaryngologists can provide new ideas in clinical work,so as to better improve the quality of life of patients.Methods:Retrospective analysis was performed on the patients who were diagnosed as allergic rhinitis and received subcutaneous specific immunotherapy in the allergy outpatient department of General Hospital of Northern Theater Command(General Hospital of Shenyang Military Command)from 2004 to 2008,including 57 males and 105 females,aged from 5 years to 56 years,with an average(16.21±10.65)years old.The history of allergic rhinitis was 0.25~28 years,with an average of(4.86±4.24)years.All patients met the following conditions: allergic rhinitis was conformed to the diagnostic and treatment guidelines of Chinese medical association for allergic rhinitis in 2016;the results of allergen skin prick test showed that Dermatophagoides pteronyssinus/Dermatophagoides farinae were and/or above "++";serumspecificity IgE level was greater than or equal to grade 2.Before specific immunotherapy,heart,liver,kidney and lung diseases were excluded,and malignant tumors,bronchiectasis,severe asthma,mental illness or mental disorders and other diseases were excluded.The desensitization treatment time was 3 years,and the total number of injections in 3 years was 39 times.(The actual number and dose of injection in the treatment process of patients were adjusted according to the adverse reaction after the previous injection).During the treatment,patients were followed up once every 4 weeks for clinical evaluation.Patients were asked to conduct a self-assessment and clinical evaluation.This study on the clinical features of patients before treatment,experimental parameters,and the patient basic data for statistics,including total nasal symptom score,allergic drugs score,patient age,gender,personal history,family history of allergies,and exposure to tobacco.To evaluate the long-term clinical efficacy of subcutaneous specific immunotherapy for allergic rhinitis and its related influencing factors by using before and after self-comparison.SPSS 22.0 software was used for statistical analysis of the data.Results:162 patients were included in this study.After 3 years of subcutaneous specific immunotherapy(SCIT),16 patients(9.88%)had local adverse reactions during the treatment,and no systemic adverse reactions occurred.The clinical symptoms score of patients after 5 and 10 years of immunotherapy,such as nasal obstruction,runny nose,sneezing,nasal itching,and medication score,were analyzed.The symptoms were significantly lower than those before treatment.The total score was reduced from 8 points to 5 points before treatment,and the difference was statistically significant(P<0.01).After 3 years of treatment,the average daily medication score per week decreased from 2 points before treatment to 1 point,and the difference was statistically significant(P<0.01).The difference of clinical symptom score and drug score between 5 years after treatment and 10 years after treatment was 0,and the difference was not statistically significant.There was no significant difference in clinical symptom score and drug score between 5 years after treatment and 10 years after treatment.Single factor analysis of the clinical efficacy of SCIT,patients’ age,gender,personal history of allergies,family history of allergies,tobacco exposure history and presence of systemic or local adverse reactions in the process of treatment and other factors in the treatment of 5 years and 10 years there was no statistically significant difference between the clinical curative effect,the number of allergens in SCIT treatment after 5 years there was no statistically significant difference(P=0.063),and after 10 SCIT treatment with statistical significance(P=0.027).Conclusions:SCIT is an effective method for the treatment of allergic rhinitis,which has a unique mechanism different from general drug treatment,and can affect the natural course of the disease,and has long-term efficacy,which can significantly improve the symptoms of the nose and eyes of patients and reduce the need for symptomatic treatment of drugs,and improve the long-term quality of life of patients.Adverse reactions are rare and the safety has been confirmed by clinical observation.The number of allergens may be a factor affecting the clinical efficacy of subcutaneous specific immunotherapy for AR.The treatment should be widely promoted and popularized in otolaryngology to benefit more AR patients.