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过敏性哮喘和过敏性鼻炎患者接受尘螨过敏原疫苗治疗的依从性及脱失情况分析
Analysis of compliance and loss of treatment for allergic asthma and allergic rhinitis patients treated with dust mite allergen vaccine
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DOI:10.3969/j.issn.1673-9701.2023.05.012
关键词:  过敏性哮喘  过敏性鼻炎  尘螨  过敏原  疫苗
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孙银萍 诸暨市中医医院耳鼻咽喉科浙江诸暨 311800绍兴市越城区人民医院耳鼻咽喉科浙江绍兴 312000绍兴文理学院附属医院耳鼻咽喉科浙江绍兴 312000 
张嘉钰 诸暨市中医医院耳鼻咽喉科浙江诸暨 311800绍兴市越城区人民医院耳鼻咽喉科浙江绍兴 312000绍兴文理学院附属医院耳鼻咽喉科浙江绍兴 312000 
钟熠颖 诸暨市中医医院耳鼻咽喉科浙江诸暨 311800绍兴市越城区人民医院耳鼻咽喉科浙江绍兴 312000绍兴文理学院附属医院耳鼻咽喉科浙江绍兴 312000 
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摘要:目的 描述过敏性哮喘患者和过敏性鼻炎患者接受尘螨过敏原疫苗治疗的依从性及脱失情况,并探索其脱失原因。方法 选取2020年1月至2021年12月诸暨市中医医院收治的接受尘螨过敏原疫苗治疗的过敏性鼻炎和过敏性哮喘患者327例,按照年龄,4~14岁分为成人组(n=138),15~64岁分为儿童组(n=189)。采用自制问卷对入选患者进行调查分析,其中在治疗期间连续两次没有按时接受治疗并经电话随访表示不再继续接受治疗的患者判定为病例脱失,分析脱失病例的脱失原因。结果 共有55例患者脱失,脱失率为16.82%;成人组患者的脱失比例(22.46%)显著高于儿童组(12.69%)(P<0.05)。起始期患者脱失比例(28.95%),显著高于维持期(13.15%)(P<0.05)。怀孕、疗效不佳、经济困难、症状改善、时间紧张等脱失原因在不同年龄组和不同阶段中的比较,差异均无统计学意义(P>0.05),但是在儿童组中因为药物不良反应而脱失的比例则显著高于成人组(P<0.05)。结论 过敏性哮喘和过敏性鼻炎患者接受尘螨过敏原疫苗治疗的临床上依从性较低,病例脱失率较高,应对患者进行有效的护理和健康教育,从而提高患者临床治疗的依从性,进而使患者配合能够全程配合治疗并巩固临床疗效。
Abstract:Objective To describe the adherence and dropout of patients with allergic asthma and allergic rhinitis treated with dust mite allergen vaccine and to explore the reasons for their dropout. Method A total of 327 patients with allergic rhinitis and allergic asthma treated with dust mite allergen vaccine in Zhuji Hospital of Traditional Chinese Medicine from January 2020 to December 2021 were selected, and 15 to 64 years were divided into the adult group (n=138) and 4 to 14 years were divided into the children's group (n=189) according to age. A self-administered questionnaire was used to survey and analyze the patients enrolled. Patients who did not receive treatment on time twice in a row during the treatment period and who were followed up by telephone indicated that they would not continue to receive treatment were considered as lost cases and the reasons for loss of cases were analyzed. Result A total of 55 patients were lost, with a loss rate of 16.82%; the proportion of patients lost in the adult group (22.46%) was significantly higher than that in the children's group (12.69%) (P<0.05). The proportion of patients who lost was significantly higher in the starting phase (28.95%) than that in the maintenance phase (13.15%) (P<0.05). There was no statistically significant differencein the comparison of reasons for discontinuation across age groups and stages, such as pregnancy, poor efficacy, financial difficulties, symptom improvement and time constraints (P>0.05), but the proportion of discontinuations due to adverse drug reactions was significantly higher in the paediatric group than in the adult group (P<0.05).Conclusion Patients with allergic asthma and allergic rhinitis have a low clinical compliance with the dust mite allergen vaccine and a high drop-out rate. Effective care and health education should be provided to improve the patient's compliance with clinical treatment so that the patient can cooperate with the treatment throughout and consolidate the clinical outcome.
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