Article record

淋巴结内免疫治疗（ILIT）与标准治疗或安慰剂治疗过敏性鼻炎的对比：随机对照试验的系统评价与荟萃分析

Intralymphatic immunotherapy (ILIT) versus standard care or placebo in allergic rhinitis: A systematic review and meta-analysis of randomized controlled trials.

综述 Meta鼻科IF 1.8Q2

文献信息

PMID	42950630
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Mohammed Ubaid Almezher 查看其他 13 位作者 Fares Alharbi；Ayshah Alshngeetee；Raneem Mohammed Almugharriq；Atheer Khalaf Alanazi；Refan Aljuaid；Rolin Gharbi；Waad Sultan Alamri；Ranen Emad Mash；May Hamad S Alqaed；Saleh Fahad Aldubayyan；Mohammed Albalawi；Ahmad M Aldhafeeri；Ahmed Elaraby
作者单位	College of Medicine, King Khalid University, Abha, Saudi Arabia. Electronic address: mhmdu142487@gmail.com. 查看其他 12 条单位信息 College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.；Ministry of Health, Riyadh Health Cluster 3, Saudi Arabia.；College of Medicine, Jouf University, Sakaka, Saudi Arabia.；College of Medicine, Tabuk University, Tabuk, 71491, Saudi Arabia.；College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.；College of Medicine, Ibnsina College, Jeddah, Saudi Arabia.；College of Medicine, King Khalid University, Abha, Saudi Arabia.；King Abdullah Medical City, Makkah, Saudi Arabia.；Qassim Health cluster, Saudi Arabia.；Arabian Gulf University, Bahrain.；Department of Otolaryngology, Hafr Albaten Central Hospital, Hafr Albaten Health cluster, Hafr Albaten, 31991, Saudi Arabia.；Faculty of Medicine, Al-Azhar university, Cairo, Egypt. Electronic address: Aelarabymd@gmail.com.
期刊	American journal of otolaryngology
SCI 分区	Q2
IF	1.8
研究类型	综述 Meta · 临床
所属专科	鼻科

中文摘要

背景： 皮下免疫治疗（SCIT）是过敏性鼻炎（AR）的金标准，但受限于治疗疗程长和依从性差。淋巴结内免疫治疗（ILIT）已成为一种省时的替代方案。
目的： 评价ILIT与安慰剂或SCIT相比在AR患者中的疗效和安全性。
方法： 我们检索了PubMed、Scopus、Web of Science、Embase和Cochrane CENTRAL截至2026年2月的随机对照试验（RCT），比较ILIT与安慰剂或SCIT。主要结局为症状与药物联合评分（CSMS）。次要结局包括生活质量（RQLQ）、症状评分和不良事件。采用随机效应模型汇总数据。
结果： 共纳入16项RCT，涉及606例患者。与安慰剂相比，ILIT显著降低CSMS（SMD = -0.51，95% CI：-0.82至-0.20，p < 0.001；MD = -1.32）。然而，鼻结膜炎生活质量问卷（RQLQ）评分未见显著差异（p = 0.74）。在与SCIT的头对头比较中，ILIT在3、6和12个月时对总症状评分（TSS）和鼻部总症状评分（TNSS）显示出相似疗效。然而，SCIT在24和36个月时表现出更优的持久性（p > 0.05，趋势支持SCIT）。在安全性方面，与安慰剂相比，ILIT与更高的局部肿胀风险相关（RR = 4.25，p < 0.001），但与SCIT相比，总不良事件风险降低58%（RR = 0.42，p = 0.01）。
结论： ILIT是一种有效的短程替代方案，与安慰剂相比可减轻症状和减少用药，但可能不会显著改善生活质量。

英文摘要

BACKGROUND: Subcutaneous immunotherapy (SCIT) is the gold standard for allergic rhinitis (AR) but is limited by long treatment duration and poor adherence. Intralymphatic immunotherapy (ILIT) has emerged as a time-efficient alternative.
OBJECTIVE: To evaluate the efficacy and safety of ILIT compared with placebo or SCIT in patients with AR.
METHODS: We searched PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL up to February 2026 for randomized controlled trials (RCTs) comparing ILIT with placebo or SCIT. The primary outcome was the Combined Symptom and Medication Score (CSMS). Secondary outcomes included quality of life (RQLQ), symptom scores, and adverse events. Data were pooled using random-effects models.
RESULTS: Sixteen RCTs involving 606 patients were included. ILIT significantly reduced CSMS compared with placebo (SMD = -0.51, 95% CI: -0.82 to -0.20, p < 0.001; MD = -1.32). However, no significant difference was observed in the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores (p = 0.74). In head-to-head comparisons with SCIT, ILIT showed similar efficacy at 3, 6, and 12 months for Total Symptom Score (TSS) and Total Nasal Symptom Score (TNSS). However, SCIT demonstrated superior durability at 24 and 36 months (p > 0.05 favoring SCIT trends). Regarding safety, ILIT was associated with a higher risk of local swelling compared with placebo (RR = 4.25, p < 0.001) but had a 58% lower risk of total adverse events compared with SCIT (RR = 0.42, p = 0.01).
CONCLUSION: ILIT is an effective short-course alternative that reduces symptoms and medication use compared with placebo, though it may not significantly improve quality of life.