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Objective: To analyze specific immunotherapy and follow-up management for respiratory allergic diseases in children., Methods: A total of 100 children with allergic bronchial asthma admitted to our hospital from November 2020 to October 2021 were selected. Based on different treatment schemes, they were divided into two groups: the routine treatment group and the immunotherapy group, with 50 cases in each group. The routine treatment group received standard care, while the immunotherapy group underwent specific immunotherapy. Assessment parameters included asthma symptom control score, pulmonary function, immune function, levels of inflammatory factors, clinical efficacy, and adverse reactions., Results: After treatment and during follow-up, the immunotherapy group showed significantly lower scores for daytime and nighttime symptoms compared to the routine treatment group (P < .05). The immunotherapy group also exhibited higher FEV1/FVC and PEF% values compared to the routine therapy group after treatment and at follow-up (P < .05). Furthermore, the immunotherapy group showed higher levels of CD3+, CD4+, and CD4+/CD8+ and lower levels of CD8+ compared to the routine therapy group (P < .05). Additionally, the immunotherapy group demonstrated lower levels of IL-4 and IL-12 compared to the routine therapy group after treatment and during follow-up (P < .05). The total effective rate of the immunotherapy group was higher than that of the routine therapy group (P < .05). The incidence of adverse reactions in the immunotherapy group was similar to that in the routine therapy group (P > .05)., Conclusions: Specific immunotherapy is a significantly effective approach to managing children's allergic bronchial asthma. It effectively controls asthma symptoms, improves lung function and immune response, and reduces inflammatory factors. It showed superior clinical efficacy and minimal adverse reactions; specific immunotherapy, therefore, is a safe and beneficial treatment option that warrants further promotion and application.