抗过敏床垫罩对中重度哮喘和屋尘螨过敏患者疗效的临床评估：一项随机双盲安慰剂对照研究。
Clinical evaluation of the effect of anti-allergic mattress covers in patients with moderate to severe asthma and house dust mite allergy: a randomised double blind placebo controlled study.
作者信息
Rijssenbeek-Nouwens L H M, Oosting A J, de Bruin-Weller M S, Bregman I, de Monchy J G R, Postma D S
机构信息
Asthmacenter Heideheuvel, Hilversum, The Netherlands.
出版信息
Thorax. 2002 Sep;57(9):784-90. doi: 10.1136/thorax.57.9.784.
BACKGROUND
The use of anti-allergic mattress covers in patients with asthma can result in a large reduction in the level of house dust mite allergen in dust samples. Apart from a reduction in histamine induced bronchial hyperresponsiveness, there are few data on the effect of mattress covers on clinical efficacy and quality of life in patients with moderate to severe asthma.
METHODS
Thirty patients with asthma and house dust mite allergy were studied in a randomised, double blind, placebo controlled study. Before and after using anti-allergic covers for 1 year, dust was collected from the mattresses to determine concentrations of Dermatophagoides pteronyssinus (Der p 1), and bronchial hyperresponsiveness and quality of life were measured. The patients scored their symptoms (lungs and nose), morning and evening peak flow values, and rescue medication for 14 days before and after the intervention period.
RESULTS
There was a significant reduction in the concentration of Der p 1 in the dust collected from the mattresses in the actively treated group after 1 year compared with before treatment; no change was found in the placebo group. In both the actively treated and placebo groups there was no significant improvement in PC(20) histamine. Quality of life improved similarly in both groups. The symptom score of the lower airways did not significantly change in either group. A significant decrease in nasal symptom score was seen in the actively treated group compared with before treatment, but there was no significant difference between the groups. No changes in morning and evening peak flow values, peak flow variability, nor in the use of rescue medication were found in either group.
CONCLUSION
The use of anti-allergic mattress covers results in significant reductions in Der p 1 concentrations in carpet-free bedrooms. However, in patients with moderate to severe asthma, airways hyperresponsiveness and clinical parameters are not affected by this effective allergen avoidance.
背景
在哮喘患者中使用抗过敏床垫套可使灰尘样本中的屋尘螨过敏原水平大幅降低。除了组胺诱导的支气管高反应性降低外，关于床垫套对中度至重度哮喘患者临床疗效和生活质量影响的数据很少。
方法
在一项随机、双盲、安慰剂对照研究中对30例哮喘合并屋尘螨过敏患者进行了研究。在使用抗过敏床罩1年前后，从床垫上收集灰尘以测定尘螨（Der p 1）浓度，并测量支气管高反应性和生活质量。患者在干预期前后14天对其症状（肺部和鼻部）、早晚峰值流速值以及急救药物进行评分。
结果
与治疗前相比，积极治疗组在1年后从床垫收集的灰尘中Der p 1浓度显著降低；安慰剂组未发现变化。在积极治疗组和安慰剂组中，组胺激发浓度（PC20）均无显著改善。两组生活质量改善情况相似。两组下呼吸道症状评分均无显著变化。与治疗前相比，积极治疗组鼻部症状评分显著降低，但两组间无显著差异。两组早晚峰值流速值、峰值流速变异性以及急救药物使用均未发现变化。
结论
使用抗过敏床垫套可使无地毯卧室中的Der p 1浓度显著降低。然而，对于中度至重度哮喘患者，这种有效的过敏原回避措施并未影响气道高反应性和临床参数。
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