Huss K, Squire E N, Carpenter G B, Smith L J, Huss R W, Salata K, Salerno M, Agostinelli D, Hershey J
Allergy/Immunology Service, Walter Reed Army Medical Center, Washington, D.C. 20307.
J Allergy Clin Immunol. 1992 Apr;89(4):836-43. doi: 10.1016/0091-6749(92)90439-9.
The effects of supplementary computer instruction in house dust mite-avoidance measures on adherence to implementing measures, on home dust mite-allergen levels, and on symptomatology were investigated in 52 adult patients with mite-associated asthma. Twenty-six patients received conventional instruction (counseling and written instruction) and the other 26 patients received conventional plus 22 minutes of interactive computer-assisted instruction. Instructions were aimed at mite-avoidance measures. Pre- and postinstruction dust samples were collected, and adherence was monitored. All patients kept symptom diaries twice a day. Patients' progress was followed for 12 weeks, and all patients completed the study. Adherence, number of observed and self-reported mite-avoidance measures implemented after visit, was higher for the computer group (p = 0.023). The computer-instructed group achieved significantly lower levels of mite allergen in bedroom carpets (p = 0.004) with mean levels of mite allergen declining from 6.5 +/- 7.6 to 2.2 +/- 4.3 micrograms/gm of dust (two-site monoclonal antibody assays), whereas levels for the conventional-instructed group did not change. Moreover, by study weeks 9 and 10, the computer-instructed group was significantly less symptomatic (p = 0.033). Mean symptom scores for this group decreased from 12.4 to 7.7, compared with 16.4 to 14.3. Conventional instruction supplemented with computer instruction is suggested in mite education.
在52例成年螨相关性哮喘患者中，研究了补充计算机辅助室内尘螨避免措施指导对措施实施依从性、家庭尘螨过敏原水平及症状学的影响。26例患者接受传统指导（咨询和书面指导），另外26例患者接受传统指导加22分钟交互式计算机辅助指导。指导内容针对尘螨避免措施。采集指导前后的灰尘样本，并监测依从性。所有患者每天记录两次症状日记。对患者进行为期12周的随访，所有患者均完成研究。计算机指导组的依从性，即就诊后观察到的和自我报告的实施尘螨避免措施的数量更高（p = 0.023）。计算机指导组卧室地毯中的螨过敏原水平显著降低（p = 0.004），螨过敏原平均水平从6.5±7.6微克/克灰尘降至2.2±4.3微克/克灰尘（两点单克隆抗体检测），而传统指导组的水平没有变化。此外，在研究的第9周和第10周，计算机指导组的症状明显减轻（p = 0.033）。该组的平均症状评分从12.4降至7.7，而传统指导组则从16.4降至14.3。建议在尘螨教育中采用传统指导辅以计算机指导的方式。
