Dharmage S, Walters E H, Thien F, Bailey M, Raven J, Wharton C, Rolland J, Light L, Freezer N, Abramson M
Department of Public Health, The University of Melbourne, Australia.
Int Arch Allergy Immunol. 2006;139(2):132-8. doi: 10.1159/000090388. Epub 2005 Dec 21.
We evaluated the impact of impermeable bed covers on asthma in asthmatics with clinically relevant house dust mite (HDM) sensitization.
The study included 32 HDM-sensitized asthmatics in whom HDM allergy was considered as a significant factor in their asthma. They were randomized into either an intervention group whose bedding was encased with impermeable covers, or a control group who received cotton covers. Before and 3 and 6 months after encasement, dust samples were collected from the bedding and assayed for Der p 1. Clinical outcomes included quality of life, lung function, bronchial reactivity to methacholine, symptoms, medications and peak flow rates.
Baseline Der p 1 levels in both the active and the placebo groups were comparable and high (19.2 vs 18.9 microg/g of dust). There was a significant reduction in Der p 1 levels in the active group after 6 months, but not in the placebo group (7.3 vs 21.9 microg/g of dust). Quality of life improved significantly in both the intervention and control groups, but there was no significant difference in the improvements between the groups. There was no significant change in lung function, symptoms, and requirements for medications.
Encasement of bedding significantly reduced the Der p 1 levels. However, this was not sufficient to produce worthwhile clinical improvement in those in whom dust mite avoidance might well have been recommended as part of their clinical management.
我们评估了使用不可渗透床罩对临床诊断为屋尘螨(HDM)致敏的哮喘患者哮喘病情的影响。
该研究纳入了32名HDM致敏的哮喘患者,HDM过敏被认为是其哮喘的一个重要因素。他们被随机分为两组,一组为干预组,其床上用品使用不可渗透的床罩包裹;另一组为对照组,使用棉质床罩。在包裹前以及包裹后3个月和6个月,从床上用品上采集灰尘样本并检测其中的Der p 1含量。临床结果包括生活质量、肺功能、对乙酰甲胆碱的支气管反应性、症状、药物使用情况和峰值流速。
活性组和安慰剂组的基线Der p 1水平相当且较高(分别为19.2和18.9微克/克灰尘)。6个月后,活性组的Der p 1水平显著降低,而安慰剂组则没有(分别为7.3和21.9微克/克灰尘)。干预组和对照组的生活质量均有显著改善,但两组之间的改善程度没有显著差异。肺功能、症状和药物需求方面没有显著变化。
使用床罩显著降低了Der p 1水平。然而,对于那些在临床管理中可能已被建议避免接触尘螨的患者而言,这不足以产生有价值的临床改善。