Burr M L, Matthews I P, Arthur R A, Watson H L, Gregory C J, Dunstan F D J, Palmer S R
Department of Epidemiology, Statistics and Public Health, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
Thorax. 2007 Sep;62(9):767-72. doi: 10.1136/thx.2006.070847. Epub 2007 Mar 27.
It is not clear whether associations between respiratory symptoms and indoor mould are causal. A randomised controlled trial was conducted to see whether asthma improves when indoor mould is removed.
Houses of patients with asthma were randomly allocated into two groups. In one group, indoor mould was removed, fungicide was applied and a fan was installed in the loft. In the control group, intervention was delayed for 12 months. Questionnaires were administered and peak expiratory flow rate was measured at baseline, 6 months and 12 months.
Eighty-one houses were allocated to the intervention group and 83 to the control group; 95 participants in 68 intervention houses and 87 in 63 control houses supplied follow-up information. Peak expiratory flow rate variability declined in both groups, with no significant differences between them. At 6 months, significantly more of the intervention group showed a net improvement in wheeze affecting activities (difference between groups 25%, 95% CI 3% to 47%; p = 0.028), perceived improvement of breathing (52%, 95% CI 30% to 74%; p<0.0001) and perceived reduction in medication (59%, 95% CI 35% to 81%; p<0.0001). By 12 months the intervention group showed significantly greater reductions than the controls in preventer and reliever use, and more improvement in rhinitis (24%, 95% CI 9% to 39%; p = 0.001) and rhinoconjunctivitis (20%, 95% CI 5% to 36%; p = 0.009).
Although there was no objective evidence of benefit, symptoms of asthma and rhinitis improved and medication use declined following removal of indoor mould. It is unlikely that this was entirely a placebo effect.
尚不清楚呼吸道症状与室内霉菌之间的关联是否为因果关系。开展了一项随机对照试验，以观察去除室内霉菌后哮喘是否会改善。
将哮喘患者的房屋随机分为两组。一组去除室内霉菌，使用杀菌剂并在阁楼安装风扇。对照组的干预措施推迟12个月。在基线、6个月和12个月时进行问卷调查并测量呼气峰值流速。
81所房屋被分配到干预组，83所房屋被分配到对照组；68所干预房屋中的95名参与者和63所对照房屋中的87名参与者提供了随访信息。两组的呼气峰值流速变异性均下降，两组之间无显著差异。在6个月时，干预组中更多人在影响活动的喘息方面有净改善（组间差异25%，95%置信区间3%至47%；p = 0.028）、呼吸改善感（52%，95%置信区间30%至74%；p<0.0001）和药物使用减少感（59%，95%置信区间35%至81%；p<0.0001）。到12个月时，干预组在预防药物和缓解药物使用方面的减少幅度明显大于对照组，在鼻炎（24%，95%置信区间9%至39%；p = 0.001）和鼻结膜炎（20%，95%置信区间5%至36%；p = 0.009）方面的改善也更多。
虽然没有客观的获益证据，但去除室内霉菌后哮喘和鼻炎症状有所改善，药物使用减少。这不太可能完全是安慰剂效应。
