Gøtzsche P C, Johansen H K
Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark.
Allergy. 2008 Jun;63(6):646-59. doi: 10.1111/j.1398-9995.2008.01690.x.
The major allergen in house dust comes from mites. We performed a systematic review of the randomized trials that had assessed the effects of reducing exposure to house dust mite antigens in the homes of people with mite-sensitive asthma, and had compared active interventions with placebo or no treatment. Fifty-four trials (3002 patients) were included. Thirty-six trials assessed physical methods (26 mattress covers), 10 chemical methods and eight a combination of chemical and physical methods. Despite the fact that many trials were of poor quality and would be expected to exaggerate the reported effect, we did not find an effect of the interventions. For the most frequently reported outcome, peak flow in the morning (1565 patients), the standardized mean difference was 0.00 (95% confidence interval (CI) -0.10 to 0.10). There were no statistically significant differences in number of patients improved (relative risk 1.01, 95% CI 0.80-1.27), asthma symptom scores (standardized mean difference -0.04, 95% CI -0.15 to 0.07) or in medication usage (standardized mean difference -0.06, 95% CI -0.18 to 0.07). Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended.
室内灰尘中的主要过敏原来自螨虫。我们对随机试验进行了系统评价，这些试验评估了减少螨虫敏感型哮喘患者家中暴露于屋尘螨抗原的影响，并将积极干预措施与安慰剂或不治疗进行了比较。纳入了54项试验（3002例患者）。36项试验评估了物理方法（26项使用床垫套），10项评估了化学方法，8项评估了化学和物理方法的联合使用。尽管许多试验质量较差，预计会夸大所报告的效果，但我们未发现干预措施有效果。对于最常报告的结局，即早晨的呼气峰流速（1565例患者），标准化均差为0.00（95%置信区间（CI）-0.10至0.10）。在病情改善的患者数量（相对风险1.01，95%CI 0.80-1.27）、哮喘症状评分（标准化均差-0.04，95%CI -0.15至0.07）或药物使用方面（标准化均差-0.06，95%CI -0.18至0.07）均无统计学显著差异。不推荐使用旨在减少暴露于屋尘螨过敏原的化学和物理方法。
