Department of Pediatrics, Tata Main Hospital, Jamshedpur, India.
Indian J Pediatr. 2012 Sep;79(9):1169-75. doi: 10.1007/s12098-011-0674-8.
To evaluate the impact of environmental interventions and lifestyle management on respiratory symptoms, concurrent changes in asthma management and whether any observed health benefit could be attributed to these interventions.
A longitudinal single cohort pre-post study was conducted on children between 5–14 y with moderate to severe asthma in an outpatient clinic at Jamshedpur over 2 y. History was noted using the pre-intervention questionnaire covering a period of 3 mo prior to enrolment. Participants were followed for 6 mo post- intervention. A childhood asthma severity (CHAS) scale was made and statistical analysis such as Wilcoxon rank sum tests and Mcnemar’s test performed to validate the outcomes. Principal component analysis was performed to classify the participants having no, mild and severe symptoms.
There was significant reduction in symptoms and need for medical care post-intervention. Mean of the respiratory symptom score decreased from 7.4 to 2.4 (p < 0.0001) and mean of the health care utilization score decreased from 4.1 to 1.7 (p < 0.0004) in the wilcoxon rank sum tests. Mcnemar’s test was used for the analysis of individual item of the asthma symptoms. A significant reduction in wheeze and cough (p < 0.001), slowing down physical activity (p < 0.001), diurnal symptoms (p < 0.000), school absence (p < 0.000), rescue therapy requirement (p < 0.1) and hospitalization (p < 0.000) was seen. PCA was used successfully to classify the participants on the basis of their severity of asthma.
Respiratory symptoms decreased significantly among asthmatic children following environmental interventions.
评估环境干预和生活方式管理对呼吸系统症状的影响，同时评估哮喘管理的变化，以及任何观察到的健康益处是否可归因于这些干预措施。
在贾姆谢德布尔的一家门诊诊所，对 5-14 岁患有中度至重度哮喘的儿童进行了为期 2 年的纵向单队列前后研究。使用预干预问卷记录病史，该问卷涵盖了入组前 3 个月的时间段。对参与者进行了 6 个月的干预后随访。制定了儿童哮喘严重程度（CHAS）量表，并进行了 Wilcoxon 秩和检验和 McNemar 检验等统计分析，以验证结果。进行主成分分析以对无、轻度和重度症状的参与者进行分类。
干预后症状和医疗需求显著减少。呼吸症状评分的平均值从 7.4 降至 2.4（p<0.0001），医疗保健利用评分的平均值从 4.1 降至 1.7（p<0.0004），Wilcoxon 秩和检验。McNemar 检验用于分析哮喘症状的各个项目。喘息和咳嗽（p<0.001）、体力活动减慢（p<0.001）、日间症状（p<0.000）、缺课（p<0.000）、抢救治疗需求（p<0.1）和住院治疗（p<0.000）均显著减少。成功地使用 PCA 根据哮喘严重程度对参与者进行分类。
环境干预后，哮喘儿童的呼吸系统症状明显减轻。
