Singh Meenu, Jaiswal Nishant
Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Cochrane Database Syst Rev. 2013 Jun 13;2013(6):CD003563. doi: 10.1002/14651858.CD003563.pub2.
Humidity control measures in the home environment of patients with asthma have been recommended, since a warm humid environment favours the growth of house dust mites. However, there is no consensus about the usefulness of these measures.
To study the effect of dehumidification of the home environment on asthma control.
The clinical trials registers of the Cochrane Collaboration and Cochrane Airways Group were searched. Searches were current as of March 2013.
Randomised controlled trials on the use of humidity control measures in the home environment of patients with asthma were evaluated for inclusion.
Data were extracted independently using a pre-designed data extraction form by two review authors.
A second trial has been added for the 2013 update of this review. The original open-label trial compared an intervention consisting of mechanical ventilation heat recovery system with or without high efficiency vacuum cleaner fitted in 40 homes of patients with asthma who had positive tests for sensitivity to house dust mite. The new double-blind trial also compared a mechanical ventilation heat recovery system with a placebo machine in the homes of 120 adults with allergy to house dust mite. The new trial, which was at low risk of bias, showed no significant difference in morning peak flow (mean difference (MD) 13.59; 95% confidence interval (CI) -2.66 to 29.84), which was the primary outcome of the trial. However, there was a statistically significant improvement in evening peak flow only (MD 24.56; 95% CI 8.97 to 40.15). There was no significant difference in quality of life, rescue medication, requirement for oral corticosteroids, visits to the GP, emergency department (ED) or hospitalisations for asthma. There was no significant difference in the house dust mite count and the antigen levels in the new trial, in contrast to the previous trial.
AUTHORS' CONCLUSIONS: Evidence on clinical benefits of dehumidification using mechanical ventilation with dehumidifiers remains scanty, and the addition of a new double blind trial to this review does not indicate significant benefit in most measure of control of asthma from such environmental interventions.
由于温暖潮湿的环境有利于屋尘螨生长,因此建议对哮喘患者的家庭环境采取湿度控制措施。然而,对于这些措施的有效性尚无共识。
研究家庭环境除湿对哮喘控制的影响。
检索了Cochrane协作网和Cochrane Airways小组的临床试验注册库。检索截至2013年3月。
对在哮喘患者家庭环境中使用湿度控制措施的随机对照试验进行纳入评估。
由两位综述作者使用预先设计的数据提取表独立提取数据。
本次综述2013年更新版增加了第二项试验。原开放标签试验比较了在40户对屋尘螨敏感性检测呈阳性的哮喘患者家中安装有或没有高效吸尘器的机械通风热回收系统组成的干预措施。新的双盲试验也在120名对屋尘螨过敏的成年人家庭中比较了机械通风热回收系统与安慰剂机器。新试验的偏倚风险较低,试验的主要结局——早晨呼气峰流速无显著差异(平均差(MD)13.59;95%置信区间(CI)-2.66至29.84)。然而,仅晚上呼气峰流速有统计学显著改善(MD 24.56;95%CI 8.97至40.15)。生活质量、急救药物、口服糖皮质激素需求、看全科医生次数、急诊就诊或因哮喘住院方面无显著差异。与之前的试验相比,新试验中的屋尘螨计数和抗原水平无显著差异。
使用带除湿功能的机械通风进行除湿的临床益处证据仍然不足,本次综述新增的一项双盲试验并未表明此类环境干预措施在大多数哮喘控制指标上有显著益处。