Yasuo Masanori, Kitaguchi Yoshiaki, Komatsu Yoshimichi, Hama Mineyuki, Koizumi Tomonobu, Agatsuma Toshihiko, Ichiyama Takashi, Kato Akane, Moteki Hideaki, Hanaoka Masayuki
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan.
Intern Med. 2017;56(1):31-39. doi: 10.2169/internalmedicine.56.7251. Epub 2017 Jan 1.
Objective This study was conducted to investigate whether the add-on treatment of allergic rhinitis (AR) based on the Self-assessment of Allergic Rhinitis and Asthma (SACRA) questionnaire for assessing AR control improves both AR and asthma control in asthmatic patients with AR. Methods This multi-center prospective study was performed in Nagano prefecture, Japan. Two hundred five asthmatic patients and 23 respiratory physicians participated in the study. We administered add-on AR treatments based on the results of the SACRA questionnaire. After the first SACRA questionnaire, 67 asthmatic patients agreed to receive an add-on AR treatment. Three months after the AR treatment, a secondary SACRA questionnaire, asthma control test (ACT), and pulmonary function tests were performed. Results After the add-on AR treatment, the visual analogue scales (VASs) for AR and asthma, as assessed by the SACRA questionnaire and ACT score, were significantly improved in the patients of the AR+ group. With regard to the pulmonary function tests, the percent predicted vital capacity, and percent predicted forced expiratory volume in one second were also significantly improved. Regardless of whether the patients had previously undergone leukotriene receptor antagonists (LTRA) treatment, the VASs for AR and asthma and the ACT score were significantly improved in the AR+ group. However, the vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume (FEV) were only significantly improved in the AR+ group that had previously undergone LTRA treatment. Conclusion SACRA questionnaire-based add-on AR treatment would be convenient for the detection of AR by respiratory physicians and would offer improved asthma control. This questionnaire can also be used to assess the therapeutic effects.
目的 本研究旨在调查基于变应性鼻炎和哮喘自我评估（SACRA）问卷评估变应性鼻炎（AR）控制情况的AR附加治疗是否能改善合并AR的哮喘患者的AR和哮喘控制情况。方法 这项多中心前瞻性研究在日本长野县进行。205名哮喘患者和23名呼吸内科医生参与了研究。我们根据SACRA问卷的结果给予AR附加治疗。在首次进行SACRA问卷后，67名哮喘患者同意接受AR附加治疗。AR治疗3个月后，进行第二次SACRA问卷、哮喘控制测试（ACT）和肺功能测试。结果 AR附加治疗后，AR+组患者通过SACRA问卷和ACT评分评估的AR和哮喘视觉模拟量表（VAS）显著改善。在肺功能测试方面，预测肺活量百分比和一秒用力呼气容积百分比也显著改善。无论患者之前是否接受过白三烯受体拮抗剂（LTRA）治疗，AR+组的AR和哮喘VAS以及ACT评分均显著改善。然而，肺活量（VC）、用力肺活量（FVC）和用力呼气容积（FEV）仅在之前接受过LTRA治疗的AR+组中显著改善。结论 基于SACRA问卷的AR附加治疗对呼吸内科医生检测AR方便可行，并能改善哮喘控制。该问卷还可用于评估治疗效果。
