ka loiloi hoʻomaʻamaʻa o ka hopena o nā moena anti-allergic i uhi ʻia i nā poʻe maʻi me ka maʻi hānō haʻahaʻa a koʻikoʻi a me ka allergy mite lepo hale: kahi haʻawina i hoʻopaʻa ʻia i ka placebo makapō pālua.

Kāpae: Hoʻohana
Hiki i nā moena maʻi maʻi maʻi ke alakaʻi i ka hoʻemi nui ʻana i ka pae o nā allergens lepo hale i nā laʻana lepo.
Ma waho aʻe o ka hoʻemi ʻana i ka hyperresponsiveness ea i hoʻoiho ʻia e ka amine, ʻaʻohe ʻikepili e hōʻike i ka hopena o nā uhi moena i ka maikaʻi o ke olakino a me ka maikaʻi o ke ola i nā maʻi me ka hānō haʻahaʻa a koʻikoʻi.
Nā Kaʻina Hana: Ua aʻo ʻia he kanakolu mau maʻi me ka hānō a me ka hale lepo lepo allergy ma kahi haʻawina randomized, double-blind, placebo-controlled study.
Ma mua a ma hope o ka hoʻohana ʻana
ʻO ka uhi allergy no 1 makahiki e hōʻiliʻili i ka lepo mai ka moena e hoʻoholo ai i ka neʻe ʻana o ka dermat i ka Hale (Der p 1)
Ua ana ʻia ka hyperreactivity a me ka maikaʻi o ke ola.
Ua kiʻi ka mea maʻi i nā hōʻailona (māmā a me ka ihu)
, Kakahiaka a me ke ahiahi peak flow value, hoʻopakele lāʻau lapaʻau 14 lā ma mua a ma hope o ka hana.
Nā hualoaʻa: ke hoʻohālikelike ʻia me ka hoʻomaʻamaʻa mua ʻana, ua emi nui ka manaʻo o Der p1 i ka lepo i hōʻiliʻili ʻia e ka moena i loko o ka hui lapaʻau ikaika ma hope o 1 makahiki;
ʻAʻohe loli i loaʻa i ka hui placebo.
I ka hoʻomaʻamaʻa ikaika a me nā pūʻulu placebo, ʻaʻohe hoʻomaikaʻi nui i ka PC20 tissue amine.
Ua hoʻomaikaʻi like ka maikaʻi o ke ola ma nā hui ʻelua.
Ma nā huiʻelua,ʻaʻohe loli nui i ka helu hōʻailona o ke ala ea haʻahaʻa.
Ke hoʻohālikelikeʻia me ka hoʻomaʻamaʻa mua, ua emi nui ka helu nasal symptom o ka hui hoʻoikaika ikaika, akā,ʻaʻohe mea nui ma waena o nā huiʻelua.
ʻAʻohe hui i ʻike i nā loli i ke kakahiaka a me ke ahiahi o ka nui o ke kahe kahe ʻana, ka hoʻololi ʻana o ka peak, a me ka hoʻohana ʻana i ka lāʻau lapaʻau.
Ka hopena: E hoʻohana i ke kū'ē
ʻO ka uhi moena maʻi maʻi e alakaʻi i ka emi nui o ka manaʻo Der p1 i loko o nā keʻena moena ʻole.
Eia naʻe, i nā poʻe maʻi me ka hānō haʻahaʻa a koʻikoʻi, ʻaʻole pili kēia pale allergen maikaʻi i ka hyperresponsiveness o ke ea a me nā ʻāpana lapaʻau.
ʻO nā hana mai Ianuali 1996 a hiki i Dekemaba 1998, ua kiʻi ʻia nā maʻi maʻi 38 o 11-44 me ka mōʻaukala o ka hānō a me ka maʻi allergy lepo hale mai ke keʻena hānō ma hilverum, Netherlands.
Ua loaʻa ka ʻae ʻike mai ka mea maʻi a i ʻole mai kona mau mākua.
Ua koho ʻia kēia mau maʻi ma muli o ka piʻi ʻana o ka pane ʻana o ke ea i ka inhalation o ka amine kiko (
PC20 1 μg Der p 1/g lepo).
ʻOi aku ma mua o 60% o nā maʻi āpau (Waiwai wānana).
ʻAʻohe moʻolelo o ka maʻi hanu i nā pule he 6 i hala iho nei a ʻaʻohe loaʻa i ka hānō koʻikoʻi i nā mahina 6 i hala.
I nā mahina ʻeono i hala iho nei, ʻaʻohe mea i loaʻa i nā steroid waha.
Ua loaʻa i nā maʻi āpau ka ʻae ʻana.
Ua ʻae ke komite olakino olakino o Asthmacenter heuvel i ke aʻo ʻana.
ʻO ka hoʻolālā haʻawina ʻo kēia haʻawina he hoʻolālā randomized, placebo-controlled, double-blind, parallel-group design i hoʻohālikelike ʻia i nā hopena o ka ʻeke allergen non-penetration ma luna o nā moena, nā uluna, a me nā uhi moe i loko o 1 makahiki a hoʻohālikelike ʻia i ka pahu placebo.
I ka hoʻomaka ʻana o ke aʻo ʻana, ua kipa aku kahi kahu hanu i aʻo ʻia i ka mea maʻi, hōʻiliʻili i nā laʻana o ka lepo mai ka moena o ka mea maʻi no nā ana Der p1, a hoʻopaʻa ʻia nā ʻano pale allergen i loaʻa ma ka home.
ʻO nā maʻi āpau i komo i loko o ke aʻo ʻana he mau papahele lumi moe.
Ua kauoha ʻia ka mea maʻi e hoʻomaʻemaʻe i nā pā ma 60 °c i kēlā me kēia pule
Ma waho aʻe o ka paʻi moena, ʻaʻohe hana ʻē aʻe i hana ʻia e pale aku i nā allergens.
I ka pau ʻana o ke aʻo ʻana, ua kipa hou ke kahu hoʻokahi i nā hale e ʻohi i ka lepo mai nā papa moe.
Ua hoʻokomoʻia ka mea maʻi i loko o ka makahiki;
ʻO ka manawa hoʻokomo he 2 mau makahiki.
Ua hoʻāʻo ʻia ka poʻe maʻi me ka maʻi pollen ma waho o ke kau pollen.
I ka huakaʻi mua, ua loiloi ʻia ka mea maʻi.
Hiki ke ola (VC)
Ua ana ʻia nā waiwai, ua hana ʻia nā hoʻāʻo ʻili, a ua loiloi ʻia ʻo Amine kiko PC20.
E ho'ōki i ka lawe ʻana i nā lāʻau ma mua o ka manawa aʻo: Inhaled steroids a me ka sodium acetate no 1 pule ma mua o ka hoʻāʻo ʻana i ka trachea tissue amine stimulation test;
Ma mua o ka ho'āʻo, theophylline, waha beta 2 adrenaline lāʻau, lōʻihi-hana inhaled beta 2 adrenaline lāʻau, a me antihistine mau no 48 hola, a me ka inhalation o pōkole-hana beta 2 adrenaline mau lāʻau no 6 hola.
ʻO ka hōʻiliʻili ʻana a me ka ʻili ʻana o ka lepo o ka hale ma mua, 4 a me 8 mau mahina o ka hana ʻana a ma ka hopena o ka hana ʻohi ʻia e ka mea hoʻomaʻemaʻe hoʻokahi (
Philips Vitall 377,1300 Watt, Philips, Eindhoven, Netherlands)
E hoʻohana i kahi mea kānana kūikawā mai ka moena holoʻokoʻa i 2 mau minuke (
ALK ma holsham, Denemaka).
I ka hoʻomaka ʻana o ke aʻo ʻana, e ʻohi pono i ka lepo mai ka moena;
I ka pau ʻana o ke aʻo ʻana, ʻohi ʻia ka lepo ma luna o kahi hoʻomoana.
Mālama ʻia ka kānana i loko o ka friji ma-20 °c a hiki i ka hana ʻana i ka nānā ʻana ma ka hopena o ke aʻo ʻana.
Ka hoʻoholo ʻana o Der P1 antigen e elisa (ELISA).
Ua hoʻopaʻa ʻia ka antibody monoclonal e kūʻē iā Der p1 ma 96-well plate.
Ma hope o ka hoʻoulu ʻia ʻana me ka ʻili o ka lepo, ua hoʻokomo ʻia ka lua me kahi antibody multi-valent (
ʻO ka sunflower over-enzyme.
Ma hope o ka hoʻohui ʻana i 1, 2-
No ka diamine HCl (OPD)
Ma ke ʻano he substrate, ua ana ʻia ka absorption ma 490 nm me ka hoʻohana ʻana i kahi mea heluhelu ELISA.
ʻO ka waiʻona amine phosphate (
ʻO ka manaʻo pālua mai ka 0. 25 a 32 mg/ml)
Hoʻoponopono ʻia ma o De Vilbiss 646 nebulizer me kahi puka o 0. 13 mg/ml.
Hoʻokomo ʻia ka nebulizer ma kahi pahu valve me kahi kānana aerosol.
ʻO ka manawa atomization he 30 kekona kahi i kauoha ʻia ai ka mea maʻi e hanu mālie.
Hoʻomaka kēia hoʻokolohua me ka inhalation o ka phosphate buffer aerosol.
ʻEkolu ana VC a me ka fev ma mua o ka inhalation (
Masterscreen).
Ua ana ʻia ʻo V1 ma hope o kēlā me kēia ʻike.
Loaʻa ʻia ʻo PC20 tissue amine e ka linear interpolation.
ʻO nā moena, nā uluna a me nā moena no ka pūʻulu hana i ʻōwili ʻia i kahi LID i hāʻawi ʻia e Carla c\'air (
ʻO ka mana maʻi maʻi AC btm Velserbroek, Netherlands).
Ua hana ʻia ka uhi placebo e ka hui like.
ʻO ke kahua hoʻomoana, i hoʻonohonoho ʻia e kahi kahu noiʻi, noho ma kahi no 1 makahiki.
Ka maikaʻi o ke ola ma o ka maikaʻi o ke ola nīnau nīnau no nā maʻi hanu (QoL-RIQ). 17 Ka QoL-
ʻO RIQ kahi nīnau nīnau pili i ka maikaʻi o ke ola no nā poʻe maʻi me ka hānō a me ka hānō mau loa, nona nā mea 55, i māhele ʻia i ʻehiku mau wahi: pilikia hanu (9 mau mea)
Nā pilikia kino (9 mau mea), nā manaʻo (9 mau mea)
, Hoʻoulu / hoʻonui i ke kūlana o nā pilikia hanu (7 mau mea)
Nā hana maʻamau (4 mau mea)
Nā hana o kēlā me kēia lā a me ka home (10 mau mea)
Nā hana kaiaulu, ka pilina pili kanaka a me ka moekolohe (7 mau mea).
I mea e kau ai ka pilikia ma ka ʻike o ka mea maʻi, ua hoʻokumu ʻia ka papahana ma ka "pehea ka nui o ka pilikia" i loaʻa iā lākou mai nā hōʻailona a i ʻole nā manaʻo i luna.
E pili ana i nā papahana pili i nā hana, ʻo ka nīnau ʻo \"pehea ka nui o ke keʻakeʻa ʻia o lākou i ka hoʻokō ʻana i kēia hana kikoʻī \".
Ua noi ʻia nā poʻe maʻi e hāʻawi i kā lākou mau pane ma ka pālākiō Likert 70-point, mai ka "ʻaʻole loa" a i ka "pilikia" pilikia a keakea paha. Pono (ho'āʻo-
Nānā hou, kūlike o loko)
A hōʻoia i kona pono.
ʻO 17 mau lāʻau lapaʻau i ka manawa 14-lā ma mua o ka hana a ma ka hopena o ka 12-mahina maloʻo maloʻo e koi i nā mea maʻi e hoʻopaʻa i nā kāleka diary no ka hānō a me nā hōʻailona o ka ihu, nā waiwai kahe nui, a hoʻopaʻa i ka lāʻau lapaʻau ʻelua i ka lā.
ʻO nā hōʻailona o ka hānō, ʻo ia ka pilikia o ka hanu, ka ʻū, ka ʻū a me ka hanu.
ʻO nā hōʻailona o ka ihu, ʻo ia ka nasal congestion, sneezing and nasal.
Hoʻokaʻawale ʻia kēlā me kēia mea mai ka helu 0 (ʻaʻohe hōʻailona) a i ka 4 (Nā hōʻailona koʻikoʻi).
Ua hoʻomaʻamaʻa ʻia nā maʻi e hana i nā haʻawina kiʻekiʻe e hoʻohana ana i ka mīkini micro-equipmentWright.
Ua aʻo ʻia lākou e hana i ʻekolu heluhelu a hoʻopaʻa i nā waiwai kiʻekiʻe loa i ko lākou ala ʻana i ke kakahiaka a ma mua o ka hiamoe ʻana i ka pō.
Ua noi ʻia nā maʻi e hoʻomau i ka lāʻau inhalation maʻamau a e hoʻopaʻa i ka lāʻau hoʻōla hou inā pono lākou.
Hana ʻia ka ʻikepili a me ka ʻikepili helu me SPSS.
Hoʻohālikelike pūʻulu (
Ma mua a ma hope o ka hana ʻana)
Hana ʻia me ka loiloi pūlima Wilcoxon.
E noʻonoʻo i ka ʻikepili log me ka hoʻohana ʻana i nā hōʻailona hōʻailona. ʻO ka Mann-
Ua hoʻohana ʻia ka hōʻike Whitney U no ka hoʻohālikelike ʻana i waena o nā hui. p waiwai o 0. 5)
I loko o ka hui lapaʻau a me ka hui placebo, aia nā helu 18 no nā pilikia hanu, nā pilikia kino e pili ana i nā pilikia o ka umauma, ke kumu / hoʻonui, a me ka helu helu.
ʻOiai ʻaʻohe ʻokoʻa koʻikoʻi o ka palena hoʻomaikaʻi ma waena o nā hui ʻelua, ʻoi aku ka maikaʻi o ka hoʻomaikaʻi ʻana i loko o ka hui lapaʻau.
ʻAʻohe ʻokoʻa koʻikoʻi i nā kumu waiwai o nā ʻāpana lapaʻau no nā helu hōʻailona hānō ma waena o nā hui (papa 2).
ʻAʻole i loli nui ka helu median lung symptom o nā hui ʻelua i loko o 1 makahiki.
Ua emi nui ka helu nasal symptom o ka hui lapaʻau (p=0. 04)
Akā ʻaʻole i ka hui placebo.
ʻAʻole nui ka ʻokoʻa ma waena o nā hui ʻelua.
kumu waiwai ef (
Kakahiaka a me ke ahiahi)
Hoʻohālikelike nā hui ʻelua (papa 3).
Ma hope o 1 makahiki o ka hana, ʻaʻohe loli nui i ke kakahiaka a me ke ahiahi ef, peak flow variability a i ʻole ka hoʻohana ʻana i nā lāʻau hoʻopakele i nā hui ʻelua o nā maʻi.
Nānā i kēia pākaukau: Nānā i ka laina e nānā i ka papa kuhikuhi pop-up 2 hōʻailona hōʻailona ma mua a ma hope o ka hana ʻana (
Hoʻopaʻa inoa ma waena o 14 mau lā)
Nānā i kēia pākaukau: E nānā i ka papa kuhikuhi pop-up 3 kiʻekiʻe ma mua a ma hope o ka hana ʻana (
Hoʻopaʻa inoa ma waena o 14 mau lā)
ʻO ke kumu o kēia haʻawina ʻo ia ke aʻo ʻana
I loko o kahi moena maʻi maʻi i loko o ke keʻena keʻena moe ʻole, i hōʻike ʻia i Der p1 ma luna o ka moena, maʻi i nā mites lepo hale i nā mea maʻi me ka hānō haʻahaʻa a koʻikoʻi.
Ua loaʻa iā mākou kahi emi nui o ka Der p1 i ka lepo i hōʻiliʻili ʻia e ka moena i loko o ka hui lapaʻau ikaika i hoʻohālikelike ʻia i ka hui placebo.
ʻAʻole i hoʻomaikaʻi maikaʻi ʻia ka ʻiʻo PC20 Amine i ka wā o ka hana 1 makahiki.
ʻOiai ua ʻike ʻia ka hoʻomaikaʻi nui ʻana o nā hōʻailona o ka ihu a me ka maikaʻi o ke ola ma ka hui lapaʻau ikaika, ʻaʻole mākou i ʻike i ka ʻokoʻa nui ma waena o ka hui placebo a me ka hui lapaʻau ikaika i nā loli i nā hōʻailona o ka māmā a me ka ihu, ka maikaʻi o ke ola, nā waiwai kahe kiʻekiʻe, a me ka hoʻohana ʻana i nā lāʻau hoʻopakele.
ʻO nā haʻawina mua me ka hoʻohana ʻana i nā ʻano like ʻole o ka ʻeke moena i hōʻike pū ʻia ka emi ʻana o ka ʻike Der p1 ma luna o ka moena (papa 4).
Eia naʻe, ʻaʻole i hōʻike ʻia nā haʻawina ʻē aʻe i ka emi ʻana o ka neʻe ʻana o Der p1, a ma kēia mau haʻawina ʻaʻole i wehe ʻia ke kapena i loko o ka lumi moe.
21,22 hoʻokaʻawale mākou i ka pilikia Der p1 mai ka papahele 13 ma o ka hoʻokomo ʻana i nā mea maʻi wale nō me ka ʻaʻohe kaʻa i loko o ka lumi moe.
Hiki i kēia ke alakaʻi i ka ʻoiaʻiʻo, ʻoiai ʻoi aku ka kiʻekiʻe o kā mākou baseline Der p1 ma mua o nā haʻawina ʻē aʻe, hiki iā mākou ke hoʻemi nui i ka hui i mālama ʻia.
22, 23 ka emi ʻana o ka ʻike allergen i hōʻea ma hope o 4 mau mahina a ʻaʻole i hoʻololi ʻia i ka wā aʻo.
E nānā i kēia papa: Nānā i ka papa kuhikuhi pop-up 4 Hōʻuluʻulu o nā hopena a me nā hoʻonohonoho o ka moena i hoʻomalu ʻia e uhi ana i ka haʻawina ʻoiai ua hoʻemi nui ʻia ka neʻe ʻana o Der p1 i loko o ka hui lapaʻau ikaika i hoʻohālikelike ʻia me ka hui placebo, ʻaʻole mākou i ʻike i kahi emi nui o ka hyperresponsiveness ea.
ʻAʻole hiki i nā haʻawina ʻē aʻe ke hōʻike i ka hoʻomaikaʻi ʻana i ka hyperresponsiveness ea.
ʻElua mau haʻawina 22, 23, 10, 11, 22 ʻaʻole i ʻike i kahi emi nui o ka ʻike allergen i ka lepo, i wehewehe i ka nele o ka hoʻomaikaʻi ʻana i ka hyperreactivity airway.
Ua ʻōlelo ʻo Frederick et al ua mālama pono ʻia nā maʻi āpau i ka mālama pale maʻamau, no laila ʻaʻole liʻiliʻi a ʻaʻohe hoʻololi i nā ʻāpana lapaʻau.
ʻOiai ʻo Cloosterman a me kāna mau hoa hana, 11 mau kānaka i hoʻāʻo e pale i kēia hopena therapeutic ma o ka hoʻokomo wale ʻana i nā maʻi i hoʻohana ʻole i nā steroid inhaled a i ʻole hiki iā lākou ke hoʻōki iā lākou, ʻaʻole i ʻike i ka hoʻomaikaʻi koʻikoʻi o ka hyperresponsiveness ea, ʻaʻohe hoʻomaikaʻi koʻikoʻi i kekahi o nā ʻāpana lapaʻau i hoʻohana ʻia, e like me nā helu hōʻailona, ef variability, a me ka reversible o F1.
Pehea e hiki ai iā mākou ke hoʻohui i kēia mau manaʻo?
ʻOiai ke kiʻekiʻe o ka nui o ka cortisol inhaled, ua loaʻa i nā poʻe maʻi i loko o kā mākou noiʻi ka hyperreactivity koʻikoʻi (> 800 μg)
ʻO ka hoʻohālikelike, ʻo ka PC20