ukuhlolwa komtholampilo komphumela wekhava ye-anti-allergies ezigulini ezinesifuba somoya esimaphakathi kuya kobunzima kanye nokungezwani komzimba nothuli lwasendlini: ucwaningo olulawulwa ngokungahleliwe oluphindwe kabili lwe-placebo.

Ingemuva: Ukusebenzisa
Izembozo zikamatilasi Ongezwani nazo ezigulini ezinesifuba somoya zingaholela ekwehleni okukhulu kwezinga lezinto ezingezwani nothuli lwasendlini kumasampula othuli.
Ngokungeziwe ekuncipheni kokusabela ngendlela yomoya okubangelwa izicubu ezibangelwa i-amine, kunedatha encane ephakamisa umthelela wekhava kamatilasi ekusebenzeni komtholampilo kanye nekhwalithi yokuphila ezigulini ezinesifuba somoya esimaphakathi kuya esibi kakhulu.
Izindlela: Iziguli ezingamashumi amathathu ezinesifuba somoya kanye nezibungu zothuli lwasendlini zacwaningwa ocwaningweni olulawulwa ngokungahleliwe, olungaboni kabili, olulawulwa yi-placebo.
Ngaphambi nangemva kokusetshenziswa
Ikhava ye-Allergy unyaka ongu-1 iqoqa uthuli kumatilasi ukuze kunqunywe ukugcwala kwesikhumba e-House (Der p 1)
I-hyperreactivity yomgwaqo womoya kanye nekhwalithi yokuphila kukalwa.
Isiguli sithole izimpawu (amaphaphu nekhala)
, Inani eliphakeme lokugeleza ekuseni nakusihlwa, imithi yokuhlenga izinsuku ezingu-14 ngaphambi nangemva kokungenelela.
Imiphumela: uma kuqhathaniswa nokwelashwa kwangaphambili, ukuhlushwa kwe-Der p1 othulini oluqoqwe umatilasi eqenjini lokwelapha elisebenzayo kwehla kakhulu ngemva konyaka we-1;
Azikho izinguquko ezitholakele eqenjini le-placebo.
Ekulapheni okusebenzayo kanye namaqembu e-placebo, kwakungekho ukuthuthukiswa okuphawulekayo ku-PC20 tissue amine.
Izinga lempilo kuwo womabili amaqembu liye lathuthuka ngendlela efanayo.
Kuwo womabili amaqembu, kwakungekho ushintsho oluphawulekayo kumphumela wezimpawu zomzila womoya ophansi.
Uma kuqhathaniswa nokwelashwa kwangaphambili, uphawu lwezimpawu zekhala zeqembu elisebenzayo lokwelapha lwehle kakhulu, kodwa kwakungekho umehluko ophawulekayo phakathi kwamaqembu amabili.
Alikho iqembu elithole izinguquko kumanani aphezulu okugeleza ekuseni nakusihlwa, ukuhlukahluka kokugeleza okuphezulu, nokusetshenziswa kwezidakamizwa zokuhlenga.
Isiphetho: Sebenzisa ukumelana
Ukufakwa kukamatilasi we-Allergic kuholela ekwehleni okukhulu kokugxilisa kwe-Der p1 emakamelweni okulala angenawo ukhaphethi.
Kodwa-ke, ezigulini ezinesifuba somoya esisesilinganisweni kuya esibi kakhulu, lokhu kugwema ukungezwani komzimba okusebenzayo akuthinti ukusabela kwe-airway hyperresponsiveness kanye nemingcele yomtholampilo.
Izindlela ezisuka kuJanuwari 1996 kuya kuZibandlela 1998, iziguli ezingama-38 ezineminyaka engu-11-44 ezinomlando wesifuba somoya kanye nokungezwani nothuli lwasendlini zabuthwa emtholampilo wesifuba somoya e-hilverum, eNetherlands.
Imvume enolwazi itholwe esigulini noma kubazali baso.
Lezi ziguli zikhethwe ngokusekelwe ekwandeni kokusabela komgwaqo womoya ekuhogeleni kwe-tissue amine (
I-PC20 1 μ g Der p 1/g uthuli).
Ngaphezu kwama-60% azo zonke iziguli (Inani lesibikezelo).
Iziguli zazingenawo umlando wezifo zokuphefumula emasontweni angu-6 okugcina futhi zazingenakho ukuhlaselwa kwesifuba somoya okunzima ezinyangeni ezingu-6 zokugcina.
Ezinyangeni eziyisithupha ezedlule, akekho othole ama-oral steroid.
Zonke iziguli zazinemvume enolwazi.
Ikomidi lezimiso zezokwelapha le-Asthmacenter heuvel ligunyaze ucwaningo.
Idizayini yocwaningo lolu cwaningo bekuwumklamo ongahleliwe, olawulwa yi-placebo, ongaboni kabili, weqembu elihambisanayo eliqhathanise imiphumela yamaphakeji angangeni e-allergen kumatilasi, imicamelo, nekhava yombhede phakathi nonyaka ongu-1 kanye nokupakishwa okufanayo kwe-placebo.
Ekuqaleni kocwaningo, umhlengikazi oqeqeshiwe wokuphefumula wavakashela isiguli, waqoqa amasampula othuli kumatilasi wesiguli ukuze athole izilinganiso ze-Der p1, futhi waqopha izindlela zokugwema ukungezwani komzimba nezitho ezazivele zikhona ekhaya.
Zonke iziguli ezifakwe ocwaningweni zazinamagumbi okulala abushelelezi.
Isiguli siyalwe ukuthi sihlanze amashidi ku-60 °c ngesonto
Ngaphezu kokufakwa kumatilasi, azikho ezinye izinyathelo ezathathwa ukugwema izinto ezingezwani nomzimba.
Ekupheleni kocwaningo, yena lo mhlengikazi wavakashela lezi zindlu futhi ezolanda uthuli emibhedeni.
Isiguli safakwa unyaka wonke;
Isikhathi sokufakwa siyiminyaka emi-2.
Iziguli ezinokungezwani nempova zahlolwa ngaphandle kwenkathi yempova.
Ekuvakasheni kokuqala, isiguli sahlolwa ngomtholampilo.
Umthamo wempilo (VC)
Amanani alinganiswa, ukuhlolwa kwesikhumba kwenziwa, futhi i-PC20 tissue Amine yahlolwa.
Yeka ukuthatha izidakamizwa ngaphambi kwesikhathi sokutadisha: I-steroids ephefumulayo ne-sodium acetate isonto elingu-1 ngaphambi kokuhlolwa kokuvuselela izicubu ze-trachea amine;
Ngaphambi kokuhlolwa, i-theophylline, izidakamizwa zomlomo ze-beta 2 adrenaline, izidakamizwa ze-beta 2 adrenaline ezidonswe isikhathi eside, kanye ne-antihistine kwathatha amahora angu-48, kanye nokuhogela izidakamizwa ze-beta 2 adrenaline ezisebenza isikhathi esifushane kwathatha amahora angu-6.
Ukuqoqwa kanye nokukhipha uthuli lwendlu ngaphambi, izinyanga ezi-4 neziyi-8 zokungenelela futhi ekupheleni kokungenelela kuqoqwa yi-vacuum cleaner efanayo (
Philips Vitall 377,1300 Watt, Philips, Eindhoven, Netherlands)
Sebenzisa idivayisi ekhethekile yokuhlunga kuwo wonke umatilasi ngemizuzu emi-2 (
I-ALK e-holsham, e-Denmark).
Ekuqaleni kocwaningo, qoqa uthuli ngokuqondile kumatilasi;
Ekupheleni kocwaningo, kwaqoqwa uthuli phezulu ekamu.
Isihlungi sigcinwa esiqandisini ngo-20 °c kuze kube yilapho kwenziwa ukuhlaziya ekupheleni kocwaningo.
Ukunqunywa kwe-Der P1 antigen ngu-elisa (ELISA).
I-Monoclonal antibody ngokumelene ne-Der p1 yayigxilwe epuleti lemithombo engama-96.
Ngemva kokufukamela nge-dust extract, isinyathelo sesibili sifakwe i-multi-valent antibody (
I-sunflower over-enzyme.
Ngemva kokungeza 1, 2-
Okwe-diamine HCl (OPD)
Njenge-substrate, ukumuncwa ku-490 nm kukalwa kusetshenziswa umfundi we-ELISA.
Isixazululo se-amine phosphate yezicubu (
Ukugxilisa ingqondo kabili kusuka ku-0. 25 kuya ku-32 mg/ml)
Ilawulwa nge-De Vilbiss 646 nebulizer enomphumela ongu-0. 13 mg/ml.
I-nebulizer ifakwe ebhokisini le-valve elinesihlungi se-aerosol.
Isikhathi se-atomization sasiyimizuzwana engu-30 lapho isiguli siyalwa ukuba siphefumule ngokuthula.
Lokhu kuhlola kwaqala ngokuhogela i-phosphate buffer aerosol.
Izilinganiso ezintathu ze-VC ne-fev ngaphambi kokuhogela (
Isikrini esikhulu).
I-V1 ikalwe ngemva kokuhlanganisa ngakunye.
I-PC20 tissue amine itholakala ngokuhunyushwa ngomugqa.
Omatilasi, imicamelo kanye nezingubo zokulala zeqembu lokungenelela zigoqwe nge-LID ehlinzekwe nguCarla c\'air (
I-Allergy Control AC btm Velserbroek, Netherlands).
Ikhava ye-placebo efanayo yenziwe inkampani efanayo.
Ikamu, elihlelwe umhlengikazi wocwaningo, lahlala unyaka owodwa.
Ikhwalithi yempilo ngokusebenzisa ikhwalithi yemibuzo yempilo yezifo zokuphefumula (QoL-RIQ). 17 IQoL-
I-RIQ iwuhlu lwemibuzo lwempilo oluqondene nesifo ezigulini ezinesifuba somoya kanye nesifuba somoya esingalapheki, elihlanganisa izinto ezingama-55, ezihlukaniswe izigaba eziyisikhombisa: izinkinga zokuphefumula (izinto eziyi-9)
Izinkinga zomzimba (9 izinto), imizwa (9 izinto)
, Qalisa/thuthukisa isimo sezinkinga zokuphefumula (izinto ezingu-7)
Imisebenzi ejwayelekile (izinto ezi-4)
Imisebenzi yansuku zonke neyasekhaya (izinto eziyi-10)
Imisebenzi yomphakathi, ubudlelwano phakathi kwabantu kanye nocansi (izinto eziyi-7).
Ukuze kugxilwe inkinga kokuhlangenwe nakho kwesiguli, iphrojekthi isekelwe \"kungakanani inkathazo" esibhekana nayo kusukela kuzimpawu noma imizwa engenhla.
Mayelana namaphrojekthi ahlobene nemisebenzi, umbuzo uthi \"zithiywe kangakanani ekwenzeni lo msebenzi othize".
Iziguli zacelwa ukuthi zinikeze izimpendulo zazo esikalini samaphuzu angama-70 se-Likert, ukusuka \"akunalutho\" kuye \"kokucindezelwa okukhulu\" noma ukuvimbela. Ukuthembeka (test-
Ukuhlola kabusha, ukuvumelana kwangaphakathi)
Futhi yafakazela ukusebenza kwayo.
Imingcele ye-17 yomtholampilo phakathi nenkathi yezinsuku ezingu-14 ngaphambi kokungenelela futhi ekupheleni kokulindela okomile kwezinyanga ezingu-12 kudinga iziguli ukuba zibhale amakhadi edayari ngezimpawu ze-asthma ne-nasal, amanani okugeleza okuphezulu, nokurekhoda imithi kabili ngosuku.
Izimpawu zesifuba somoya zihlanganisa ubunzima bokuphefumula, ukukhwehlela, ukukhwehlela nokuphefumula.
Izimpawu zamakhala zihlanganisa ukuminyana emakhaleni, ukuthimula nokuluma.
Into ngayinye ihlukaniswe kusuka kumaphuzu angu-0 (akukho zimpawu) kuya ku-4 (Izimpawu ezinzima).
Iziguli zaqeqeshelwa ukwenza ama-peak flow drill zisebenzisa imitha ye-micro-equipmentWright.
Bayalwe ukuthi benze ukufundwa kathathu futhi baqophe amanani aphezulu lapho bevuka ekuseni nangaphambi kokulala ebusuku.
Iziguli zacelwa ukuthi ziqhubeke nemithi evamile yokuhogela futhi ziqophe imithi eyengeziwe yokulondoloza uma kwenzeka ziyidinga.
Ukuhlaziywa kwedatha nokuhlaziywa kwezibalo kwenziwa nge-SPSS.
Ukuqhathanisa kweqembu (
Ngaphambi nangemva kokungenelela)
Kwenziwe ngokubuyekezwa kwesiginesha ye-Wilcoxon.
Hlaziya idatha yelogi usebenzisa izivivinyo zezimpawu. I-Mann-
Ukuhlolwa kukaWhitney U kwasetshenziselwa ukuqhathanisa phakathi kwamaqembu. p amanani angu-0. 5)
Eqenjini lokwelapha kanye neqembu le-placebo, kwakukhona amaphuzu angu-18 ngezinkinga zokuphefumula, izinkinga zomzimba ezihlobene nezinkinga zesifuba, i-trigger / ukuthuthukiswa, kanye nenani eliphelele.
Nakuba kwakungekho umehluko omkhulu emkhawulweni wokuthuthukiswa phakathi kwamaqembu amabili, ukuthuthukiswa ngaphakathi kweqembu lokwelapha kwakubalulekile.
Kwakungekho mehluko obalulekile kumanani ayisisekelo amapharamitha omtholampilo wamaphuzu ezimpawu zesifuba somoya phakathi kwamaqembu (ithebula 2).
Isilinganiso samaphaphu esimaphakathi samaqembu amabili asishintshanga kakhulu phakathi nonyaka ongu-1.
Isikolo sezimpawu zamakhala seqembu lokwelapha lehle kakhulu (p=0. 04)
Kodwa hhayi eqenjini le-placebo.
Umehluko phakathi kwamaqembu amabili wawungabalulekile.
Isisekelo se-ef value (
Ekuseni nakusihlwa)
Amaqembu amabili ayaqhathaniseka (ithebula 3).
Ngemuva konyaka we-1 wokungenelela, kwakungekho ushintsho oluphawulekayo ekuseni nakusihlwa ef, ukuhlukahluka kokugeleza okuphezulu noma ukusetshenziswa kwezidakamizwa zokuhlenga kuzo zombili amaqembu eziguli.
Buka leli thebula: Buka i-inline Buka ithebula le-pop-up 2 lezimpawu ngaphambi nangemuva kokungenelela (
Ukubhaliswa okumaphakathi ezinsukwini eziyi-14)
Buka leli thebula: Buka i-inline Buka ithebula le-pop-up 3 inani eliphakeme lethrafikhi ngaphambi nangemva kokungenelela (
Ukubhaliswa okumaphakathi ezinsukwini eziyi-14)
Inhloso yalolu cwaningo ukufunda
Ephaketheni likamatilasi ongezwani nomzimba egumbini lokulala elingenakhaphethi, elivezwe ku-Der p1 embhedeni, elingezwani nezibungu zothuli zasendlini ezigulini ezinesifuba somoya esimaphakathi kuya kwesibi kakhulu.
Sithole ukwehla okuphawulekayo ekugxilweni kwe-Der p1 othulini oluqoqwe umatilasi eqenjini lokwelapha elisebenzayo uma kuqhathaniswa neqembu le-placebo.
Izicubu ze-PC20 i-Amine ayizange ithuthuke phakathi nokungenelela konyaka we-1.
Nakuba ukuthuthukiswa okuphawulekayo kwezimpawu zamakhala kanye nekhwalithi yokuphila kwabonwa kuphela eqenjini lokwelapha elisebenzayo, asitholanga umehluko ophawulekayo phakathi kweqembu le-placebo kanye neqembu lokwelapha elisebenzayo ekushintsheni kwezimpawu zamaphaphu namakhala, izinga lokuphila, amanani okugeleza okuphezulu, kanye nokusetshenziswa kwezidakamizwa zokuhlenga.
Izifundo zakuqala zisebenzisa izinhlobo eziningana ezihlukene zokupakishwa komatilasi nazo zabonisa ukwehla kokuchayeka kwe-Der p1 phezulu komatilasi (ithebula lesi-4).
Kodwa-ke, ezinye izifundo azizange zibonise ukwehla kokuhlushwa kwe-Der p1, futhi kulezi zifundo ukhaphethi ekamelweni awuzange ususwe.
21,22 asilufaki udaba lokungcoliswa kwe-Der p1 esitezi 13 ngokufaka iziguli kuphela ezingenakhaphethi ekamelweni.
Lokhu kungase kuholele eqinisweni lokuthi, nakuba isisekelo sethu sokugxilisa i-Der p1 siphakeme kunezinye izifundo, singakwazi ukwehla kakhulu eqenjini eliphathwe ngenkuthalo.
22, 23 ukwehla kokuhlushwa kwe-allergen kufinyelele ngemva kwezinyanga ezi-4 futhi kwahlala kungashintshile phakathi nesikhathi socwaningo.
Buka leli thebula: Buka okusemgqeni Buka ithebula le-pop-up 4 Isifinyezo semiphumela nezilungiselelo zocwaningo lokumboza umatilasi olawulwayo nakuba ukugxila kwe-Der p1 eqenjini lokwelapha elisebenzayo kwancipha kakhulu uma kuqhathaniswa neqembu le-placebo, asizange sithole ukwehla okuphawulekayo ekuphenduleni kwe-hyperresponsiveness yomoya.
Ezinye izifundo nazo zehlulekile ukukhombisa ukuthuthukiswa kokusabela ngendlela yomoya.
Izifundo ezimbili ze-22, 23, 10, 11, 22 azizange zithole ukwehla okuphawulekayo kokuhlushwa kwe-allergen othulini, okuchaza ukuntuleka kokuthuthukiswa kwe-airway hyperreactivity.
UFrederick et al uthe zonke iziguli zazilawulwa ngokunengqondo ekwelashweni okuvamile kokuvimbela, ngakho-ke kwaba noshintsho oluncane noma alukho nhlobo kumingcele yomtholampilo.
Ngisho noCloosterman nozakwabo, abantu abangu-11 abazama ukugwema lo mphumela wokwelapha ngokuhlanganisa kuphela iziguli ezingazange zisebenzise i-steroids ephefumulayo noma ezikwazi ukuzimisa, abazange bathole ukuthuthukiswa okuphawulekayo ekuphenduleni kwe-airway hyperresponsiveness, akukho ukuthuthukiswa okuphawulekayo kunoma yimiphi imingcele yomtholampilo esetshenzisiwe, njengezimpawu zezimpawu, ukuhlukahluka kwe-ef, nokuhlehliswa kwe-F1.
Singayihlanganisa kanjani le mibono?
Naphezu komthamo omkhulu we-cortisol ehogeliwe, iziguli ezihilelekile ocwaningweni lwethu zazine-hyperreactivity enzima (> 800 μg)
Ngokuphambene, i-PC20