Complex spa therapy and airway inflammation in bronchial asthma
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概要
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気管支喘息55例を対象に,複合温泉療法(温泉プール水泳訓練+ヨードゾル吸入+鉱泥湿布療法)を試み,その臨床効果と気道炎症反応との関連について,若干の検討を加えた｡1.複合温泉療法の臨床効果では,著効15例(27.3%),有効32例(58.2%),やや有効6例,無効2例であり,明らかに有効と判断された症例は,55例中47例(85.5%)であった｡2.複合温泉療法は,気管支肺胞洗浄液(BALF)中の細胞成分(リンパ球,好中球,好酸球など)が多い症例,すなわち気道炎症反応がより強い症例により有効であった｡このことは,複合温泉療法が,単純性の(化学伝達物質による)気管支攣縮よりも,気道炎症反応をともなった病態により強く影響を及ぼすことを示している｡3.複合温泉療法による換気機能の改善(1秒量)は,BAL液中の好中球数が少ない症例においてより高度であった｡このことは,BAL液中に高度な好中球増多が見られる症例に対しては,より長期的な複合温泉療法が必要であることを示しているものと考えられた｡Efficacy of complex spa therapy was studied in 55 patients with bronchial asthma. Complex spa therapy was effective in 47 (85.5%) of the 55 patients with bronchial asthma : marked efficacy was observed in 15 (27.3%), moderate in 32(58.2%), slight in 6 (10.9%) and no efficacy in 2 patients (3.6%). Improvement of clinical symptoms and findings by complex spa therapy was more clearly observed in patients with an increased proportion of BAL lymphocytes, neutrophils and eosinophils. These findings suggest that complex spa therapy more affects cell infiltration in theairways than bronchoconstriction induced by chemical mediators. Improvement of ventilatory function represented by FEV1.0% value was higher in patients with a low proportion of BAL neutrophils, suggesting that patients with increased number of BAL neutrophils require longer complex spa therapy than those without BAL neutrophilia.
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