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ステロイド依存性重症難治性喘息に対する温泉療法の重要性。過去10年間の181例を対象に。

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  • Spa therapy is very important for the treatment of steroid-dependent intractable asthma (SDIA). Analysis of 181 patients with SDIA.

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Abstract

Characteristics of 181 patients with steroid-dependent intractable asthma (SDIA) who were admitted to our hospital and had spa therapy for last 10 years were examined in relation to the methods of spa therapy. For last 10 years, three kinds ofspa therapies were administered: spa therapy A (swimming training in a hot spring pool) in the first atage (1982-1985), spa therapy B (swimming training + inhalation of iodine salt solution) in the middle stage (1986 -1989), and spa therapy C (swimming training + inhalation of iodine salt solution + fango therapy) in the last stage (1990-1991) of this study. 1. The number of patients with SDIA who were admitted to our hospital and had spa therapy tended to increase from 2 in 1986 to 35 in 1991. 2. The number of SDIA patients over the age of 60 or over the age at onset of 40 tended to increase from the first stage to the last stage. 3. The proportion of patients from distant areas (prefectures other than Tottori) was decreasing for the last stage, although the number of these patients was increasing in recent years. 4. The proportions of patients divided by serum IgE levels and by clinical asthma types did not change for last 10 years. 5. The proportion of type Ib and type II asthma was considerably high in patients with SDIA for last 10 years. 6. Clinical effects of spa therapy were observed in 21 of the 30 (70.0%)patients with SDIA in the first stage (1982-1985) with spa therapy A, 68 of the 83 (74.7%) patients with SDIA in the middle stage (1986-1989) with spa therapy B, and 61 of the 68 (89.7%) patients with SDIA in the last stage (1990-1991) with spa therapy C.

最近10年間に三朝分院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息181例を対象に,温泉療法の方法との関連のもとに,対象患者の背景について検討を加えた。最近10年間に3種類の温泉療法が行われた。温泉療法A(温泉プール水泳訓練)は初期(1982-1985),温泉療法B(水泳訓練+ヨードゾル吸入)は中期(1986-1989),また,温泉療法C(水泳訓練+ヨードゾル吸入+鉱泥湿布療法)は後期(1990-1991)に行われた。1.当院へ入院し,温泉療法を受けたステロイド依存性重症難治性喘息(SDIA)患者の数は,1986年の2例から1991年の35例へと増加の傾向を示した。2.SDIA患者のうち,60才以 上の症例および40才以降の発症症例の数は,1986年以降急激な増加傾向を示した。3.鳥取県以外の他県(遠隔地)からの入院患者の頻度は,近年減少の傾向を示したが,その絶対数は増加の傾向であった。4.血清IgE値はいずれの時期においても200IU/mℓ以下の症例が多い傾向が見られた。5.臨床病型では,通常の喘息に比べIb型およびII型の頻度が高い傾向が見られた。6.温泉療法の臨床効果は,温泉療法Aが行われた初期では70.0%,温泉療法Bの中期では74.7%,温泉療法Cの後期では89.7%であった。

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