気管支喘息の温泉療法 ―93例の臨床的検討―

1982年1月から1988年12月までの7年間に三朝分院内科に入院し，温泉療法を受けた気管支喘息93例を対象に，その背景因子，免疫アレルギー学的要素および温泉療法の臨床効果について総合的に検討した。１．年齢の平均は52.6才，発症年齢の平均は41.7才であり，両者ともやや高齢であった。2．血清IgE値の平均は506.2IU／mℓであった。300IU／mℓ以下の症例は59例（63.4％）であり，半数以上の症例が血清IgE値正常ないし低値を示した。3．皮内反応ではカンジダに陽性を示す症例が44例と最も多く，次にハウスダスト（以下HDと略す）26例，スギ13例，キヌ8例であった。4．換気機能検査では気管支攣縮型において換気機能の低下傾向が最も少なく，細気管支閉塞型で換気機能の低下傾向が特に％ MMF，％ V（50），％　V（25）のような細気管支の閉塞を示すパラメーターの低下傾向がより高度であった。5．対象症例の臨床病型は気管支攣縮型が4７例でほぼ対象症例の半数を占め次いで気管支攣縮＋過分泌型29例，細気管支閉塞型17例の順であった。6．温泉療法の全般的有効率は79.6％であった。臨床病型別では細気管支閉塞型17例中16例（94.1％）が有効例であり，細気管支閉塞型で最も有効例がみられた。

Allergological characteristics and factors of spa therapy in relation to clinical effects were studied on 93 patients, who were adirnitted at Misasa Branch Hospital from 1982 to 1988. Fifty-seven out of 93 cases were steroid-dependent intractable asthma. 1. The mean age was 52.6 and the mean age at onset was 41.7 years old. The age and age at onset were higher ip these asthma cases. 2. The mean serum IgE levels was 506.2IU/mℓ. Serum IgE levels were generally low, and less than 300IU/mℓ in many cases. 3. Frequency of positive skin reactions to various allergens was generally low, and considerably higher in the two allergens, candida albicans and house dust. Cases with posiitive RAST score was most frequently observed in house dust, followed by candida albicans and J. cedar. 4. Ventilatory function tests of these patients showed that % V(50), % V(25)and % MMF which represent small airway obstruction were less decreased in bronchospasm type and most deereased in bronchiolar obstruction type. 5. The bronchospasm type was most frequently observed, followed by bronchospasm-hypersecretion type and bronchiolar obstruction type. 6. Spa therapy was effective in 74 cases (79.6%) out of the 93　patients, and regarding clinical classification of asthma type, spa therapy was most effective in the cases with bronchiolar obstruction type.