Spa therapy and serum cortisol levels in patients with steroid-dependent intractable asthma (SDIA)

Serum cortisol levels before and after spa therapy were compared in 30 patients with steroid-dependent intractable asthma (SDIA) in relation to clinical asthma types. 1. The mean level of serum cortisol in patients with type la-1 asthma was 2.0±0.7mcg/dℓ before spa therapy, and significantly increased to 9.0±3.1mcg/dℓ　(p<0.001). The serum cortisol level of patients with type la-2 also significantly increased from 3.3±1.5mcg/dℓ before spa therapy to 5.9±3.1 mcg/dℓ after the therapy (p<0.05). 2. The level of serum cortisol in patients with type Ib increased from 4.0±1.6mcg/dℓ to 7.8±1.4mcg/ dℓ after spa therapy (p<0.001). In contrast, the serum cortisol levels in patients with type II were not significantly different before (2.7±1.3mcg/dℓ) and after spa therapy (3.5±3.0mcg/dℓ). The results showed that an increase in the levels of serum cortisol by spa therapy was more clearly observed in patients with type la-1 asthma compared to that in type la-2 or type Ib, and that, in contrast, the serum cortisol levels in patients with type II asthma did not significantly increase by spa therapy, since their asthma attacks were always severe and chronic in spite of long-term glucocorticoid regimen.

ステロイド依存性重症難治性気管支喘息患者30名において温泉療法前後の血清コルチゾール値を,臨床病型に基づいて検討した｡1.Ia-1型の症例における血清コルチゾール値は温泉療法前の2.0±0.7μg/dℓから9.0±3.lμg/dℓに有意に増加していた(p<0.001)｡Ia-2型でも3.3±1.5μg/dℓから5.9±3.1g/dℓに有意に増加していた(pく0.05)｡ 2.Ib型では温泉療法前後で4.0±1.6μg/dℓから7.8±1.4μg/dℓに有意に増加した｡一方,Ⅱ型の症例では,温泉療法前2.7±1.3μg/dℓ,温泉療法後3.5±3.0μg/dℓで有意な変化は認められなかった｡以上のように,温泉療法の血清コルチゾールに対する効果は,Ia-2,Ib型に比較してIa-1型で明らかであった｡一方,Ⅱ型の気管支喘息症例の血清コルチゾ-ル値は,温泉療法によって有意な変化を認めなかった｡これは長期にわたる副腎皮質ホルモン投与にかかわらず,Ⅱ型の症例の喘息発作は常に慢性的で重篤であるからと考えられる。