호흡기 알레르기질환에서 환경관리: 집먼지진드기에 민감한 천식환자에서 항원비투과 커버의 효과

초록

Background: Allergen avoidance is the most important treatment strategy in allergic diseases. Although encasing bedding in allergen-impermeable covers is the most effective house dust mite (HDM) control measure, its efficacy and clinical effectiveness is uncertain in usual domestic environment in Korea. Objective: A double-blind trial was conducted to assess the effect of impermeable covers without any other form of mite-reduction measures. Methods: Thirty-five patients with HDM-sensitive mild-to-moderate asthma were randomly assigned to receive impermeable (Allergy-X-Cover) or non-impermeable (placebo) covers for their beddings. The level of HDM major allergen in dust from patient‘s bedding was measured at baseline and every 2-month interval. Visual-analogue scale for asthma symptom, asthma-specific QOL and PEF were assessed at baseline and every 2-month interval. Spirometry was performed at baseline and after 6 and 12 months. Results: Compared with placebo group, the amount of dust collected from bedding was decreased in active group. Active group showed decreased concentration of HDM Group 1 allergen in bedding dust during the first 6 months. Symptom score and visual-analogue scale was improved in active group more than in placebo group. In active group, PEF was significantly improved during the study period, and FEV1 was improved at 6 months. Asthma-specific QOL was improved in both group during 1 year. Conclusions: These results suggest that simple application of impermeable cover without any strict management plan provide incomplete but significant reduction to allergen exposure and clinical benefits.