長期喫煙歴を有する喘息症例に対する温泉療法の臨床効果気道過敏性、ロイコトリエンB4およびC4産生能による評価
20年以上の長期喫煙歴を有する気管支喘息症例 (22例) に対する温泉療法の臨床効果について、非喫煙喘息症例 (36例) を対照に検討した。1. 温泉療法の臨床効果は、長期喫煙例では、著効4例 (18.2%)、有効11例 (50.0%)、やや有効あるいは無効7例 (31.8%) であり、著効を含めた明らかな有効例は15例 (68.2%) であった。一方、非喫煙例では、明らかな有効例は36例中29例 (80.6%) で、温泉療法の臨床効果は非喫煙例で有意に高いことが明らかとなった。2. IgE系反応、気道過敏性、ロイコトリエンB4(LTB4) およびC4(LTC4) 産生能いずれも、長期喫煙例で...
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| Published in | 日本温泉気候物理医学会雑誌 Vol. 68; no. 2; pp. 83 - 91 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本温泉気候物理医学会
2005
|
| Online Access | Get full text |
| ISSN | 0029-0343 1884-3697 |
| DOI | 10.11390/onki1962.68.83 |
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| Abstract | 20年以上の長期喫煙歴を有する気管支喘息症例 (22例) に対する温泉療法の臨床効果について、非喫煙喘息症例 (36例) を対照に検討した。1. 温泉療法の臨床効果は、長期喫煙例では、著効4例 (18.2%)、有効11例 (50.0%)、やや有効あるいは無効7例 (31.8%) であり、著効を含めた明らかな有効例は15例 (68.2%) であった。一方、非喫煙例では、明らかな有効例は36例中29例 (80.6%) で、温泉療法の臨床効果は非喫煙例で有意に高いことが明らかとなった。2. IgE系反応、気道過敏性、ロイコトリエンB4(LTB4) およびC4(LTC4) 産生能いずれも、長期喫煙例で有意の亢進が観察された。3. 非喫煙例では、温泉療法とIgE抗体産生亢進との間にある程度の関連が見られたが、喫煙例では関連は見られなかった。4. 気道過敏性は非喫煙例、喫煙例いずれにおいても著効、有効例に比べやや有効ないし無効例で有意の亢進が見られた。5. LTB4産生能は非喫煙例、喫煙例とも明らかな有効例に比べ、やや有効ないし無効例で亢進の傾向は見られたが、推計学的には有意の差ではなかった。6. LTC4産生能は、喫煙者では有効性との間に関連は見られなかったが、非喫煙例では明らかな有効例と比べ、やや有効ないし無効例で産生亢進の傾向が見られた。しかし、推計学的には有意差は見られなかった。以上の結果より、温泉療法の有効性が、非喫煙例に比べ、長期喫煙歴を有する喘息症例で有意に低いのは、喫煙によるIgE系反応や気道過敏性の亢進、さらにはLTB4、LTC4の産生亢進などが関与している可能性が示唆された。 |
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| AbstractList | 20年以上の長期喫煙歴を有する気管支喘息症例 (22例) に対する温泉療法の臨床効果について、非喫煙喘息症例 (36例) を対照に検討した。1. 温泉療法の臨床効果は、長期喫煙例では、著効4例 (18.2%)、有効11例 (50.0%)、やや有効あるいは無効7例 (31.8%) であり、著効を含めた明らかな有効例は15例 (68.2%) であった。一方、非喫煙例では、明らかな有効例は36例中29例 (80.6%) で、温泉療法の臨床効果は非喫煙例で有意に高いことが明らかとなった。2. IgE系反応、気道過敏性、ロイコトリエンB4(LTB4) およびC4(LTC4) 産生能いずれも、長期喫煙例で有意の亢進が観察された。3. 非喫煙例では、温泉療法とIgE抗体産生亢進との間にある程度の関連が見られたが、喫煙例では関連は見られなかった。4. 気道過敏性は非喫煙例、喫煙例いずれにおいても著効、有効例に比べやや有効ないし無効例で有意の亢進が見られた。5. LTB4産生能は非喫煙例、喫煙例とも明らかな有効例に比べ、やや有効ないし無効例で亢進の傾向は見られたが、推計学的には有意の差ではなかった。6. LTC4産生能は、喫煙者では有効性との間に関連は見られなかったが、非喫煙例では明らかな有効例と比べ、やや有効ないし無効例で産生亢進の傾向が見られた。しかし、推計学的には有意差は見られなかった。以上の結果より、温泉療法の有効性が、非喫煙例に比べ、長期喫煙歴を有する喘息症例で有意に低いのは、喫煙によるIgE系反応や気道過敏性の亢進、さらにはLTB4、LTC4の産生亢進などが関与している可能性が示唆された。 |
| Author | 保崎, 泰弘 濱田, 全紀 光延, 文裕 岩垣, 尚史 藤井, 誠 高田, 真吾 芦田, 耕三 谷崎, 勝朗 永田, 拓也 |
| Author_xml | – sequence: 1 fullname: 藤井, 誠 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 芦田, 耕三 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 保崎, 泰弘 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 光延, 文裕 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 高田, 真吾 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 永田, 拓也 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 岩垣, 尚史 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 – sequence: 1 fullname: 濱田, 全紀 organization: 岡山大学医学部・歯学部附属病院三朝医療センターリハビリテーション科 – sequence: 1 fullname: 谷崎, 勝朗 organization: 岡山大学医学部・歯学部附属病院三朝医療センター内科 |
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| References | 21) Tanizaki Y, Komagoe H, Sudo M, et al.: Swimming training in a hot spring pool as therapy for steroid-dependent asthma. Jpn J Allergol 1984; 33: 389-395. 8) Ashida K, Mitsunobu F, Hosaki Y, et al.: Decrease in low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) by long-term spa therapy in patients with asthma. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 115-122. 13) Mitsunobu F, Ashida K, Hosaki Y, et al.: Influence of long-term cigarette smoking on immunoglobulin E-mediated allergy, pulmonary function, and high-resolution computed tomography lung densitometry in elderly patients with asthma. Clin Exp Allergy 2004; 34: 59-64. 27) Mitsunobu F, Mifune T, Hosaki Y, et al.: Improvement of pulmonary function by spa therapy in patients with emphysema, evaluated by residual volume (RV) and low attenuation area (LAA) of high-resolution computed tomography (HRCT). J Jpn Assoc Phys Med Balneol Climatol 1999; 62: 121-128. 10) British Thoracic Society. BTS Guideline for the management of chronic obstructive pulmonary disease. Thorax 1997; 52 (Suppl 5): S1-28. 14) Barrett EG, Wilder JA, March TH, Espindola T, Bice DE.: Cigarette smoke-induced airway hyperresponsiveness is not dependent on elevated immunoglobulin and eosinophilic inflammation in a mouse model of allergic airway disease. Am J Respir Crit Care Med 2002; 165: 1410-1418. 4) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 9. Suppression of bronchial hyperresponsiveness. J Jpn Assoc Phys Med Balneol Climatol 1993; 56: 135-142. 6) Ashida K, Mitsunobu F, Mifune T, et al.: Clinical effects of spa therapy on patients with asthma accompanied by emphysematous changes. J Jpn Assoc Phys Med Balneol Climatol 2000; 63 113-119. 22) Chai H, Farr RS, Froehlech LA, Methison DA, et al.: Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 1975; 56: 323-327. 25) Lam S, Chan H, LeReiche JC, Chan-Yeung M, Salari H: Release of leukotrienes in patients with bronchial asthma. J Allergy Clin Immunol 1988; 81: 711-717. 5) Tanizaki Y, Kitani H, Mifune T, et al.: Ten-year study on spa therapy in 329 patients with bronchial asthma. J Jpn Assoc Phys Med Balneol Climatol 1994; 57: 142-150. 9) Siafakas NM, Vermeire P, Pride N, et al.: Optimal assessment and management of chronic obstructive pulmonary disease (COPD): a consensus statement of the European Respiratory Society. Eur Respir J 1995; 8: 1398-1420. 16) Troisi RJ, Speizer FE, Rosner B, Trichopoulos D, Willett WC.: Cigarette smoking and incidence of chronic bronchitis and asthma in women. Chest 1995; 180: 1557-1561. 20) Tanizaki Y, Komagoe H, Sudo M, et al.: Intractable asthma and swimming training in a hot spring pool. J Jpn Assoc Phys Med Balneol Climatol 1984; 47: 115-122. 2) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 1. Relationship to clinical asthma types and patient age. J Jpn Assoc Phys Med Balneol Climatol 1992; 55: 77-81. 17) Larson L.: Incidence of asthma in Swedish teenager: relation to sex and smoking-habits. Thorax 1995; 50: 260-264. 15) Siroux V, Pin I, Orysczyn MP, Le Moual N, Kaufmann F.: Relationship to asthma and asthma severity in EGEA study. Eur Respir J 2000; 15: 470-477. 18) Ronmark E, Lundback B, Jonsson E, Jonsson AC, Lindstrom M. Sandstrom T.: Incidence of asthma-report from the Obstructive Lung Disease in Northern Sweden Study. Allergy 1997; 532 1071-1078. 19) Langhammer A, Johnsen R, Holmen J, Gulsvik A, Bjermer L.: Cigarette smoking gives more respiratory symptoms among women than among men. J Epidemiol Community Health 2000; 54: 917-922. 26) Mitsunobu F, Mifune T, Hosaki Y, et al.: Effects of spa therapy on patients with pulmonary emphysema. Relationship to disease severity evaluated by low attenuation area of the lung on high resolution computed tomography. J Jpn Assoc Phys Med Balneol Climatol 1998; 61:79-86. 1) Mitsunobu F, Mifune T, Hosaki Y, et al.: Enhanced peripheral leukocyte leukotriene production and bronchial hyperresponsiveness in asthmatics. Eur Respir J 2000; 16: 504-508. 11) Gortmaker SL, Walker DK, Jacobs FH, Ruch-Ross H.: Parental smoking and risk of childhood asthma. Am J Public Health 1982; 72: 574-579. 28) Mitsunobu F, Mifune T, Hosaki Y, et al.: Effects of spa therapy on pulmonary emphysema in relation to IgE-mediated allergy. J Jpn Assoc Phys Med Balneol Climatol 2000; 63: 120-126. 29) Mitsunobu F, Hosaki Y, Ashida K, et al.: Long-term spa therapy prevents the progressive pathological changes of the lung in patients with pulmonary emphysema. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 91-98. 23) Tanizaki Y, Kitani H, Okazaki M, Mifune T, Mitsunobu F, Kimura I: Changes in the proportion of bronchoalveolar neutrophils and basophilic cells and the release of histamine and leukotrienes from bronchoalveolar cells in patients with steroid-dependent intractable asthma. Int Arch Allergy Immunol 1993; 101: 196-202. 24) Mitsunobu F, Mifune T, Hosaki Y, et al.: Enhanced production of leukotrienes by peripheral leukocytes and specific IgE antibodies in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol 2001; 107: 492-498. 3) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 7. Relationship between spa effects and airways inflammation. J Jpn Assoc Phys Med Balneol Climatol 1993; 56: 79-86. 7) Ashida K, Mitsunobu F, Mifune T, et al.: Effect of spa therapy on low attenuation area (LAA) of the lungs on high-resolution computed tomography (HRCT) and pulmonary function in patients with asthma. J Jpn Assoc Phys Med Balneol Climatol 2001; 64: 203-209. 12) Weitzman M, Gortmaker S, Walker DK, Socol A.: Maternal smoking and childhood asthma. Pediatrics 1990; 85: 505-511. |
| References_xml | – reference: 20) Tanizaki Y, Komagoe H, Sudo M, et al.: Intractable asthma and swimming training in a hot spring pool. J Jpn Assoc Phys Med Balneol Climatol 1984; 47: 115-122. – reference: 21) Tanizaki Y, Komagoe H, Sudo M, et al.: Swimming training in a hot spring pool as therapy for steroid-dependent asthma. Jpn J Allergol 1984; 33: 389-395. – reference: 2) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 1. Relationship to clinical asthma types and patient age. J Jpn Assoc Phys Med Balneol Climatol 1992; 55: 77-81. – reference: 14) Barrett EG, Wilder JA, March TH, Espindola T, Bice DE.: Cigarette smoke-induced airway hyperresponsiveness is not dependent on elevated immunoglobulin and eosinophilic inflammation in a mouse model of allergic airway disease. Am J Respir Crit Care Med 2002; 165: 1410-1418. – reference: 10) British Thoracic Society. BTS Guideline for the management of chronic obstructive pulmonary disease. Thorax 1997; 52 (Suppl 5): S1-28. – reference: 22) Chai H, Farr RS, Froehlech LA, Methison DA, et al.: Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 1975; 56: 323-327. – reference: 1) Mitsunobu F, Mifune T, Hosaki Y, et al.: Enhanced peripheral leukocyte leukotriene production and bronchial hyperresponsiveness in asthmatics. Eur Respir J 2000; 16: 504-508. – reference: 6) Ashida K, Mitsunobu F, Mifune T, et al.: Clinical effects of spa therapy on patients with asthma accompanied by emphysematous changes. J Jpn Assoc Phys Med Balneol Climatol 2000; 63 113-119. – reference: 29) Mitsunobu F, Hosaki Y, Ashida K, et al.: Long-term spa therapy prevents the progressive pathological changes of the lung in patients with pulmonary emphysema. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 91-98. – reference: 18) Ronmark E, Lundback B, Jonsson E, Jonsson AC, Lindstrom M. Sandstrom T.: Incidence of asthma-report from the Obstructive Lung Disease in Northern Sweden Study. Allergy 1997; 532 1071-1078. – reference: 13) Mitsunobu F, Ashida K, Hosaki Y, et al.: Influence of long-term cigarette smoking on immunoglobulin E-mediated allergy, pulmonary function, and high-resolution computed tomography lung densitometry in elderly patients with asthma. Clin Exp Allergy 2004; 34: 59-64. – reference: 5) Tanizaki Y, Kitani H, Mifune T, et al.: Ten-year study on spa therapy in 329 patients with bronchial asthma. J Jpn Assoc Phys Med Balneol Climatol 1994; 57: 142-150. – reference: 11) Gortmaker SL, Walker DK, Jacobs FH, Ruch-Ross H.: Parental smoking and risk of childhood asthma. Am J Public Health 1982; 72: 574-579. – reference: 9) Siafakas NM, Vermeire P, Pride N, et al.: Optimal assessment and management of chronic obstructive pulmonary disease (COPD): a consensus statement of the European Respiratory Society. Eur Respir J 1995; 8: 1398-1420. – reference: 3) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 7. Relationship between spa effects and airways inflammation. J Jpn Assoc Phys Med Balneol Climatol 1993; 56: 79-86. – reference: 24) Mitsunobu F, Mifune T, Hosaki Y, et al.: Enhanced production of leukotrienes by peripheral leukocytes and specific IgE antibodies in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol 2001; 107: 492-498. – reference: 17) Larson L.: Incidence of asthma in Swedish teenager: relation to sex and smoking-habits. Thorax 1995; 50: 260-264. – reference: 27) Mitsunobu F, Mifune T, Hosaki Y, et al.: Improvement of pulmonary function by spa therapy in patients with emphysema, evaluated by residual volume (RV) and low attenuation area (LAA) of high-resolution computed tomography (HRCT). J Jpn Assoc Phys Med Balneol Climatol 1999; 62: 121-128. – reference: 28) Mitsunobu F, Mifune T, Hosaki Y, et al.: Effects of spa therapy on pulmonary emphysema in relation to IgE-mediated allergy. J Jpn Assoc Phys Med Balneol Climatol 2000; 63: 120-126. – reference: 8) Ashida K, Mitsunobu F, Hosaki Y, et al.: Decrease in low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) by long-term spa therapy in patients with asthma. J Jpn Assoc Phys Med Balneol Climatol 2003; 66: 115-122. – reference: 19) Langhammer A, Johnsen R, Holmen J, Gulsvik A, Bjermer L.: Cigarette smoking gives more respiratory symptoms among women than among men. J Epidemiol Community Health 2000; 54: 917-922. – reference: 26) Mitsunobu F, Mifune T, Hosaki Y, et al.: Effects of spa therapy on patients with pulmonary emphysema. Relationship to disease severity evaluated by low attenuation area of the lung on high resolution computed tomography. J Jpn Assoc Phys Med Balneol Climatol 1998; 61:79-86. – reference: 7) Ashida K, Mitsunobu F, Mifune T, et al.: Effect of spa therapy on low attenuation area (LAA) of the lungs on high-resolution computed tomography (HRCT) and pulmonary function in patients with asthma. J Jpn Assoc Phys Med Balneol Climatol 2001; 64: 203-209. – reference: 25) Lam S, Chan H, LeReiche JC, Chan-Yeung M, Salari H: Release of leukotrienes in patients with bronchial asthma. J Allergy Clin Immunol 1988; 81: 711-717. – reference: 16) Troisi RJ, Speizer FE, Rosner B, Trichopoulos D, Willett WC.: Cigarette smoking and incidence of chronic bronchitis and asthma in women. Chest 1995; 180: 1557-1561. – reference: 15) Siroux V, Pin I, Orysczyn MP, Le Moual N, Kaufmann F.: Relationship to asthma and asthma severity in EGEA study. Eur Respir J 2000; 15: 470-477. – reference: 4) Tanizaki Y, Kitani H, Okazaki M, et al.: Clinical effects of spa therapy on bronchial asthma. 9. Suppression of bronchial hyperresponsiveness. J Jpn Assoc Phys Med Balneol Climatol 1993; 56: 135-142. – reference: 12) Weitzman M, Gortmaker S, Walker DK, Socol A.: Maternal smoking and childhood asthma. Pediatrics 1990; 85: 505-511. – reference: 23) Tanizaki Y, Kitani H, Okazaki M, Mifune T, Mitsunobu F, Kimura I: Changes in the proportion of bronchoalveolar neutrophils and basophilic cells and the release of histamine and leukotrienes from bronchoalveolar cells in patients with steroid-dependent intractable asthma. Int Arch Allergy Immunol 1993; 101: 196-202. |
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| Snippet | 20年以上の長期喫煙歴を有する気管支喘息症例 (22例) に対する温泉療法の臨床効果について、非喫煙喘息症例 (36例) を対照に検討した。1. 温泉療法の臨床効果は、長期喫煙例では、著効4例 (18.2%)、有効11例 (50.0%)、やや有効あるいは無効7例 (31.8%)... |
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| Title | 長期喫煙歴を有する喘息症例に対する温泉療法の臨床効果気道過敏性、ロイコトリエンB4およびC4産生能による評価 |
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| ispartofPNX | 日本温泉気候物理医学会雑誌, 2005, Vol.68(2), pp.83-91 |
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