기관지 천식 환자에 대한 임상 및 피내반응에 관한 고찰

Abstract

[한글]

CLINICAL OBSERVATION AND SKIN TEST FOP BRONCHIAL ASTHMA

Young Nam Whang

Department of medical Science The Graduate School Yonsei University

(Directed by Professor Sang Yong Lee)

Bronchial asthma is one of the most common allergic syndrome characterized by

recurrent acute attack of wheezing and dyspnea due to a widespread narrowing of the

smaller bronchi and bronchioles usually associated with specific sensitization or

nespiratory infection.

Many different factors appear to be involved in the etiology of bronchial asthma,

but most of asthma patients are related to allergic reaction to inhaled antigens,

particularly pollens, molds and house dust, which are actual causation of asthma.

proper treatment of asthma requires a combination of effective symptomatic

treatment and specific management. Specific management is based upon determining

the factors. responsible for the asthmatic attacks. This is accomplished by

specific test, namely the application of a variety of environmental allergens to

their intradermal injection. Once the specific offending agents have been

identified, their avoidance offers the most satisfactory and effective treatment of

asthma. In many situation, however, because of the complexity of the etiology of

the asthma or the inability to avoid an allergen, specific hyposensitization by

injection therapy with an extract of the antigen may be necessary for adequate

control.

The present study is aimed to report the results of clinical abservation on 260

asthma patients and intradermal skin test with standard allergen extracts to detect

offending allergens in 125 asthma patients at the Yonsei University Severance

Hospital from June 1967 to June 1973.

1) One hundred-forty cases of 260 asthma patients were male and 120 cases were

female. Their ages ranged from 7 years to 72 years. male to female ratio was 1.2:1

and the peak age in incidence of asthma was in 4th decade(25.3%).

2) The peak age in the onset of asthma was also in 4th decade(25.0%).

3) One hundred-five cases(40.4%) had family history.

4) According to Rackemann's classification, 160 cases of 260 asthma

patients(61.5%) were mixed type, 63 cases(24.2%) atopic type, and 37 cases(14.2%)

intrinsic type.

5) Monthly distribution of asthma attack revealed the peak occurrence in

September.

6) Asthma attack was most common at night of the day.

7) Symptoms during the interval between asthma attacks were relieved completely

in 60.4%.

8) Sixty-eight cases of 260 asthma patients(26.2%) has preceding other allergy

and among them urticari was most common.

9) Frequency of predisposing or aggravating factors in bronchial asthma was in

order of smoke(64.6%), emotional stress(51.9%), exercise and fatigue(48.8%),

weather change(41.9%) and dust (37.7%)

10) Positive reaction in 125 patients with intradermal skin test was 86.4%. Total

number of the sort of the offending allergens were 71 and total frequency of

detection of the allergen revealed 484.

11) Among offending allergens dust was 62.9%, mold 54.6%, pollen 37.0%, food

23.1% and combined 57.4%.

12) Barn dust(61.8%) was most common of dust allergens, monilia(66.1%) of mold

allergens, acasia(55.0%) of pollen allergens, and salmon(68.0%) of food allergens.

[영문]

Bronchial asthma is one of the most common allergic syndrome characterized by recurrent acute attack of wheezing and dyspnea due to a widespread narrowing of the smaller bronchi and bronchioles usually associated with specific sensitization or

nespiratory infection.

Many different factors appear to be involved in the etiology of bronchial asthma, but most of asthma patients are related to allergic reaction to inhaled antigens, particularly pollens, molds and house dust, which are actual causation of asthma.

proper treatment of asthma requires a combination of effective symptomatic treatment and specific management. Specific management is based upon determining the factors. responsible for the asthmatic attacks. This is accomplished by specific test, namely the application of a variety of environmental allergens to

their intradermal injection. Once the specific offending agents have been identified, their avoidance offers the most satisfactory and effective treatment of asthma. In many situation, however, because of the complexity of the etiology of

the asthma or the inability to avoid an allergen, specific hyposensitization by injection therapy with an extract of the antigen may be necessary for adequate control.

The present study is aimed to report the results of clinical abservation on 260 asthma patients and intradermal skin test with standard allergen extracts to detect offending allergens in 125 asthma patients at the Yonsei University Severance Hospital from June 1967 to June 1973.

1) One hundred-forty cases of 260 asthma patients were male and 120 cases were female. Their ages ranged from 7 years to 72 years. male to female ratio was 1.2:1 and the peak age in incidence of asthma was in 4th decade(25.3%).

2) The peak age in the onset of asthma was also in 4th decade(25.0%).

3) One hundred-five cases(40.4%) had family history.

4) According to Rackemann's classification, 160 cases of 260 asthma patients(61.5%) were mixed type, 63 cases(24.2%) atopic type, and 37 cases(14.2%) intrinsic type.

5) Monthly distribution of asthma attack revealed the peak occurrence in September.

6) Asthma attack was most common at night of the day.

7) Symptoms during the interval between asthma attacks were relieved completely in 60.4%.

8) Sixty-eight cases of 260 asthma patients(26.2%) has preceding other allergy and among them urticari was most common.

9) Frequency of predisposing or aggravating factors in bronchial asthma was in order of smoke(64.6%), emotional stress(51.9%), exercise and fatigue(48.8%), weather change(41.9%) and dust (37.7%)

10) Positive reaction in 125 patients with intradermal skin test was 86.4%. Total number of the sort of the offending allergens were 71 and total frequency of detection of the allergen revealed 484.

11) Among offending allergens dust was 62.9%, mold 54.6%, pollen 37.0%, food 23.1% and combined 57.4%.

12) Barn dust(61.8%) was most common of dust allergens, monilia(66.1%) of mold allergens, acasia(55.0%) of pollen allergens, and salmon(68.0%) of food allergens.