过敏性鼻炎和支气管哮喘治疗的统一性与整体观

过敏性鼻炎和支气管哮喘是常见的上下气道联合炎性疾病.尽管其治疗手段多样,效果良好,但由于目前对过敏性鼻炎的认识及重视程度不够,治疗现状并不乐观.从哲学上辩证统一的认识过敏性鼻炎和支气管哮喘的治疗,并以现代整体医学的观点分析两者的同一性,为临床实践中针对两者进行整体治疗提供理论依据.     

特应性皮炎与过敏进程

过敏性疾病已成为备受关注的社会问题,包括特应性皮炎、食物过敏、过敏性鼻炎、过敏性哮喘等,其发生和发展一直是学术界和社会公众高度关注的话题。变态反应症状可表现在皮肤、胃肠道、鼻腔、支气管等不同部位,流行病学研究发现各类过敏性疾病的出现呈现从儿童湿疹、食物过敏逐渐向过敏性鼻炎、过敏性哮喘发展的过程,婴儿或儿童早期出现的伴高IgE的特应性皮炎往往预示着未来会发生其他过敏性疾病,这种现象被称为变态反应性疾病的自然进程又称过敏进程,即“AllergyMarch”。本文就特应性皮炎与过敏进程的相关研究进行回顾与讨论,以期引起社会各界对特应性皮炎的重视。     

小儿支气管哮喘和胃食管返流关系的哲学思考

支气管哮喘是当今世界上最常见的气道慢性炎症性疾病,运用哲学的观点认识小儿支气管哮喘与胃食管返流之间的关系,对于支气管哮喘合并胃食管返流的临床治疗非常重要.     

支气管哮喘诊断和治疗的哲学启示

1　支气管哮喘诊断和治疗的发展演化支气管哮喘 (Ｂｒｏｎｃｈｉａｌａｓｔｈｍａ)简称哮喘 (Ａｓｔｈ ｍａ) ,是一种古老的疾病 ,表现为反复发作性的气喘、胸闷、咳嗽、咳痰 ,可在短时间内自行缓解或经药物治疗而缓解 ,缓解时可完全恢复正常。早在 2 50 0～ 30 0 0年以前人们就已认识到气道阻力增高可以引起呼吸困难。但由于当时对本病的病因、病理缺乏认识 ,对本病的治疗只能是凭经验用一些简单的草药治疗。随着对呼吸系统的深入研究 ,对支气管哮喘的研究也有了很大的进展。 2 0世纪 50年代末至 70年代初 ,人们把支气管哮喘定义为 :发作性…     

鼻部因素在阻塞性睡眠呼吸暂停低通气综合征中的作用

比较临床鼻中隔偏曲、解剖鼻中隔偏曲及无鼻中隔偏曲组间睡眠呼吸紊乱指数(AHI)、最低血氧饱和度的差异.比较过敏性鼻炎与无过敏性鼻炎病史组间AHI、最低血氧饱和度的差异.分析性别、年龄、病程、过敏性鼻炎、鼻中隔偏曲等多种因素对AHI和最低血氧饱和度的影响作用.比较临床鼻中隔偏曲组、解剖鼻中隔偏曲组、无鼻中隔偏曲组的AHI和最低血氧饱和度,均无统计学差异.比较过敏性鼻炎组与无过敏性鼻炎组AHI和最低血氧饱和度,过敏性鼻炎组的AHI大于无过敏性鼻炎组,差异有统计学意义,两组间最低血氧饱和度无统计学差异.多种因素对AHI和最低血氧饱和度的影响作用无统计学意义.合并过敏性鼻炎的OSAHS患者可能睡眠中的呼吸暂停和低通气次数更多,但不能通过性别、年龄、病程、过敏性鼻炎及鼻中隔偏曲的因素来预测OSAHS的疾病严重程度.     

支气管哮喘患者预防性吸入治疗的依从性及综合干预

支气管哮喘的预防重于治疗,长期小剂量吸入糖皮质激素是预防支气管哮喘的最佳选择,已得到国际医学界的广泛认可.本文通过对300例成人支气管哮喘患者预防性吸入治疗依从性进行调查分析,提示医务人员在支气管哮喘患者预防性治疗期间,应针对每个个体,从各个不同角度对患者进行综合干预,以达到预防性治疗的目的.     

婴幼儿喘息的分类和小儿哮喘的鉴别诊断

喘息是小儿时期常见的症状,尤其是婴幼儿。婴幼儿喘息分为三种类型：一过性的早期喘息,只发生在3岁以前的喘息。无家族的哮喘病史,与过敏原的致敏无关,与父母吸烟有关。持续性的早发的喘息,即非过敏的喘息,与病毒感染诱发有关。晚发的喘息/哮喘,即过敏性的喘息, 有湿疹和哮喘的气道病理特点。在诊断支气管哮喘前,还必须排除以下疾病：先天性气道和肺的发育异常,先天性心、血管异常,异物吸入,胃食管返流,支气管结核,纤毛不动综合征,免疫缺陷病等。     

湿疹？还是特应性皮炎？

特应性皮炎（AD）是一种慢性复发性、瘙痒性、炎症性皮肤疾病,常自幼时发病,可持续终生,严重影响患者的生活质量。目前尚无单一特异性的,洛床表现或实验室检查指标可以鉴别诊断AD与湿疹。然而,与湿疹相比较,AD患者常伴有血清免疫球蛋白IgE增高,个人及家族遗传性AD、过敏性哮喘和／或过敏性鼻炎的病史,且皮疹及瘙痒更为严重,还可合并皮肤感染及皮肤屏障功能的损害。因此,区分湿疹还是AD,对于正确诊断及采取合适的治疗方案具有重要意义。     

婴幼儿喘息的分类和小儿哮喘的鉴别诊断

喘息是小儿时期常见的症状,尤其是婴幼儿.婴幼儿喘息分为三种类型:一过性的早期喘息,只发生在3岁以前的喘息.无家族的哮喘病史,与过敏原的致敏无关,与父母吸烟有关.持续性的早发的喘息,即非过敏的喘息,与病毒感染诱发有关.晚发的喘息/哮喘,即过敏性的喘息.有湿疹和哮喘的气道病理特点.在诊断支气管哮喘前,还必须排除以下疾病:先天性气道和肺的发育异常,先天性心、血管异常,异物吸入,胃食管返流,支气管结核,纤毛不动综合征,免疫缺陷病等.     

校园心理疾病的防治

近年来,校园里与学习环境和生态环境有关的疾病在不断增多。早期的过敏性鼻炎、皮炎、肺炎和哮喘已为大家所熟悉。由于现代青少年处于急剧变幻的社会,来自各方面的压力不断增加,学习紧张,校园交谊活动兴盛,生活节奏加快,故容易产生劣性情绪。加上噪声、拥挤、     

Comorbidity in allergic asthma and allergic rhinitis: functional somatic syndromes

Based on the concept of central sensitisation, the present study tested the hypothesis of comorbidity in allergic asthma and allergic rhinitis with diagnoses of functional somatic syndromes (FSSs), including fibromyalgia, irritable bowel syndrome and migraine. Data were used from the population-based Västerbotten Environmental Health Study (n = 3406). The participants consisted of 164 individuals with allergic asthma and 298 individuals with allergic rhinitis as well as 2876 individuals without allergic or non-allergic asthma, allergic rhinitis or atopic dermatitis. Diagnoses were based on self-reports of having been diagnosed by a physician. Odds ratios (ORs) were calculated from binary logistic regression analysis, both crude and adjusted for age and education. The adjusted ORs (1.87–4.00) for all FSSs differed significantly from unity for both allergic asthma and rhinitis. The results provide support for the hypothesis of comorbidity in allergic asthma and rhinitis with FSSs. Since central sensitisation is likely to underlie FSSs, the present findings raises the question as to whether central sensitisation may also be involved in allergic asthma and rhinitis.     

Pilot study of personality traits assessed by the Karolinska Scales of Personality (KSP) in asthma, atopy, and rhinitis

Asthma and atopy are common diseases. To study associations between personality and asthma, atopy, rhinitis, and personality traits were measured on the Karolinska Scales of Personality for 193 persons working in 19 buildings with suspected indoor air problems. In addition, information on history of atopy, asthma, and rhinitis was collected by postal questionnaire. In analyses, asthma was associated with higher impulsiveness scores, and atopy in non-asthmatics was associated with higher social desirability scores and lower irritability, guilt, and impulsiveness scores. Non-atopic rhinitis was associated with scores on several anxiety-related scales, while atopic rhinitis was not associated with scores on the Karolinska Scales of Personality. This exploration implies that asthma, atopy, and rhinitis may be associated with various but different personality trait scores. The finding of such personality trait associations in persons with non-asthmatic atopy raises the question of a potential role of an emotional conflict in atopy and the role of personality in asthma, atopy, and rhinitis.     

支气管哮喘伴发抑郁与人格、应对和社会支持的关系分析

研究分析支气管哮喘伴发抑郁与人格、应对和社会支持的关系。对216例支气管哮喘患者应用自评抑郁量表、大五人格量表、特质应对方式问卷和社会支持评定量表进行调查,对收集到的数据进行Pearson相关分析、多元逐步回归分析和路径分析。结果显示49．1％的支气管哮喘患者存在不同程度的抑郁情绪;哮喘患者的抑郁程度、人格、应对方式和社会支持之间存在着不同程度的显著相关;人格、应对和社会支持都是影响支气管哮喘伴发抑郁的影响因素,人格的神经质是其重要的预测因素,它除了能直接影响哮喘患者的抑郁程度,还能通过社会支持和应对方式对其起间接的作用。研究提示人格的神经质、公正严谨性和消极应对方式是支气管哮喘伴发抑郁的直接的预测因素。     

Allergic disorders and attention deficit disorder in children

It has been suggested that children with attention deficit disorder-hyperactivity (ADDH) are likely to show allergic disorders, and that both ADDH and allergic disorders may share a common biological background. In a large sample of children from the general population we found no association between parent, teacher, and self-reports of ADDH behaviors and a history of allergic disorders (asthma, eczema, rhinitis, and urticaria) at ages 9 or 13 years. Similarly, reports of ADDH behaviors at age 13 years were not related to level of atopic responsiveness by skin test or serum IgE levels. Our findings call into question the hypothesis that there is a relationship between ADDH and allergic disorder.The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Health Research Council of New Zealand, and involves several departments of the University of Otago. The authors are indebted to the many people whose contributions made this study possible, and in particular the members of the sample and their parents.     

Impact of Allergic Rhinitis on Simulated Real‐World Performance1

A few studies have shown that untreated seasonal allergic rhinitis (hay fever) may have unfavorable effects on performance. However, prior research has employed tasks of limited or moderate difficulty (e.g., verbal learning) or has focused on visual‐motor efforts (e.g., driving a vehicle). The present research compared performance in the absence (asymptomatic) versus presence (symptomatic) of rhinitis, using the validated strategic management simulation (SMS). Obtained data indicated that whenever task‐demands were contextual (e.g., cued by the environment), no differences between symptomatic and asymptomatic conditions were obtained. Whenever task‐demands were more difficult, untreated seasonal allergic rhinitis decreased effectiveness. To avoid loss of productivity and limit decrements in quality of life, treatment of seasonal allergic rhinitis with medications without sedating effects appears of value.     

Relationships between psychological variables relevant to asthma and patients' quality of life

The relationships between health-related quality of life and various psychological variables relevant to the clinical evolution of bronchial asthma were evaluated for 101 asthma patients ages 14 to 72 years. Scores on quality of life exhibited a significant negative correlation with perceived vulnerability, panic-fear personality, and irritability, fatigue, airway obstruction, hyperventilation, and panic-fear during attacks but was not significantly correlated with preventive behaviour, attack-related behaviour, recognition, and control of respiratory function, or quality of care. These results imply that the effects of the former group of variables should be taken into account when assessing asthmatic patients' quality of life.     

Nasal diseases and psychological distress

A high rate of ENT doctors were murdered by nasal disordered patients in China recently. It is obviously important and urgent to find out whether there is any potential relationship between nasal diseases (ND) and psychological distress that might contribute to violent behavior. For this purpose, we carried out this literature review. There is a complex relationship between ND and psychiatric distress, which is mainly considered as a bidirectional causal relationship with other controversy opinions. However, most of the previous studies were found to be focused on allergic rhinitis and chronic rhinosinusitis, while reports about other ND were rare. Further study is still needed to uncover the secret aspects in this field, and more attentions need to be paid to other ND.