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[Effects of institutional therapy and factors which influence the prognosis]
H Sugimoto1, K Matsubara, S Matsuda
1National Higashi-Saitama Hospital.
Insights
Institutional therapy improved pulmonary function, exercise capacity, and reduced asthma attacks in children. Prognosis was linked to medication, bronchial hypersensitivity, and age of symptom onset and progression.
Area of Science:
- Pediatric Pulmonology
- Environmental Medicine
Background:
- Asthma management in children often requires comprehensive therapeutic approaches.
- Institutional therapy, combining physical training and environmental control, is explored for persistent pediatric asthma.
Purpose of the Study:
- To evaluate the effectiveness of institutional therapy in asthmatic children.
- To identify factors influencing treatment prognosis in pediatric asthma.
Main Methods:
- Analysis of questionnaires and laboratory findings from 565 children treated between 1978 and 1997.
- Assessment of pulmonary function tests (e.g., FEV1.0) and bronchial hypersensitivity (acetylcholine inhalation test).
- Evaluation of exercise abilities and asthma attack frequency.
Main Results:
- Institutional therapy improved pulmonary function, bronchial hypersensitivity, and exercise capacity.
- Over 40% of patients experienced no or few mild asthma attacks post-therapy.
- Remission group differed significantly in medication dosage, bronchial hypersensitivity, age of onset, and symptom progression timeline.
Conclusions:
- Institutional therapy is effective for pediatric asthma, particularly when symptoms become perennial.
- A combination of physical training and environmental control should be considered a key therapeutic strategy.
- Prognostic factors include medication use, bronchial hyperresponsiveness, and age-related symptom characteristics.
Abstract:
We examined the effect of institutional therapy on asthmatic children and evaluating the factors influencing the prognosis. We analyzed the questionnaires and laboratory findings obtained form the 565 children who had been treated with the therapy in National Higashi-Saitama Hospital from April 1978 to March 1997. The institutional therapy seems to be effective in the following 3 aspects. 1) Pulmonary function test such as FEV1.0, and bronchial hypersensitivity test such as acetylcholine inhalation test were improved. 2) Exercise abilities such as free running were improved. 3) More than 40% of the patients had no asthma attack or only a few mild asthma attacks requiring no medication. When compared the group whose symptoms were not improved with the remission group, who had no asthma attack, significant differences were seen in the following points, 1) The dose and the number of the medicines at the end of the hospitalization, 2) the bronchial hypersensitivity test, 3) the age of onset, 4) the age of the symptoms become perennial and 5) the term from the symptoms become perennial to the hospitalization were significantly different. The therapy principles including the recipes for exercise training were not different between the two groups. It is concluded that we should consider institutional therapy or, a combination of physical training and environmental control as one of the most important therepeutic methods when asthmatic symptoms become perennial in spite of the conventional medication.