臺灣博碩士論文加值系統

摘要
隨著盛行率的提高,因氣喘而致死的病例也時有所聞,如何治療及做好環境控制來防治氣喘,是醫界一直以來的努力方向,塵璊是所有過敏原中最多也最常見的一種;在世界各地都陸續有塵璊的調查研究,在台灣的調查僅限於台北地區,其他地區的資料則是十分有限。
本研究依前人的模式,在中部氣喘病童家中在四個不同部位:客廳地板,客廳沙發,臥室地板,臥室床舖,為期一年每隔兩個月採樣一次,同時與對照組做比較,並對所採得璊類做進一步的種類鑑定,共有8名實驗組及4名對照組。
研究結果顯示:以實驗組及對照組一年的塵璊分佈來說,並沒有明顯的差異。隨著溫度的降低,塵璊量在冬季(1月份)時最少,之後,隨著溫度升高而增加,以分佈部位而言,在臥室床墊的含量最高,且與對照組相較有統計學上的意義。可是在與氣喘發作的頻率而言,和塵璊量並沒有正相關的發現。至於璊類的族群仍是以歐洲室塵璊佔最大部份(77%),美洲室塵璊次之(13%),至於熱帶無爪璊則只佔1%。
氣喘是一個多因子誘發的疾病,除了在藥物治療外,環境控制更是治療的第一步。由本研究可知,在中部地區,病童長時間密切接觸的床墊,更是防治的重點。

Abstract
Many studies including skin test and radioallergosorbent test (RAST) strongly suggested that house dust mite are the most important allergen in Taiwan, especially in asthmatic children. Taiwan is a subtropical island. The high temperature and relative humidity throughout the year and overcrowding are ideal condition for mite growth. There were few reports about distribution of mite in Taiwan especially in Taichung.
We collected every two months between June 1998 and May 1999 from eight houses of mite-allergic patients and four normals. About 1m surface area, each of living room, floor, sofa, bed room and mattress was vacuumed for one minute. The floating method was used to collect mites in dusts and the mites were countered under stereo-microscope. House dust mites species were identified, too.
The results showed the following five points. First, the average number of mites in patients’ houses was not different that in normal’s houses. Second, the total mite amounts were greater in July to November and lowest in January. It was compatible with the lowest temperature in January with constant relative humidity all the year. Third, the mattress was the largest mite amount among four different vacuumed areas. Forth, the total amount of mites was not correlated with the frequency of asthma attacks. Fifth, the Dermatophagoides pteronyssinus (DP) was the dominant specie (77%) of house dust mites found in Taichung and Dermatophagoides farinae (DF) was the second (13%).
Environmental control of house dust mites is the first line management for mite-sensitive asthmatic patients. Mattress is a very important area to reduce the mite amounts according to our study.

目 錄
中文摘要
英文摘要
第一章 研究問題的發展
第一節 研究背景…………………………….1
第二節 研究動機…………………………….3
第三節 研究目的…………………………….5
第四節 研究假設…………………………….6
第二章 文獻回顧
第一節 塵璊的分佈………………………….7
第二節 璊類的分離與鑑定………………….13
第三章 研究方法
第一節 研究設計…………………………….16
第二節 研究工具…………………………….17
第三節 研究實施步驟……………………….18
第四章 研究結果
第一節 研究對象基本資料…………………..21
第二節 一年中塵璊分佈情形………………..23
第三節 塵璊分佈與溫度及相對濕度的關係..32
第四節 不同採樣部位的塵璊分佈…………..33
第五節 一年中氣喘發作次數………………..34
第六節 塵璊的鑑定 ………………………….35
第五章 討論
第一節 一年中塵璊的分佈情形……………..36.
第二節 塵璊分佈與溫度及相對濕度的關係..38
第三節 不同採樣部位的塵璊分佈…………..39
第四節 塵璊分佈與氣喘發作………………..41
第五節 塵璊的種類…………………………..42
第六節 結論…………………………………..43
第七節 研究限制及建議……………………..44
參考文獻…………………………………………45
附圖………………………………………………48

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