過敏性鼻炎患者接受免疫療法之生活品質; Quality of Life of Allergic Rhinitis Patients after Immunotherapy. Formosan Journal of Medicine

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题名:	過敏性鼻炎患者接受免疫療法之生活品質;Quality of Life of Allergic Rhinitis Patients after Immunotherapy. Formosan Journal of Medicine
作者:	劉博仁(Po-Jen Liu)*;李采娟(Tsai-Chung Li)
贡献者:	中醫學院中國醫學研究所
关键词:	過敏性鼻炎,免疫療法,生活品質;allergic rhinitis,immunotherapy,quality of life
日期:	2005-07
上传时间:	2009-08-24 14:47:38 (UTC+8)
摘要:	本研究主要目的是調查過敏性鼻炎病患接受免疫療法後對其生活品質的影響，以作為這類治療的依據參考。以不同的方式選取包括一般罹患過敏性鼻炎的病人29人（AR組）以及已接受免疫療法病人26人（ARIT組），同時接受中文版「SF-36 整體健康調查問卷」(Medical Outcome Study Short-form 36-item Health Survey, MOS SF-36)以及「過敏性鼻炎疾病特殊性問卷」(Allergic Rhinitis Quality of Life Instrument, ARQOL)測驗；另選取完全無過敏性鼻炎的正常人30位（Normal組），給予「ARQOL」問卷調查。最後將這三組之「SF-36」及「ARQOL」來作一比較。結果發現AR組之「SF36整體健康調查問卷」所有次向量除了身體功能(physical functioning, PF)以及身體疼痛(bodily pain, BP)外，其他六個次向量的分數差異均顯著異於群體常值(p<0.05)，ARIT組的「SF36整體健康調查問卷」與群體常值得分比較之結果，顯示除了一般健康狀況(general health, GH)一次向量分數差異有顯著意義(p<0.05)以外，其餘次向量幾乎與正常群體相似。在「過敏性鼻炎疾病特殊性問卷」相關症狀(symptom ST)、活動限制(activity restriction, AR)以及醫療資源耗用(medical resource utilization, MR)三大項目，其測試－再測試信度的Pearson相關係數皆在0.9以上；Normal組均較AR及ARIT組有較高的症狀、活動限制、醫療資源耗用三次向量及總分分數(p<0.05)，而ARIT組除了醫療資源耗用以外，其餘次向量都也都顯著高於AR組(p<0.05)。而「SF36整體健康調查問卷」及「過敏性鼻炎疾病特殊性問卷」得分結果之相關性方面，可見AR組這兩種問卷幾乎不呈現相關性；但是在ARIT組中，可見症狀及活動限制二次向量與整體健康問卷八次向量中有六次向量呈中度到高度相關(p<0.05)，但在醫療資源耗用方面與整體健康問卷無關。因此本研究發現在「SF36整體健康調查問卷」上，過敏性鼻炎患者在整體健康生活品質表現上大部分比正常人差；而過敏性鼻炎患者接受免疫療法後，在整體健康生活品質表現上幾乎與正常人相似。而在「過敏性鼻炎疾病特殊性問卷」方面，本研究發現ARIT組生活品質比AR組還要好，但是無法達到和一般正常人相同的程度。本研究所使用之「過敏性鼻炎疾病特殊性問卷」其測試－再測試信度的可靠度相關係數高，可見此表是一穩定的量表。而「SF36整體健康調查問卷」及「過敏性鼻炎疾病特殊性問卷」得分之相關性顯示在做有關過敏性鼻炎研究其生活品質變化方面仍然應該將這兩種不同性質的測量工具納入，比較客觀。 The aim of this study was to measure quality of life outcomes following immunotherapeutic treatment of allergic rthinitis. A cross-sectional study design with three groups was conducted. Twenty nine patients with allergic rhinitis (group AR) and twenty six patients with allergic rhinitis who had undergone immunotherapy (group ARIT) were evaluated with the generic outcome measure (validated Chinese version of the Medical Outcome Study Short-form 36 item Health Survey, SF-36) and disease-specific outcome measure (Allergic Rhinitis Quality of Life Instrument, ARQOL). Thirty people without allergic rhinitis (group Normal) also completed the ARQOL. The SF-36 and ARQOL survey scores were compared with normative data and each other. Group AR reported significant impacts (all p<0.05) in six out of eight SF-36 domains, the two insignificant domains being physical functioning and bodily pain. The only statistically significant difference in the eight SF-36 domains between the group ARIT and Taiwan norms was the general health domain (p<0.05). In the three ARQOL dimensions, the Pearson correlations of test-retest reliability were all greater than 0.9. Group Normal was found to have higher total and ARQOL subscale scores (p<0.05) than the other two groups, and group ARIT was also found to have significantly higher total and ARQOL subscale scores (p<0.05) than group AR, with the exception of medical resource utilization. There was no correlation between the SF-36 and ARQOL in group AR, but in group ARIT, the correlation between the six SF-36 domains and symptoms and activity restrictions in the three ARQOL dimensions were moderate to strong. In general, allergic rhinitis has great impact on generic QOL but generic QOL approaches the same level after immunotherapy. Although immunotherapy improves disease-specific QOL of allergic rhinitis patients, there still exist differences between patients with immunotherapy and normal persons. The high test-retest reliability of the ARQOL suggests that it is a stable instrument. Using the two different instrument is an objective method for assessing quality of life in patients with allergic rhinitis.
關聯:	台灣醫學 9(4)455~466
显示于类别:	[中國醫學研究所] 期刊論文

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