鼻アレルギーの治療（II）—特異的減感作療法とその問題点

IMMUNOTHERAPY OF THE NASAL ALLERGY (PART TWO)

　I．はじめに

　喘息，鼻アレルギーなどの気道アレルギーの治療法には，1）アレルゲンからの逃避，2）対症療法，3）特異的減感作療法，4）非特異的減感作療法，5）手術療法などがある。3）の特異的減感作療法は近年広く行なわれるようになり多くの報告がなされているがその臨床的効果および作用機序に関してなお異なつた見解があるようである。この治療法はアレルギーの本質に対する治療法として期待されている。今回，私どもの鼻アレルギー外来における長期観察例よりみた特異的減感作療法の効果を報告し，現時点における問題点を検討した。

　The significance of the immunotherapy of nasal allergy is discussed. Fifty seven patients withnasal allergy were treated with specific desensitization for a period more than one year. Following results are obtained.

　1. Among these cases 27 or 47.0% showed good results; 21 or 37% showed fairly good result; the treatment was ineffective in other remaining cases.

　2. The 57 patients were divided into 3 groups in accordance to the offending agents, namely, house dust, ragweed and others. The treatment was highly effective in 10 cases among the 26 effected with house dust allergens (38%). However, with ragweed allergens 4 cases out of the 9 showed a high effectivity. The reason for not having obtained good results in the house dust allergens as compared to that of the ragweed appeared to be the failure of the house dust allergens being purified perfectly. According to newer concepts the house dust allergens are composed of mites, dermatophagides farinae.

　3. At the beginning of the therapy all patients showed significantly positive skin reactions but these reactions were scarcely changed during the entire course of the therapy. These results suggest that the effectivity of immunotherapy does not parallel with the skin reaction.