Clinical Studies on Bronchial Asthma-Differences between nasal and bronchial types with regard to the symptoms recorded on asthma diary

Abstract

Patients of bronchial asthma, 47 cases in total, were followed up clinically during six months since their first day of visit to our clinic as out-patients. Asthma diary was designed and prepared for the purpose of checking symptoms every day by patients themselves. Patients were also tested on routine clinical examinations including skin tests, provocation tests by allergen and achetylcholine inhalation test. 1.There are three types of asthmatic attacks with regard to the onset and the course: the major type shows a symptom complex consisted of severely developing attacks within several days and symptoms suggesting of bronchial infection, the chronic type has attacks followed by continuous wheezing of several days, and the periodic type shows an attack occurring at a fixed time in a day without following wheezing afterward. 2.These three types of attack could apear alternately in the same patient during six months observed. But a certain patient had a predominant type of attacks through whole period of observation. Patients of nasal type(asthma attacks with rhinorrhea) suffered more likely from periodical attacks in the morning, and patients of bronchial type from chronic attacks. 3.Headache, sneeze, perspiration and palpitation were seen more frequently in asthma attack among patients of nasal type. 4.Coincidence rate of rhinorrhea with asthma attack is related positively to the size of skin reaction by house dust antigen and higher bronchial sensitivity to acetylcholine test. Patients positive to provocation test by house dust antigen reacted also positive to skin test and showed higher incidence of asthma attack with rhinorrhea.