過敏性鼻炎評分量表（SFAR）與臨床病程之相關性研究

Correlation Study of the Score for Allergic Rhinitis and Clinical Course in Adolescence of Yilan County

目的：過敏性鼻炎是所有過敏疾病中最常見，估計全球患有超過 5億的過敏性鼻炎患者，而台灣地區的盛行率愈來愈高，本病與氣喘為同一發病過程，在氣道不同部位的表現，過敏性鼻炎的診斷，至今沒有國際公認的標準，通常會結合患者的病史、典型的症狀及一或二項的實驗室檢查，做為研究或臨床工作中的診斷標準，過敏性鼻炎評分量表（The Score For Allergic Rhinitis 簡稱SFAR）已經被證明是一種有效的篩選診斷工具，因此本研究乃針對青少年進行 SFAR評量，進一步調查是否與過敏性鼻炎各項相關危險因子有所關聯，希望能夠幫助並提供中西醫師在臨床上之參考。方法：本研究採取橫斷式問卷調查法，以方便取樣為原則，第一階段選取宜蘭縣某高職學生830位進行SFAR問卷調查，第二階段從SFAR得分大於等於7分者之中，隨機選出125 位符合取樣標準之個案，進行問卷調查。結果：830位受訪者中過敏性鼻炎發生率為49.8％，其中男性有143人（34.6％），佔男性人數的42.4％，女性有270人（65.4％），佔女性人數的54.8％；收案125名過敏性鼻炎患者，其SAFR得分平均為 10.7分，最低分為7分，最高分為15分，其中得13分人數最多，有26位（20.8％），得7分人數最少，只有2位（1.6％）；中輕度間歇性者15位（12.0％），中重度間歇性者58位（46.4％），輕度持續性者3位（2.4％），中重度持續性者49位（39.2％）；過敏性鼻炎患者之病程和SFAR呈現正相關（r＝0.351，p＜0.01），此外腰圍與身體質量指數也具有正相關（r＝0.843，p＜0.01）。結論：隨著病程的加長，過敏性鼻炎的嚴重程度也會增加，換言之過敏性鼻炎如果沒有得到良好的控制，就會增加氣喘發生的可能性。SFAE不同分數所代表的不同生理意義值得未來進一步去研究，並可作為臨床中醫學的輔助與參考。

The allergic rhinitis was the most common disease in all allergic diseases. There were more than five hundred million patients suffers from allergic rhinitis in the world and more and more prevalence in Taiwan. There were all the same course between allergic rhinitis and athma, but the different airway appearance. There was no international standard diagnosis of allergic rhinitis so far. In general, the diagnosis standard of clinics and study was according to combining medical history, typical symptom and one or two kind of laboratory examination results. The score for allergic rhinitis (SFAR) was already approved as an effective screening and diagnosis tool in medicine. The purpose of the study was to assessment SFAR of adolescence and further correlation study between SFAR and related risk factors. We hope the study could make the favor of clinical works in traditional medicine and modern medicine. Methods: This study used the cross-sectional questionnaire survey with the convenience sampling method. The study subjects of the first step were 830 students with questionnaire survey of the SFAR. The study subjects of the second step were 125 students that came from equal or greater than 7 score of the SFAR with random. Results: We found that allergic rhinitis prevalence was 49.8% of 830 subjects that contained 143 males (34.6%) that the number of females accounted for 42.4% and 270 females (65.4%) that the number of females accounted for 65.4%. The average score of SFAR was 10.7 all the 125 study subjects and lowest score of SFAR was 7, the highest score of SFAR was 15, beside 26 subjects (20.8%) were score 13 with highest subjects in the study subjects and 2 subjects (1.6%) were score 7 with lowest subjects in the study subjects. 15 subjects (12.0%) were moderate to mild intermittent and 58 subjects (46.4%) were moderate to severe intermittent and 3 subjects were mild persistent, 49 subjects were moderate to severe persistent. There was significant positive correlation (r = 0.351, p＜0.01) between clinical course and SFAR, beside all the same between waist circumference and body mass index (r= 0.843, p＜0.01). Conclusion: The more severity of allergic rhinitis was appeared following more clinical course. In other words, there was no good control of allergic rhinitis could increase the propobility of athma. It was valued to further study that the different score of SFAR represent different physiology and it was beneficial to the clinical traditional Chinese medicine.