Pulmonary Function Testing
After 30 min of rest, baseline pulmonary function assessment with measurements of FVC and FEV\, using the best of the three vital capacity efforts, was done on a water-filled spirometer of 10-L capacity (Goddard Expirograph, Could Instruments, Cleveland). Transfer factor for Deo was measured, using Morgan transfer test system (P.K. Morgan Ltd., Chatham, Kent, United Kingdom), in the past three months during a routine pulmonary physiologic evaluation of the patients. After baseline FEV, and FVC was recorded, an aerosol of phosphate-buffered saline solution via a Wight nebulizer with oxygen at a flow rate of 7 L/min, was given for two minutes with the nose clipped. cialis professional
Subjects were requested to inhale the aerosol through the mouth using tidal breathing for two minutes. Measurements of FEV, and FVC were made at 30 and 90 s after inhalation of the aerosol. Thereafter, bronchial provocation with an aerosol of HAP in a similar manner as just noted was given at five-min intervals in doubling concentrations from 0.0325mg/ml to 8mg/ml. Spirometry was repeated at 30 and 90 s following each inhalation. The inhalations were discontinued when a fall of 20 percent in FEV, was achieved. This was calculated from the lowest post-saline FEV, (FEVA) and the lowest post-HAP FEV, (FEVB) as follows:
The method described here is that reported by Cockroft et al. The dose of HAP producing a 20 percent fall was designated as the PC20. This dose of HAP was calculated from a dose-response curve, or if only one concentration had been given, from the formula:
On the second and third study days after baseline FEV, and FVC values were measured in order to ensure a stable condition of the patients, the subjects were then randomly administered either real or placebo acupuncture in another room by the acupuncturist. The order of real or placebo acupuncture treatment was predetermined by a computer-generated randomization table. The observer and the patients were unaware of the nature of the acupuncture treatment given. No patient had previously received treatment with acupuncture. Immediately after acupuncture, FEV, and FVC were again measured, and then a histamine inhalation test was performed to obtain the HAP concentration required for PC20 in the manner described above. After histamine inhalation test, all subjects were given treatment with nebulized salbutamol aerosol for two minutes to reverse the histamine-induced bronchospasm. No patient left the laboratory until his FEV, and FVC values had returned to the baseline values measured at the onset of the study.