Heart Rate Variability Biofeedback Does Not Substitute for Asthma Steroid Controller Medication.
Heart Rate Variability Biofeedback Does Not Substitute for Asthma Steroid Controller Medication.
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DOI：
10.1007/s10484-017-9382-0
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发表时间：
2018-03
影响因子：
3
通讯作者：
Wamboldt FS
中科院分区：
文献类型：
--
作者：
Lehrer PM;Irvin CG;Lu SE;Scardella A;Roehmheld-Hamm B;Aviles-Velez M;Graves J;Vaschillo EG;Vaschillo B;Hoyte F;Nelson H;Wamboldt FS
尽管先前发现心率变异性生物反馈（HRVB）对哮喘的治疗效果，但尚不清楚HRVB是否可以替代控制药物或急救药物，或者它是否会影响气道炎症。在一项双中心试验中，68名患有轻度或中度哮喘的未接受过类固醇治疗的付费志愿者接受了3个月的HRVB或由EEG α生物反馈与放松音乐和放松节奏呼吸（EEG+）组成的比较条件。所有参与者在随机分组前接受了一个月的强化哮喘教育。两种治疗条件对乙酰甲胆碱激发试验（MCT）、哮喘症状和哮喘生活质量（AQOL）产生了相似的显著改善。MCT效应的大小与其他地方报道的增强安慰剂程序相似，并且是生物反馈训练后给予亚组参与者的高效吸入性类固醇布地奈德疗程的65%。呼出气一氧化氮仅在HRVB组有明显下降，为布地奈德效果的81%，但组间无明显差异。参与者报告说，在这两种技术的实践中变得更加放松。在生物反馈治疗后给予沙丁胺醇，肺功能检查结果有很大改善，表明两种治疗都不能使肺功能正常化，作为一种有效的控制药物。脉冲阻抗法显示两组在生物反馈期间上气道（声带）阻力增加。这些数据表明，HRVB不应被视为哮喘控制药物的替代品（例如，吸入类固醇），尽管两种生物反馈条件都产生了一些有益的效果，但这阻碍了进一步的研究，并暗示了潜在的互补作用。提出了各种假设来解释为什么HRVB对哮喘的影响在这项研究中出现较小的比在早期的研究。
Despite previous findings of therapeutic effects for heart rate variability biofeedback (HRVB) on asthma, it is not known whether HRVB can substitute either for controller or rescue medication, or whether it affects airway inflammation. Sixty-eight paid volunteer steroid naïve study participants with mild or moderate asthma were given three months of HRVB or a comparison condition consisting of EEG alpha biofeedback with relaxing music and relaxed paced breathing (EEG+), in a two-center trial. All participants received a month of intensive asthma education prior to randomization. Both treatment conditions produced similar significant improvements on the methacholine challenge test (MCT), asthma symptoms, and asthma quality of life (AQOL). MCT effects were of similar size to those of enhanced placebo procedures reported elsewhere, and were 65% of those of a course of a high-potency inhaled steroid budesonide given to a sub-group of participants following biofeedback training. Exhaled nitric oxide decreased significantly only in the HRVB group, 81% of the budesonide effect, but with no significant differences between groups. Participants reported becoming more relaxed during practice of both techniques. Administration of albuterol after biofeedback sessions produced a large improvement in pulmonary function test results, indicating that neither treatment normalized pulmonary function as a potent controller medication would have done. Impulse oscillometry showed increased upper airway (vocal cord) resistance during biofeedback periods in both groups. These data suggest that HRVB should not be considered an alternative to asthma controller medications (e.g., inhaled steroids), although both biofeedback conditions produced some beneficial effects, warranting further research, and suggesting potential complementary effects. Various hypotheses are presented to explain why HRVB effects on asthma appeared smaller in this study than in earlier studies.
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DOI：
10.1164/rccm.2201081
发表时间：
2002-06-15
影响因子：
24.7
作者：
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通讯作者：
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影响因子：
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影响因子：
3.3
作者：
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