Biofeedback Training to Increase P co2 in Asthma With Elevated Anxiety: A One-Stop Treatment of Both Conditions?
Biofeedback Training to Increase P co2 in Asthma With Elevated Anxiety: A One-Stop Treatment of Both Conditions?
复制标题
生物反馈训练可增加哮喘伴焦虑症患者的二氧化碳分压：这两种疾病的一站式治疗？
DOI：
10.1097/psy.0000000000001188
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发表时间：
2023
影响因子：
3.3
通讯作者：
Ritz,Thomas
中科院分区：
文献类型：
--
作者：
Meuret,AliciaE;Rosenfield,David;Millard,MarkM;Ritz,Thomas
目的焦虑在哮喘患者中非常普遍。哮喘症状和药物会加剧焦虑，反之亦然。不幸的是，焦虑和哮喘的共病治疗在很大程度上是缺乏的。这两种情况的一个共同问题是过度换气。它会对肺功能以及哮喘和焦虑症的症状产生不利影响。方法120例讲英语或西班牙语的成人哮喘患者被随机分为两组，一组接受Capneter辅助呼吸训练(CART)以提高PCO2，另一组接受慢呼吸训练(SLOW)。虽然焦虑不是纳入标准，但21.7%的患者在医院焦虑和抑郁量表(HADS)上达到了临床相关的焦虑水平。分别于基线、治疗后、1个月随访和6个月随访时评定焦虑(HADS-A)、抑郁(HADS-D)量表、焦虑敏感指数(焦虑敏感指数)和消极情绪(积极情感-消极情感量表中的消极情感)。结果在二次分析中，基线焦虑程度高的哮喘患者CART的焦虑敏感指数和PANAS-N的下降幅度明显大于慢性组(p值≤)。005，Cohen d值≥为0.58.此外，在6个月的随访中，CART组的ASI、PANAS-N和HADS-D也低于慢组(p值≤)。012，Cohen d值≥为0.54)。低基线焦虑的患者在CART组和SLOW组的预后没有差异。结论对于高焦虑的哮喘患者，我们设计的提高PCO2的短期训练与慢呼吸训练相比，焦虑敏感度和负性情绪显著而持续地降低。这些发现支持PCO2作为降低哮喘焦虑的潜在生理靶点。
ObjectiveAnxiety is highly prevalent in individuals with asthma. Asthma symptoms and medication can exacerbate anxiety, and vice versa. Unfortunately, treatments of comorbid anxiety and asthma are largely lacking. A problematic feature common to both conditions is hyperventilation. It adversely affects lung function and symptoms in asthma and anxiety. We examined whether a treatment to reduce hyperventilation, shown to improve asthma symptoms, also improves anxiety in asthma patients with high anxiety.MethodOne hundred twenty English-or Spanish-speaking adult patients with asthma were randomly assigned to either Capnometry-Assisted Respiratory Training (CART) to raise P co 2 or feedback to slow respiratory rate (SLOW). Although anxiety was not an inclusion criterion, 21.7% met clinically relevant anxiety levels on the Hospital Anxiety and Depression Scale (HADS). Anxiety (HADS-A) and depression (HADS-D) scales, anxiety sensitivity (Anxiety Sensitivity Index [ASI]), and negative affect (Negative Affect Scale of the Positive Affect Negative Affect Schedule) were assessed at baseline, posttreatment, 1-month follow-up, and 6-month follow-up.ResultsIn this secondary analysis, asthma patients with high baseline anxiety showed greater reductions in ASI and PANAS-N in CART than in SLOW (p values≤. 005, Cohen d values≥ 0.58). Furthermore, at 6-month follow-up, these patients also had lower ASI, PANAS-N, and HADS-D in CART than in SLOW (p values≤. 012, Cohen d values≥ 0.54). Patients with low baseline anxiety did not have differential outcomes in CART than in SLOW.ConclusionsFor asthma patients with high anxiety, our brief training designed to raise P co 2 resulted in significant and sustained reductions in anxiety sensitivity and negative affect compared with slow-breathing training. The findings lend support for P co 2 as a potential physiological target for anxiety reduction in asthma.