AIRWAY REACTIVITY TO SUGGESTION AND STRESS IN ASTHMA

我们设计了两个实验来检验暗示和强调的效果。 以及心身哮喘的一般模型。模型 预测心理因素只会影响支气管功能 在主要由迷走神经介导的哮喘阻塞患者中 上呼吸道，这些个体也会表现出更大的迷走性 对压力的反应能力。它还预测焦虑，压抑性应对， 暗示性/催眠性将预测由此导致的支气管变化 对以上呼吸道为主的个体进行心理干预 哮喘。 用氦氧肺测量哮喘患者的呼吸道阻塞部位 机械和哮喘的存在/严重程度通过乙酰甲胆碱激发试验。 在一项实验中，受试者将被给予错误的暗示，即他们是 吸入了一种强力的支气管收缩药。对肺功能的影响将是 评估过了。在另一项实验中，受试者将暴露在实验室中 应激源，而肺和其他措施的交感和 采取副交感神经活动，包括呼吸性窦性心律失常 作为衡量迷走神经张力和尿儿茶酚胺水平的指标。这项研究将 试图确定交感神经和副交感神经的相对作用 活动中对心身哮喘的贡献。受试者的 对支气管收缩的感觉将通过心理物理学进行评估 可伸缩。 其他研究将评估呼吸性窦性心律失常的有效性 哮喘患者迷走神经张力的测定及茶碱的影响 对第二次实验中采取的依赖措施用药。

Two experiments are proposed to examine the effect of suggestion and stress on the airways, and a general model for psychosomatic asthma. The model predicts that psychological factors will affect bronchial function only among those with asthmatic obstruction primarily in mostly vagally-mediated upper airways, and that these individuals also will show greater vagal reactivity to stress. It also predicts that anxiety, repressive coping, and suggestibility/hypnotizability will predict bronchial changes resulting from psychological interventions in individuals with primarily upper-airway asthma. Site of airway obstruction in asthma will be measured by heliox lung mechanics and asthma presence/severity by the methacholine challenge test. In one experiment, subjects will be given false suggestions that they are inhaling a potent bronchoconstrictor. Effects on pulmonary function will be assessed. In another experiment, subjects will be exposed to laboratory stressors, while pulmonary and other measures of sympathetic and parasympathetic activity are taken, including respiratory sinus arrhythmia as a measure of vagal tone and urine catecholamine levels. This study will attempt to determine the relative roles of sympathetic and parasympathetic activity in the contribution to psychosomatic asthma. Subjects' perceptions of bronchoconstriction will be assessed by psychophysical scaling. Other studies will evaluate the validity of respiratory sinus arrhythmia as a measure of vagal tone among asthmatics, and the effects of theophylline medication on the dependent measures taken in the second experiment.