Anbar Ran D
Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY 13210, United States.
BMC Pediatr. 2003 Jul 22;3:7. doi: 10.1186/1471-2431-3-7.
Management of asthma can be complicated by both medical and psychiatric conditions, such as gastroesophageal reflux, chronic sinusitis, and anxiety. When symptoms of asthma are interpreted without regard to such conditions treatment may yield a suboptimal outcome. For example, anxiety-associated dyspnea, tachypnea, and chest tightness can be mistakenly interpreted as resulting from an exacerbation of asthma. Medical treatment directed only for asthma may thus lead to overuse of asthma medications and increased hospitalizations.
The described case illustrates how a systemic steroid-dependent patient with asthma benefited from receiving care from a pediatric pulmonologist who also was well versed in the diagnosis and treatment of anxiety. By using self-hypnosis, the patient was able to reduce her dependence on bronchodilators. Following modification of her medical therapy under supervision of the pulmonologist, and regular use of hypnosis, the patient ultimately was weaned off her systemic steroid therapy.
This report emphasizes that anxiety must be considered as a comorbid condition in the treatment of asthma. Self-hypnosis can be a useful skill in the treatment of a patient with anxiety and asthma.
哮喘的管理可能因医学和精神状况而变得复杂,如胃食管反流、慢性鼻窦炎和焦虑症。如果在不考虑这些状况的情况下解读哮喘症状,治疗可能无法取得最佳效果。例如,与焦虑相关的呼吸困难、呼吸急促和胸闷可能会被错误地解读为哮喘加重所致。仅针对哮喘的药物治疗可能会导致哮喘药物的过度使用和住院次数增加。
所描述的病例说明了一名对全身性类固醇药物依赖的哮喘患者如何从一位精通焦虑症诊断和治疗的儿科肺科医生的治疗中获益。通过自我催眠,患者能够减少对支气管扩张剂的依赖。在肺科医生的监督下调整其药物治疗方案,并定期进行催眠后,患者最终停用了全身性类固醇药物治疗。
本报告强调,在哮喘治疗中必须将焦虑症视为一种合并症。自我催眠对于治疗患有焦虑症和哮喘的患者可能是一项有用的技能。