Jacob R G, Shapiro A P, O'Hara P, Portser S, Kruger A, Gatsonis C, Ding Y
Western Psychiatric Institute and Clinic, Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
Psychosom Med. 1992 Jan-Feb;54(1):87-101. doi: 10.1097/00006842-199201000-00011.
We determined the effect of relaxation therapy for hypertension in patients whose blood pressure remained elevated despite the use of antihypertensive medication. The effect was assessed in multiple settings, including the relaxation therapist's office, the Hypertension Clinic, and the patient's natural environment, the latter using 24-hour automated ambulatory blood pressure measures. Nineteen patients were randomized either to temperature biofeedback-assisted relaxation or to an attention control, "stress education." Antihypertensive medication was kept constant. In the behavioral therapist's office, blood pressure decreased in equivalent amounts with both treatments. Hypertension Clinic nurse blood pressure remained stable or increased with both treatments, but again there was no difference between treatments. Ambulatory blood pressure increased with relaxation therapy and decreased with stress education, the effect being significant for diastolic pressure. The effects on ambulatory blood pressure were limited to the waking hours. The only variable that showed superior effects for relaxation therapy was physician-determined blood pressure. These results call into question the generalizability of the effects of relaxation therapy from one setting to another.
我们确定了放松疗法对那些尽管使用了抗高血压药物但血压仍居高不下的高血压患者的疗效。在多个环境中对疗效进行了评估，包括放松治疗师的办公室、高血压诊所和患者的自然环境，后者采用24小时自动动态血压测量。19名患者被随机分为温度生物反馈辅助放松组或注意力控制组，即“压力教育”组。抗高血压药物保持不变。在行为治疗师的办公室里，两种治疗方法使血压下降的幅度相当。高血压诊所护士测量的血压在两种治疗中均保持稳定或升高，但两种治疗之间同样没有差异。动态血压在放松疗法中升高，在压力教育中降低，这种影响对舒张压而言具有显著性。对动态血压的影响仅限于清醒时间。唯一显示放松疗法效果更佳的变量是医生测定的血压。这些结果让人质疑放松疗法的效果从一种环境到另一种环境的可推广性。
