儿童慢性哮喘的家庭治疗
Family therapy for chronic asthma in children.
作者信息
Yorke J, Shuldham C
机构信息
Royal Brompton Hospital, Sydney Street, London, UK.
出版信息
Cochrane Database Syst Rev. 2005 Apr 18;2005(2):CD000089. doi: 10.1002/14651858.CD000089.pub2.
BACKGROUND
Psychosocial and emotional factors are important in childhood asthma. Nevertheless, drug therapy alone continues to be the main treatment. Treatment programmes that include behavioural or psychological interventions have been developed to improve disturbed family relations in the families of children with severe asthma. These approaches have been extended to examine the efficacy of family therapy to treat childhood asthma in a wider group of patients. This review systematically examines these studies.
OBJECTIVES
Recognition that asthma can be associated with emotional disturbances has led to the investigation of the role of family therapy in reducing the symptoms and impact of asthma in children. The objective of this review was to assess the effects of family therapy as an adjunct to medication for the treatment of asthma in children.
SEARCH STRATEGY
We searched the Cochrane Airways Group trials register, Psychlit and Psychinfo. Searches are current as of January 2005.
SELECTION CRITERIA
Randomised trials comparing children undergoing systematic therapy focusing on the family in conjunction with asthma medication, with children taking asthma medication only.
DATA COLLECTION AND ANALYSIS
Two reviewers assessed the studies for inclusion in the review.
MAIN RESULTS
Two trials with a total of 55 children were included. It was not possible to combine the findings of these two studies because of differences in outcome measures used. In one study, gas volume, peak expiratory flow rate and daytime wheeze showed improvement in family therapy patients compared to controls. In the other study, there was an improvement in overall clinical assessment and number of functionally impaired days in the patients receiving family therapy. There was no difference in forced expiratory volume or medication use in both studies.
AUTHORS' CONCLUSIONS: There is some indication that family therapy may be a useful adjunct to medication for children with asthma. This conclusion is limited by small study sizes and lack of standardisation in the choice of outcome measures.
背景
心理社会和情感因素在儿童哮喘中很重要。然而，仅药物治疗仍然是主要的治疗方法。已经制定了包括行为或心理干预的治疗方案，以改善重度哮喘儿童家庭中失调的家庭关系。这些方法已扩展到检验家庭治疗在更广泛的患者群体中治疗儿童哮喘的疗效。本综述系统地考察了这些研究。
目的
认识到哮喘可能与情绪障碍有关，这促使人们研究家庭治疗在减轻儿童哮喘症状和影响方面的作用。本综述的目的是评估家庭治疗作为药物辅助手段治疗儿童哮喘的效果。
检索策略
我们检索了Cochrane Airways Group试验注册库、Psychlit和Psychinfo。检索截至2005年1月。
选择标准
随机试验，比较接受以家庭为重点的系统治疗并结合哮喘药物治疗的儿童与仅服用哮喘药物的儿童。
数据收集与分析
两名评价者评估纳入综述的研究。
主要结果
纳入了两项共55名儿童的试验。由于所使用的结局指标不同，无法合并这两项研究的结果。在一项研究中，与对照组相比，接受家庭治疗的患者气体量、呼气峰值流速和日间喘息症状有所改善。在另一项研究中，接受家庭治疗的患者在总体临床评估和功能受损天数方面有所改善。两项研究中用力呼气量或药物使用情况均无差异。
作者结论
有一些迹象表明家庭治疗可能是儿童哮喘药物治疗的有用辅助手段。这一结论受到研究规模小和结局指标选择缺乏标准化的限制。
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