Mass R, Dahme B, Richter R
Abteilung für Psychosomatik und Psychotherapie, Universitätskrankenhaus Hamburg-Eppendorf.
Pneumologie. 1992 May;46(5):183-9.
For measuring the interoception of airway resistance, bronchial obstructions are often simulated by flow-resistive loads applied externally (i.e. outside the body) into the respiratory flow. However, it is open to doubt whether interoception characteristics obtained in this manner are really related to the clinical pattern of complaints of asthmatic patients. Possibly such externally applied resistance simulates merely an aspect of the physics of apnoea but not a clinical and hence also psychological aspect of the same. To estimate the significance of these aspects for the perception of obstructions, this ability was measured in 25 asthmatic patients first by means of external added loads; this test was then repeated by noting the subjective assessment of bronchial obstructions caused during a routine histamine provocation test. Both interoception parameters correlated only slightly (rxy = 0.31) which is discussed as a pointer to the assumption that, among other parameters, psychological factors may considerably modify the perception of flow resistivity. No correlations were seen between the characteristic interoception value obtained by means of mesh resistivities and the different variables of the clinical pattern of symptoms. On the other hand, the interoception parameter measured on the basis of bronchial obstructions revealed significant connections with several clinical variables: the greatly increased incidence of respiratory distress at night or during certain external conditions, coping medication, physical exercise and style. It is concluded that only such parameters of perception of obstructions are clinically relevant for patients suffering from asthma, which consider not only the somaticophysical but also the psychic component of asthmatic respiratory distress.
为了测量气道阻力的内感受，支气管阻塞通常通过外部（即身体外部）施加于呼吸气流的流阻负荷来模拟。然而，以这种方式获得的内感受特征是否真的与哮喘患者的临床症状模式相关，仍值得怀疑。可能这种外部施加的阻力仅仅模拟了呼吸暂停的物理方面，而没有模拟其临床方面，因而也没有模拟其心理方面。为了评估这些方面对于阻塞感知的重要性，首先通过外部附加负荷对25名哮喘患者的这种能力进行了测量；然后通过记录在常规组胺激发试验期间引起的支气管阻塞的主观评估来重复该测试。两个内感受参数之间的相关性仅为轻微相关（rxy = 0.31），这被认为表明了这样一种假设，即在其他参数中，心理因素可能会显著改变对流阻的感知。通过网格电阻获得的特征性内感受值与症状临床模式的不同变量之间未发现相关性。另一方面，基于支气管阻塞测量的内感受参数与几个临床变量之间存在显著关联：夜间或某些外部条件下呼吸窘迫的发生率大幅增加、应对药物治疗、体育锻炼及方式。得出的结论是，对于哮喘患者而言，只有这样的阻塞感知参数在临床上才是相关的，这些参数不仅考虑了哮喘呼吸窘迫的躯体物理成分，还考虑了其心理成分。
