Yorke Janelle, Fleming Sharon L, Shuldham Caroline
Royal Brompton and Harefield NHS Trust, Sydney Street, London, UK.
Respir Med. 2007 Jan;101(1):1-14. doi: 10.1016/j.rmed.2006.04.003. Epub 2006 Jun 6.
The purpose of this study was to conduct a systematic review of randomized controlled trials where the efficacy of psychological interventions in modifying health and behavioural outcomes for adults with asthma was investigated.
A review of randomized controlled trials was designed. The literature search was conducted until May 2005.
Fourteen studies, involving 617 adults, were included in the review. The use of 'as needed' medications was reduced by relaxation therapy (OR 4.47, CI 1.22-16.44), quality of life, measured using the Asthma Quality of Life Questionnaire, showed a positive effect following cognitive behavioural therapy (WMD 0.71, CI 0.23-1.19), and peak expiratory flow outcome data indicated a significant difference in favour of bio-feedback therapy (SMD 0.66, CI 0.09-1.23).
Some promising results did emerge from meta-analyses performed. However, due to heterogeneity and the low quality of included studies, this review was unable to draw firm conclusions for the role of psychological interventions in asthma. We recommend that larger and well-conducted randomized trials use valid outcome measures to evaluate the effectiveness of psychological interventions for adults with asthma.
本研究旨在对随机对照试验进行系统评价，这些试验调查了心理干预对成年哮喘患者健康和行为结果的改善效果。
设计了一项随机对照试验的综述。文献检索持续至2005年5月。
该综述纳入了14项研究，涉及617名成年人。放松疗法降低了“按需”用药的使用（比值比4.47，可信区间1.22 - 16.44），使用哮喘生活质量问卷测量的生活质量在认知行为疗法后显示出积极效果（加权均数差0.71，可信区间0.23 - 1.19），呼气峰值流速结果数据表明生物反馈疗法有显著差异（标准化均数差0.66，可信区间0.09 - 1.23）。
进行的荟萃分析确实得出了一些有前景的结果。然而，由于纳入研究的异质性和低质量，本综述无法就心理干预在哮喘中的作用得出确凿结论。我们建议进行更大规模且实施良好的随机试验，使用有效的结局指标来评估心理干预对成年哮喘患者的有效性。
