Stanton Andrew E, Vaughn Pamela, Carter Roger, Bucknall Christine E
Department of Respiratory Medicine, Glasgow Royal Infirmary, Glasgow, UK.
J Asthma. 2008 Nov;45(9):758-65. doi: 10.1080/02770900802252093.
Dysfunctional breathing (DB) is recognized as an associated problem in patients with asthma and may be identified by the Nijmegen questionnaire. We conducted an observational study to determine if breathing control therapy (BCT) improved Nijmegen scores or asthma-related quality of life in patients attending a problem asthma clinic.
Nijmegen and Mini Asthma Quality of Life (Mini-AQLQ) questionnaires were completed. Patients with a positive Nijmegen (> or = 23, DB) were referred for BCT and progressive exercise testing (PET) to seek confirmation of dysfunctional breathing. Follow-up questionnaire data were collected at 6 months.
A total of 102 patients were studied. The total mean Nijmegen score was 26.4 (range 1-61). Those with a score > or = 23 (DB group, n = 65, 64%) had significantly lower Mini-AQLQ (mean 2.83) than the non-DB group (n = 37, mean 4.12, 95% CI for difference 0.87, 1.87, p < 0.0001). There was a strong relationship between Nijmegen score and Mini-AQLQ (r = -0.63, p < 0.001) at baseline; 10 of 17 DB patients who completed PET showed inappropriate hyperventilation. Follow-up data, available for Nijmegen and Mini-AQLQ in 44 and 46 patients respectively, showed no significant change in either of these parameters.
The strong relationship between Mini-AQLQ and Nijmegen scores and poor relationship between Nijmegen scores and PET-identified inappropriate hyperventilation suggest that a positive Nijmegen score overestimates the presence of dysfunctional breathing in patients with moderate to severe asthma. We found no evidence that a moderate intensity breathing control intervention had any impact on Nijmegen scores or asthma-related quality of life in this patient group.
功能失调性呼吸（DB）被认为是哮喘患者的一个相关问题，可通过奈梅亨问卷识别。我们进行了一项观察性研究，以确定呼吸控制疗法（BCT）是否能改善在问题哮喘诊所就诊患者的奈梅亨评分或哮喘相关生活质量。
完成奈梅亨问卷和哮喘生活质量简易问卷（Mini - AQLQ）。奈梅亨问卷结果为阳性（≥23分，即DB）的患者被转介接受BCT和递增运动试验（PET），以确认是否存在功能失调性呼吸。在6个月时收集随访问卷数据。
共研究了102例患者。奈梅亨总分平均为26.4分（范围1 - 61分）。评分≥23分的患者（DB组，n = 65，64%）的Mini - AQLQ得分（平均2.83）显著低于非DB组（n = 37，平均4.12，差异的95%置信区间为0.87，1.87，p < 0.0001）。基线时，奈梅亨评分与Mini - AQLQ之间存在很强的相关性（r = -0.63，p < 0.001）；17例完成PET的DB患者中有10例表现出不适当的过度通气。分别有44例和46例患者可获得奈梅亨问卷和Mini - AQLQ的随访数据，这些参数均无显著变化。
Mini - AQLQ与奈梅亨评分之间的强相关性以及奈梅亨评分与PET识别的不适当过度通气之间的弱相关性表明，奈梅亨问卷阳性评分高估了中重度哮喘患者功能失调性呼吸的存在。我们没有发现证据表明中等强度的呼吸控制干预对该患者组的奈梅亨评分或哮喘相关生活质量有任何影响。
