Hagman Carina, Janson Christer, Emtner Margareta
Department of Physiotherapy, Falu Hospital, Falun, Sweden.
Clin Respir J. 2008 Apr;2(2):86-91. doi: 10.1111/j.1752-699X.2007.00036.x.
The term dysfunctional breathing (DB) has been introduced to describe patients who display a divergent breathing pattern and have breathing problems that cannot be attributed to a specific medical diagnosis such as asthma, chronic obstructive pulmonary disease or sensory hyper-reactivity.
The objective of this study was to investigate similarities and differences in patients with DB, and patients with well-controlled asthma regarding health-related quality of life, anxiety, depression, sense of coherence (SOC), hyperventilation and effects on daily life.
Twenty-five consecutive patients with DB, and 25 age- and sex-matched patients with asthma (ages 20-73 years) participated in the study. The diagnosis of DB was based on the presence of a dysfunctional breathing pattern and at least five symptoms associated with DB.
The group with DB had lower health-related quality of life (short form 36): vitality (mean) 47 vs 62, social functioning 70 vs 94 and role emotional 64 vs 94 (P < 0.05) than the asthmatic group. The DB group also had a higher prevalence of anxiety (56% vs 24%) and a lower SOC (134 vs 156) (P < 0.05). Hyperventilation, defined according to the Nijmegen symptoms questionnaire, was observed in 56% of patients with DB vs 20% in the asthma group (P = 0.02).
The results of the study indicate that patients with DB are more disabled than patients with well-controlled asthma. There is a great need for more knowledge about breathing symptoms of a dysfunctional nature, to be able to identify and manage these patients adequately.
“功能失调性呼吸(DB)”这一术语已被用于描述那些呈现出异常呼吸模式且存在无法归因于特定医学诊断(如哮喘、慢性阻塞性肺疾病或感觉过敏)的呼吸问题的患者。
本研究的目的是调查功能失调性呼吸患者与哮喘控制良好的患者在健康相关生活质量、焦虑、抑郁、连贯感(SOC)、过度通气以及对日常生活的影响方面的异同。
连续纳入25例功能失调性呼吸患者以及25例年龄和性别匹配的哮喘患者(年龄20 - 73岁)参与本研究。功能失调性呼吸的诊断基于异常呼吸模式的存在以及至少五种与功能失调性呼吸相关的症状。
功能失调性呼吸组的健康相关生活质量(简短健康调查问卷36项)较低:活力(平均值)分别为47和62,社会功能分别为70和94,角色情感分别为64和94(P < 0.05),低于哮喘组。功能失调性呼吸组焦虑的患病率也更高(56%对24%),连贯感更低(134对156)(P < 0.05)。根据奈梅亨症状问卷定义的过度通气在56%的功能失调性呼吸患者中观察到,而哮喘组为20%(P = 0.02)。
研究结果表明,功能失调性呼吸患者比哮喘控制良好的患者功能障碍更严重。非常需要更多关于功能失调性质的呼吸症状的知识,以便能够充分识别和管理这些患者。