Ahnert J, Löffler S, Müller J, Vogel H
Institut für Psychotherapie und Medizinische Psychologie, Arbeitsbereich Rehabilitationswissenschaften, Universität Würzburg, Würzburg.
Rehabilitation (Stuttg). 2010 Jun;49(3):147-59. doi: 10.1055/s-0030-1254081. Epub 2010 Jun 8.
Relevant data bases were used to collect and evaluate guidelines, meta-analyses, and reviews as well as primary studies dealing with asthma therapy for children and adolescents. Treatment approaches whose effectiveness with regard to bronchial asthma was empirically verified (i. e., evidence-based) were identified (medical and diagnostic procedures as well as drug trials were excluded from the analysis). 152 methodically sound studies referring to asthma treatment of children and adolescents were selected. Strong evidence was found for patient education, parent education, exercise therapy, inhalation, and tobacco withdrawal. Nutritional counseling and avoidance of allergens showed limited evidence. Psychotherapy, relaxation techniques, breathing exercises, climate therapy, clinical social work (social and legal counseling services, vocational reintegration counseling, aftercare) and integration counseling showed inconsistent evidence. No evidence was found for alternative medicine. Challenges regarding the development of treatment standards for children and adolescent rehabilitation are highlighted; these refer to limitations in report quality in some of the studies, the validity of treatments for comorbid conditions, a lack of differentiation for different age groups, and transferability of outpatient or international study results to inpatient rehabilitation.
使用相关数据库收集并评估指南、荟萃分析、综述以及涉及儿童和青少年哮喘治疗的原始研究。确定了在支气管哮喘方面经实证验证有效的治疗方法（即基于证据的方法）（分析中排除了医疗和诊断程序以及药物试验）。选择了152项关于儿童和青少年哮喘治疗的方法合理的研究。发现患者教育、家长教育、运动疗法、吸入疗法和戒烟有充分证据。营养咨询和避免接触过敏原的证据有限。心理治疗、放松技巧、呼吸练习、气候疗法、临床社会工作（社会和法律咨询服务、职业重新融入咨询、后续护理）和综合咨询的证据不一致。未发现替代医学的证据。强调了儿童和青少年康复治疗标准制定方面的挑战；这些挑战包括一些研究报告质量的局限性、合并症治疗的有效性、不同年龄组缺乏区分以及门诊或国际研究结果向住院康复的可转移性。
