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正念训练对哮喘生活质量和肺功能的影响:一项随机对照试验。

Effect of mindfulness training on asthma quality of life and lung function: a randomised controlled trial.

机构信息

Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.

出版信息

Thorax. 2012 Sep;67(9):769-76. doi: 10.1136/thoraxjnl-2011-200253. Epub 2012 Apr 27.

Abstract

BACKGROUND

This study evaluated the efficacy of a mindfulness training programme (mindfulness-based stress reduction (MBSR)) in improving asthma-related quality of life and lung function in patients with asthma.

METHODS

A randomised controlled trial compared an 8-week MBSR group-based programme (n=42) with an educational control programme (n=41) in adults with mild, moderate or severe persistent asthma recruited at a university hospital outpatient primary care and pulmonary care clinic. Primary outcomes were quality of life (Asthma Quality of Life Questionnaire) and lung function (change from baseline in 2-week average morning peak expiratory flow (PEF)). Secondary outcomes were asthma control assessed by 2007 National Institutes of Health/National Heart Lung and Blood Institute guidelines, and stress (Perceived Stress Scale (PSS)). Follow-up assessments were conducted at 10 weeks, 6 and 12 months.

RESULTS

At 12 months MBSR resulted in clinically significant improvements from baseline in quality of life (differential change in Asthma Quality of Life Questionnaire score for MBSR vs control: 0.66 (95% CI 0.30 to 1.03; p<0.001)) but not in lung function (morning PEF, PEF variability and forced expiratory volume in 1 s). MBSR also resulted in clinically significant improvements in perceived stress (differential change in PSS score for MBSR vs control: -4.5 (95% CI -7.1 to -1.9; p=0.001)). There was no significant difference (p=0.301) in percentage of patients in MBSR with well controlled asthma (7.3% at baseline to 19.4%) compared with the control condition (7.5% at baseline to 7.9%).

CONCLUSIONS

MBSR produced lasting and clinically significant improvements in asthma-related quality of life and stress in patients with persistent asthma, without improvements in lung function.

CLINICAL TRIAL REGISTRATION NUMBER

Asthma and Mindfulness-Based Reduction (MBSR) Identifier: NCT00682669. clinicaltrials.gov.

摘要

背景

本研究评估了正念训练计划(正念减压(MBSR))在改善哮喘患者哮喘相关生活质量和肺功能方面的疗效。

方法

一项随机对照试验比较了 8 周的基于 MBSR 的团体计划(n=42)与教育对照计划(n=41)在大学医院门诊初级保健和肺保健诊所招募的轻度、中度或重度持续性哮喘成人中的疗效。主要结局为生活质量(哮喘生活质量问卷)和肺功能(2 周平均晨峰呼气流量(PEF)的变化)。次要结局为 2007 年美国国立卫生研究院/美国国立心肺血液研究所指南评估的哮喘控制情况,以及应激(感知压力量表(PSS))。随访评估在 10 周、6 个月和 12 个月时进行。

结果

在 12 个月时,MBSR 导致生活质量从基线开始出现临床显著改善(MBSR 与对照组相比,哮喘生活质量问卷评分的差异变化:0.66(95%CI 0.30 至 1.03;p<0.001)),但肺功能(晨 PEF、PEF 变异性和 1 秒用力呼气量)没有改善。MBSR 还导致感知压力出现临床显著改善(MBSR 与对照组相比,PSS 评分的差异变化:-4.5(95%CI-7.1 至-1.9;p=0.001))。与对照组相比(从基线的 7.5%到 7.9%),MBSR 组哮喘控制良好的患者比例(从基线的 7.3%到 19.4%)没有显著差异(p=0.301)。

结论

MBSR 可改善持续性哮喘患者的哮喘相关生活质量和应激,持续时间长且具有临床意义,而对肺功能无改善。

临床试验注册号

哮喘和正念减压(MBSR)标识符:NCT00682669. clinicaltrials.gov。

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