35%二氧化碳（CO）吸入对创伤后应激障碍（PTSD）患者的影响：一项双盲、随机、安慰剂对照、交叉试验。
Effects of 35% carbon dioxide (CO) inhalation in patients with post-traumatic stress disorder (PTSD): A double-blind, randomized, placebo-controlled, cross-over trial.
机构信息
University Hospital Hamburg-Eppendorf, Dept. of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany; Hospital Herford, Dept. of Psychiatry, Psychotherapy and Psychosomatics, Schwarzenmoorstraße 70, 32049 Herford, Germany.
University Hospital Hamburg-Eppendorf, Dept. of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany; Schön Hospital Hamburg Eilbek, Department of Psychosomatics, Dehnhaide 120, 22081 Hamburg, Germany.
出版信息
J Psychiatr Res. 2018 Jan;96:260-264. doi: 10.1016/j.jpsychires.2017.10.019. Epub 2017 Oct 31.
BACKGROUND
In patients with post-traumatic stress disorder (PTSD) two open pilot studies about the effects of 35% carbon dioxide (CO) exist. One shows an augmented panicogenic and anxiogenic response (Muhtz et al., 2011), the other does not (Talesnik et al. 2007). We further characterized the CO reactivity in PTSD using for the first time placebo-controlled and double-blind conditions.
METHODS
In 20 patients with PTSD we assessed panic, anxiety, dissociative and PTSD symptoms after a single vital capacity inhalation of 35% CO compared to a placebo gas condition in a within-participant cross-over, placebo-controlled, double-blind and randomized design.
RESULTS
Inhalation of 35% CO versus placebo provoked significantly increased panic, anxiety, dissociative and PTSD symptoms. The reaction to placebo gas was minimal. Order of inhalation, patients' sex or age did not influence the results. The panic and anxiety response under CO was considerably higher in the PTSD patients than in healthy controls from our previous open study.
CONCLUSIONS
The results corroborate that our preceding findings of an increased CO reactivity in patients with PTSD are not false positive due to the open design or the lack of placebo control. Replication in a larger number of PTSD patients and matched control subjects is needed. The potential role of childhood traumatisation, psychiatric comorbidity, psychotropic medication and trait dissociation in prior contradictory reports should be clarified.
背景
在创伤后应激障碍（PTSD）患者中，有两项关于 35%二氧化碳（CO）影响的开放性初步研究。一项研究显示增强的惊恐和焦虑反应（Muhtz 等人，2011 年），另一项则没有（Talesnik 等人，2007 年）。我们首次采用安慰剂对照和双盲条件进一步描述了 PTSD 中的 CO 反应性。
方法
在 20 名 PTSD 患者中，我们在一项参与者内交叉、安慰剂对照、双盲和随机设计中，比较了单次肺活量吸入 35%CO 与安慰剂气体条件后，评估了惊恐、焦虑、分离和 PTSD 症状。
结果
与安慰剂相比，吸入 35%CO 会显著增加惊恐、焦虑、分离和 PTSD 症状。对安慰剂气体的反应最小。吸入顺序、患者性别或年龄均不影响结果。与我们之前的开放性研究中的健康对照组相比，PTSD 患者在 CO 下的惊恐和焦虑反应明显更高。
结论
这些结果证实，我们之前发现的 PTSD 患者 CO 反应性增加并不是由于开放性设计或缺乏安慰剂对照而产生的假阳性。需要在更多的 PTSD 患者和匹配的对照组中进行复制。应阐明儿童创伤、精神共病、精神药物和特质分离在先前矛盾报告中的潜在作用。
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