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哮喘的语音引导呼吸再训练:在现实生活门诊环境中的随机对照交叉试验。

Speech-guided breathing retraining in asthma: a randomised controlled crossover trial in real-life outpatient settings.

作者信息

von Bonin Dietrich, Klein Sabine D, Würker Jana, Streit Eva, Avianus Oliver, Grah Christian, Salomon Jörg, Wolf Ursula

机构信息

Institute of Complementary Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.

Present address: Branch organisation of Swiss Arts Therapy associations, OdA ARTECURA, Utzigen, Switzerland.

出版信息

Trials. 2018 Jun 25;19(1):333. doi: 10.1186/s13063-018-2727-z.

Abstract

BACKGROUND

Breathing retraining techniques have received increased attention in the management of asthma, because there is growing evidence of the usefulness of such methods in improving quality of life, reducing symptoms and reducing bronchodilator use. Our study investigated the effect of anthroposophic therapeutic speech (ATS), which uses sounds and syllabic rhythm to improve articulation, breathing and cardiorespiratory interaction, in patients with asthma in a real-life outpatient setting.

METHODS

In a randomised controlled crossover trial, patients with asthma in three centres in Switzerland and Germany were randomised to either receive 11 ATS sessions or to wait. Subsequently, patients changed either to wait or to receive ATS. Primary outcomes were changes from the beginning to the end of each phase in the Asthma Quality of Life Questionnaire (AQLQ) and spirometry parameters. Secondary outcomes were changes in inhaled glucocorticoids, the Asthma Control Test (ACT), peak flow and asthma exacerbations.

RESULTS

Altogether, 63 patients were randomised, of which 56 were enrolled and 49 completed the study. Statistically significant differences between the ATS groups and waiting control groups were found for the overall AQLQ score (d = 0.86, p = 0.001) and the domain scores for symptoms, activity limitation and emotional function as well as ACT score (d = 0.53, p = 0.048). No significant differences were observed in spirometry parameters, inhaled glucocorticoids, peak flow and days without asthma exacerbation per week. No serious adverse events occurred during ATS sessions.

CONCLUSIONS

ATS significantly improves asthma control and quality of life in patients with asthma. Whether ATS may improve lung function remains to be shown.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02501824 . Retrospectively registered on 8 July 2015.

摘要

背景

呼吸再训练技术在哮喘管理中受到了越来越多的关注,因为越来越多的证据表明这些方法在改善生活质量、减轻症状和减少支气管扩张剂使用方面是有用的。我们的研究在现实生活中的门诊环境中,调查了人智学治疗性言语(ATS)对哮喘患者的影响,该治疗方法利用声音和音节节奏来改善发音、呼吸和心肺相互作用。

方法

在一项随机对照交叉试验中,瑞士和德国三个中心的哮喘患者被随机分为接受11次ATS治疗或等待治疗。随后,患者交换为等待治疗或接受ATS治疗。主要结局指标为每个阶段开始到结束时哮喘生活质量问卷(AQLQ)和肺功能测定参数的变化。次要结局指标为吸入糖皮质激素、哮喘控制测试(ACT)、呼气峰值流速和哮喘急性发作次数的变化。

结果

总共63例患者被随机分组,其中56例被纳入研究,49例完成了研究。在总体AQLQ评分(d = 0.86,p = 0.001)、症状、活动受限和情绪功能领域评分以及ACT评分(d = 0.53,p = 0.048)方面,ATS组与等待对照组之间存在统计学显著差异。在肺功能测定参数、吸入糖皮质激素、呼气峰值流速和每周无哮喘急性发作天数方面未观察到显著差异。在ATS治疗期间未发生严重不良事件。

结论

ATS可显著改善哮喘患者的哮喘控制和生活质量。ATS是否能改善肺功能仍有待证实。

试验注册

ClinicalTrials.gov NCT02501824。于2015年7月8日进行回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b2/6019518/454c71675eb4/13063_2018_2727_Fig1_HTML.jpg

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