Das Rashmi Ranjan, Sankar Jhuma, Kabra Sushil Kumar
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, India.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Curr Pediatr Rev. 2019;15(3):175-183. doi: 10.2174/1573396315666190121122452.
Various complementary or alternative medicines (including breathing exercises and yoga/pranayama) have been tried as an attractive option to pharmacotherapy in childhood asthma.
To evaluate the role of breathing exercise and yoga/pranayama as add on therapy to the "pharmacologically recommended treatment" of childhood asthma.
We searched the published literature in the major databases: Medline via Ovid, PubMed, CENTRAL, Embase, and Google Scholar till June 2018. Randomized trials comparing breathing exercises and yoga/ pranayama versus control or as part of a composite intervention versus control were included. The primary outcome measures were quality of life and change in asthma symptoms. Secondary outcomes were: decrease in medication use, number of exacerbations, change in lung function and immunological parameters, school absenteeism and adverse events.
A total of 10 trials (466 children, 6-14 years age) were included. The severity of asthma varied among the trials. The data for primary outcome measures could not be pooled, there were mixed results for both primary and secondary outcomes. No significant benefit was obtained in acute asthma and the lung function tests [except PEFR % at 4-6 weeks, PEF absolute at 3 months, and FVC absolute at 3 months] in chronic asthma. One trial compared breathing exercise versus yoga and found no difference. Adverse events were not significant.
Breathing exercise and yoga/ pranayama may have some additive role in the treatment of childhood asthma. However, at present, it cannot be recommended as a standard of care due to insufficient data.
各种补充或替代医学（包括呼吸练习和瑜伽/调息法）已被尝试作为儿童哮喘药物治疗的一种有吸引力的选择。
评估呼吸练习和瑜伽/调息法作为儿童哮喘“药理学推荐治疗”的附加疗法的作用。
我们检索了主要数据库中截至2018年6月已发表的文献：通过Ovid检索Medline、PubMed、CENTRAL、Embase以及谷歌学术。纳入比较呼吸练习和瑜伽/调息法与对照组，或作为综合干预一部分与对照组比较的随机试验。主要结局指标为生活质量和哮喘症状变化。次要结局包括：药物使用减少、发作次数、肺功能和免疫参数变化、缺课情况及不良事件。
共纳入10项试验（466名6 - 14岁儿童）。各试验中哮喘严重程度不同。主要结局指标的数据无法合并，主要和次要结局的结果不一。急性哮喘未获得显著益处，慢性哮喘的肺功能测试[除4 - 6周时的呼气峰流速百分比、3个月时的呼气峰流速绝对值和3个月时的用力肺活量绝对值外]也未获得显著益处。一项试验比较了呼吸练习与瑜伽，但未发现差异。不良事件不显著。
呼吸练习和瑜伽/调息法在儿童哮喘治疗中可能有一些附加作用。然而，目前由于数据不足，不能推荐将其作为标准治疗方法。
