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哮喘患儿的布悌约卡呼吸技术:一项随机对照的初步研究。

The Buteyko breathing technique in children with asthma: a randomized controlled pilot study.

机构信息

ARCIM Institute, Filderstadt, Germany; Department of Pediatrics, Filderklinik, Filderstadt, Germany; Department of Neonatology, Children's Hospital, University of Tübingen, Tübingen, Germany.

ARCIM Institute, Filderstadt, Germany.

出版信息

Complement Ther Med. 2021 Jan;56:102582. doi: 10.1016/j.ctim.2020.102582. Epub 2020 Oct 23.

Abstract

BACKGROUND

Evidence supports the Buteyko breathing technique (BBT) as reducing medication and improving control and quality of life in adults with asthma, but having minimal impact on spirometry. For children with asthma, evidence addressing the utility of BBT is sparse. We evaluated the effectiveness of BBT in managing various aspects of asthma in children.

METHODS

Thirty-two children with partly controlled asthma (age 6-15 years, 66% male) were randomized to either Treatment as Usual (TAU) or TAU combined with Buteyko training (Buteyko group, BG). Children in the BG received an intensive five-day training followed by three months of home practice. Primary outcome was bronchodilator reduction. Secondary outcomes were changes in physiological parameters FEV1_AR (at rest), FEV1_ER (after ergometry), FEV1_BR (after bronchospasmolysis), corticosteroid use, FeNO, SpO2, breath-hold test and questionnaire data [Asthma Control Questionnaire and Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ)]. All measures were collected at Baseline and a three-month follow-up.

RESULTS

For the primary outcome, no significant between-group difference was found. Regarding the secondary outcomes, children receiving treatment augmented with BBT revealed significantly greater improvement at the follow-up than those receiving TAU for FEV1_AR (p = .04, d=-0.50), FEV1_ER (p = .02, d=-0.52), and the emotional function subscale of the PACQLQ (p < .01, d = 1.03). No between-group differences were found for the remaining secondary measures of outcome.

CONCLUSIONS

Our preliminary findings suggest that the addition of BBT to treatment as usual for children with asthma enhances outcomes with respect to spirometry and parental emotional function but does not lead to reductions in medication, at least over the short term.

摘要

背景

有证据表明,布地奈德福莫特罗粉吸入剂(Buteyko breathing technique,BBT)可减少药物使用,改善成人哮喘的控制和生活质量,但对肺功能的影响较小。然而,关于儿童哮喘应用 BBT 的证据却很少。本研究旨在评估 BBT 在管理儿童哮喘各方面的有效性。

方法

32 名部分控制的哮喘儿童(年龄 6-15 岁,66%为男性)被随机分为常规治疗组(TAU)或 TAU 联合布地奈德福莫特罗粉吸入剂治疗组(Buteyko 组,BG)。BG 组患儿接受为期 5 天的强化训练,随后进行为期 3 个月的家庭练习。主要结局为支气管扩张剂的减少。次要结局为生理参数的变化,包括静息时的 FEV1_AR、运动后 FEV1_ER、支气管痉挛缓解后 FEV1_BR、皮质类固醇使用、FeNO、SpO2、屏气试验以及问卷数据[哮喘控制问卷和儿童哮喘照顾者生活质量问卷(PACQLQ)]。所有测量均在基线和 3 个月时进行。

结果

在主要结局方面,两组之间没有显著差异。在次要结局方面,接受 BBT 治疗的患儿在 FEV1_AR(p=0.04,d=-0.50)、FEV1_ER(p=0.02,d=-0.52)和 PACQLQ 的情绪功能子量表(p<0.01,d=1.03)方面的改善明显大于接受 TAU 的患儿。对于其他次要结局指标,两组之间没有差异。

结论

本研究初步结果表明,在哮喘儿童的常规治疗中加入 BBT,可以改善肺功能和父母情绪功能的结局,但至少在短期内不会减少药物的使用。

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