哮喘相关焦虑的在线认知行为疗法：一项随机对照试验
2026/02/02
摘要
目的：焦虑影响多达三分之一的成年哮喘患者，并与较差的疾病预后和生活质量下降有关。本研究评估了由治疗师指导的基于互联网的认知行为疗法（ICBT）与常规治疗加医学教育相比，在减轻哮喘相关焦虑方面的疗效。
方法：开展了一项随机对照试验，纳入90名患有哮喘相关焦虑的成年参与者。ICBT由治疗师指导，为期8周。主要结局指标“哮喘灾难化量表”从治疗前评估至16周的主要终点。次要结局指标包括哮喘控制情况、回避行为和生活质量。使用数字肺量计收集1秒用力呼气容积（FEV1）。
结果：与对照组相比，ICBT显著降低了哮喘灾难化思维（平均差异 - 18.53，95%置信区间 - 25.54至 - 11.53，p<0.001）。与对照组相比，ICBT组的哮喘控制情况、回避行为、生活质量和其他关键结局指标有显著改善。未观察到FEV1的变化。改善效果在6个月随访时仍持续存在。
结论：ICBT能有效且安全地减轻哮喘灾难化思维，改善哮喘控制情况、回避行为和生活质量，是为伴有焦虑的哮喘患者常规医疗护理的一种有前景的辅助疗法。
Online cognitive behaviour therapy for asthma-related anxiety: a randomised controlled trial
Marianne Bonnert, Stephen Nash, Erik M Andersson, Sten Erik Erik Bergström, Jenny Görling, Christer Janson, Josefin Särnholm, Catarina Almqvist
Abstract
Objective: Anxiety affects up to one-third of adults with asthma and is linked to poorer disease outcomes and reduced quality of life. This study evaluated the efficacy of therapist-guided, internet-delivered cognitive behavioural therapy (ICBT) versus treatment as usual plus medical education for reducing asthma-related anxiety.
Methods: A randomised controlled trial was conducted including 90 adult participants with anxiety related to asthma. ICBT was therapist-guided and lasted 8 weeks. The primary outcome, the Catastrophising about Asthma Scale, was assessed from pretreatment to the primary endpoint at 16 weeks. Secondary outcomes included asthma control, avoidance behaviour and quality of life. Forced expiratory volume in 1 s (FEV1) was collected using a digital spirometer.
Results: ICBT demonstrated a significantly larger reduction in catastrophising about asthma than the control group (mean difference -18.53, 95% CI -25.54 to -11.53, p<0.001). Asthma control, avoidance behaviour, quality of life and other key outcomes improved significantly more in the ICBT group compared with controls. No changes in FEV1 were observed. Improvements were sustained at 6 months follow-up.
Conclusion: ICBT effectively and safely reduces catastrophising about asthma, improves asthma control, avoidance behaviour and quality of life and represents a promising adjunct to routine medical care for patients with asthma complicated by anxiety.
目的：焦虑影响多达三分之一的成年哮喘患者，并与较差的疾病预后和生活质量下降有关。本研究评估了由治疗师指导的基于互联网的认知行为疗法（ICBT）与常规治疗加医学教育相比，在减轻哮喘相关焦虑方面的疗效。
方法：开展了一项随机对照试验，纳入90名患有哮喘相关焦虑的成年参与者。ICBT由治疗师指导，为期8周。主要结局指标“哮喘灾难化量表”从治疗前评估至16周的主要终点。次要结局指标包括哮喘控制情况、回避行为和生活质量。使用数字肺量计收集1秒用力呼气容积（FEV1）。
结果：与对照组相比，ICBT显著降低了哮喘灾难化思维（平均差异 - 18.53，95%置信区间 - 25.54至 - 11.53，p<0.001）。与对照组相比，ICBT组的哮喘控制情况、回避行为、生活质量和其他关键结局指标有显著改善。未观察到FEV1的变化。改善效果在6个月随访时仍持续存在。
结论：ICBT能有效且安全地减轻哮喘灾难化思维，改善哮喘控制情况、回避行为和生活质量，是为伴有焦虑的哮喘患者常规医疗护理的一种有前景的辅助疗法。
（中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校）
（Thorax. 2026 Jan 6:thorax-2025-223886. doi: 10.1136/thorax-2025-223886.）
（Thorax. 2026 Jan 6:thorax-2025-223886. doi: 10.1136/thorax-2025-223886.）
Online cognitive behaviour therapy for asthma-related anxiety: a randomised controlled trial
Marianne Bonnert, Stephen Nash, Erik M Andersson, Sten Erik Erik Bergström, Jenny Görling, Christer Janson, Josefin Särnholm, Catarina Almqvist
Abstract
Objective: Anxiety affects up to one-third of adults with asthma and is linked to poorer disease outcomes and reduced quality of life. This study evaluated the efficacy of therapist-guided, internet-delivered cognitive behavioural therapy (ICBT) versus treatment as usual plus medical education for reducing asthma-related anxiety.
Methods: A randomised controlled trial was conducted including 90 adult participants with anxiety related to asthma. ICBT was therapist-guided and lasted 8 weeks. The primary outcome, the Catastrophising about Asthma Scale, was assessed from pretreatment to the primary endpoint at 16 weeks. Secondary outcomes included asthma control, avoidance behaviour and quality of life. Forced expiratory volume in 1 s (FEV1) was collected using a digital spirometer.
Results: ICBT demonstrated a significantly larger reduction in catastrophising about asthma than the control group (mean difference -18.53, 95% CI -25.54 to -11.53, p<0.001). Asthma control, avoidance behaviour, quality of life and other key outcomes improved significantly more in the ICBT group compared with controls. No changes in FEV1 were observed. Improvements were sustained at 6 months follow-up.
Conclusion: ICBT effectively and safely reduces catastrophising about asthma, improves asthma control, avoidance behaviour and quality of life and represents a promising adjunct to routine medical care for patients with asthma complicated by anxiety.
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经胎盘抗菌抗体与儿童哮喘：母体出生地作为上游因素
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阻塞性肺疾病患者长期使用质子泵抑制剂的病情恶化风险
