心身症における呼吸制御 : バイオフィードバックの適用と限界(心身医学における各技法の適用と限界)

抄録

Autonomic functions such as related to the circulation system is influenced by respiration, and respiration is also influenced by emotion. It is suggested that respiratory control is accompanid by the simultaneous control of autonomic function and emotion. An attempt was made to identify the characteristic resiratory patterns of psychosomatic patients, and then, applied some respiratory therapy using a biofeedback technique to the patients with neurosis and hypertension. As the result, an abnormal respiratory pattern was found, in patients with neurosis and hypertension and among the three sub-groups of neuroses, depressive, anxiety and hysteric, the respiration patterns were different. Next, in order to control the respiratory pattern, we gave a respiratory training to the patients (abdominal breathing) by feedback with visual analogue information. This effect was noticed clearly, especially in cases of anxiety state. Along with improvement in respiratory pattern, subjective complaints decreased in the patients with anxiety neurosis and hyperventilation syndrome. No noticeable effect was obtained, however, in depressive and hysterical patients. These subjects who showed abnormal egogram patterns were also unresponsive to the respiratory training. In moderate hypertensive patients, the blood pressure lowering effect of the respiratory training was confirmed; this was especially marked when deep breathing was practiced at rest. The question has been raised, however, as to whether this effect continues for a long period of time after the training. Finally, a review was made on clinical application of biofeedback training in relation to Blanchard and Hirai reports. Further work needs to be done to clarify its application and limitation as the biofeedback technique has only a short history of clinical application.