比較不同吸－－呼比率之慢速呼吸對門診焦慮患者之影響

Comparisons of Different Breathing Ratios of Slow Breathing among Outpatients with Anxiety Disorders

目的：臨床上常利用竇性心律不整機制（Respiratory Sinus Arrhythmia: RSA）訓練慢速呼吸技巧，以減緩焦慮感受及生理激發狀態。本研究探討每分鐘呼吸6次的速度下，3:6吸－－呼比率相較於5:5吸－－呼比率，是否提供更佳之初始訓練效果。方法：受試對象為30位中部某教學醫院具焦慮診斷之精神科門診個案，以心跳變異率（Heart rate variabi1ity; HRV）及受試者的主觀感受評估初始訓練效果。結果：兩種吸－－呼比率相較各自基準期，正常心跳間距標準差（Standard Deviation of Normal to Normal R Wave; SDNN）、低頻（Log of low-frequency; lnLF）、RSA振幅及和諧比率（Coherence ratio）皆顯著提昇（p<0.001），心率則顯著降低（p<0.05）。比較兩吸－－呼比率間的差異，僅高頻的變化量（Log of high-frequency; lnHF）達顯著差異（p<0.05）；主觀感受及其他指標變化量則無顯著差異。結論：本研究證實以每分鐘呼吸6次的速度呼吸，兩種吸－－呼比率皆能提昇心跳變異率，但沒有一致的證據支持3:6吸－－呼比率相較於5:5吸－－呼比率能提供更佳之初始訓練效果。

Objectives. The mechanism of respiratory sinus arrhythmia (RSA) was utilized to train anxious patients to breathe slowly (a breathing rate at 6 breaths/min) to yield greater modulation of autonomic activity. The purpose of this study was to compare the immediate effects of breathing with a 5:5 ratio of inhale-exhale to breathing with a 3:6 ratio of inhale-exhale. Methods. Thirty participants with anxiety disorders operated both breathing ratios, but were randomly assigned to two different sequence groups by a Latin-square design. The Heart rate variability (HRV), heart rate (HR), respiratory sinus arrhythmia amplitude (RSA amplitude) and coherence ratio were measured and subjects were asked to rate how comfortable they felt when breathing with different breathing ratios to evaluate the immediate effects. Results. The post-hoc comparison of one-way repeated measure ANOVA revealed that both a 3:6 ratio of inhale-exhale and a 5:5 ratio of inhale-exhale had a higher Standard Deviation of Normal to Normal R Wave (SDNN), a lower frequency (InLF), RSA amplitude and coherence ratio (p<0.001) as well as a lower HR. (p<0.05), all compared to baseline. Only a 5:5 ratio of inhale-exhale decreased at a higher frequency (InHF) than the 3:6 ratio of inhale-exhale (p<0.05). Conclusion. This study confirmed that a breathe rate at 6 breaths per min, either a 3:6 ratio of inhale-exhale or a 5:5 ratio of inhale-exhale can increase SDNN, InLF, RSA amplitude, coherence ratio, and decrease HR. There was no consistent evidence to support that a 3:6 ratio of inhale-exhale caused better immediate effects than a 5:5 ratio of inhale-exhale.