66
醫
學模式
張 倩
（內科主任醫生）
Zhang Qin
ASTHMA COMES FROMTHE
MIND
Asthma is common, espe-
cially in kids; apar t from
allergens, psychogenic causes
are also relevant: (1)When Zhou
Yun began his studies in a ma-
jor foreign university, military
training was also required. Soon,
he had an asthmatic attack that
was caused by the loss of his
usual practice of total depen-
dence on his loving mother. (2)
A very hard working and ambi-
tious primary 3 pupil had so
much psychological pressure
that on the day before a term
examination, he had an attack
of asthma due to extremely high
expectations. (3) After having
missed her boyfriend who used
to send her home, Qin went
home all alone but was so
scared by unrealistic fears that
she had asthma due to release
of much histamine and acetyl-
choline inducing laryngeal swell-
ing and muscle spasms. (4) Xiao
Ming, a primary 4 pupil, had an
asthmatic attack when suddenly
asked to solve a problem on the
class-room board in front of the
whole class - actually, 50% of
asthma kids got it through bad
psychology. (5) Psychogenic
asthma cases abound, e.g.,
asthma attacks that come upon
witnessing others having attacks
or on sighting flowers that were
actually artificial with no pollen
as allergens.
!"#$%
支氣管哮喘（簡稱哮喘）是一種常見病，尤其在兒童
中，近來發病率呈上升趨勢。它是在支氣管高反應狀態下，
由於變應原或其它因素引起的廣泛氣道狹窄的疾病。其臨床
特點為發作性胸悶、咳嗽，大多是帶有哮鳴音的呼氣性困
難，可自行或經治療後緩解。本病的病因較復雜，但專家們
多認為是一種多基因遺傳病，受遺傳因素和環境因素的雙重
影響。它在患者吸入某些特異性或非特異性的物質、呼吸道
感染、進食過敏性食物或某些藥品，以及氣候改變、運動、
性生活、月經與妊娠期、情緒改變等情況下，都可被激發。
其中，由精神心理因素而促使哮喘的發作，在生物－心理－
社會醫學模式已被人們普遍認同的今天，尤其引起了人們的
關注。
案例一
趙雲終於圓了大學夢。在金秋季節裡，跨進了外地某重點大
學大門。入校後，迎接他的是緊張的軍訓生活。不久後的一天晚
上，他突然氣喘氣急，被同學們趕緊送到了醫院，醫生說他是哮
喘發作。病情緩解後，醫生在與他聊天時得知：他3歲時父親因車
