慢性阻塞性肺疾病患者的肺康复运动训练新进展

肺康复任慢性阻塞性肺疾病治疗中有明确的效果,其核心内容是运动训练。对于慢性阻塞性肺疾病患者而言,运动训练的难点之一是如何提高运动强度并延缓呼吸困难的产生。近年来的部分研究通过吸入氦氧气体或呼吸训练等方式来改善运动中的过度充气,从而提高运动训练的效果。本文就这方而的进展作一综述。     

慢性阻塞性肺疾病肺康复的研究进展

近年来,肺康复被越来越多的国内外学者认为是慢性阻塞性肺疾病（COPD）稳定期治疗的一个不可或缺的组成部分[1]。全球COPD控制策略（GOLD）中已将肺康复治疗,特别是下肢运动训练列为中重度COPD患者治疗的主要措施之一[2]。目前国内对肺康复的重要性、     

慢性阻塞性肺疾病康复治疗进展

慢性阻塞性肺疾病(COPD)作为一种高患病率、高致残率和高死亡率的疾病而严重危害了人民的身体健康,肺康复已被证实能有效减轻COPD患者的呼吸困难,提高运动耐力和健康相关生活质量,不同严重程度的COPD患者均可从肺康复中获益,本文就COPD康复治疗措施及其进展做一综述.     

慢性阻塞性肺疾病患者肺康复治疗效果及其评价

慢性阻塞性肺疾病（COPD）大部分中重度患者活动能力受限，并出现心理障碍及社会适应力降低，同时COPD的高患病率、高致残率使其占据了相当大的社会医疗资源。肺康复治疗的目的并非阻止或逆转肺功能的降低，而是通过肺康复计划改善患者的呼吸困难，提高运动耐力及生活质量，改善患者心理障碍及社会适应能力。全球COPD控制策略（GOLD）中首次将肺康复治疗，特别是下肢运动训练列为中重度COPD患者治疗的主要措施之一。目前国内对肺康复的重要性、相关的研究和临床工作与国外差距较大，对运动训练在肺康复中的重要地位缺少认识，且康复效果评价方法欠规范，在此就部分相关内容进行综述。     

慢性阻塞性肺疾病患者肺康复的临床研究进展

<正>慢性阻塞性肺疾病(COPD)是一种常见的以持续性呼吸道症状和气流受限为特征的可以预防和治疗的疾病~([1]),具有致残率高和病死率高等特点,影响患者的生活质量,给其家庭和社会带来沉重的经济负担。目前主要通过戒烟和流感疫苗预防COPD,药物治疗缓解症状,但由于COPD患者严重程度不同,所以需要采用个体化方案进行综合管理。肺康复作为患者整体管理的一部分,是多学科共同参与的综合性治疗,内容主要包括呼吸肌训练、运动     

慢性阻塞性肺疾病肺康复治疗进展及实践

已证实肺康复能有效地减轻慢性阻塞性肺疾病(COPD)患者的呼吸困难,提高运动耐力和健康相关生活质量。不同严重程度的COPD患者均可从肺康复中受益。其内容主要包括运动锻炼、吸气肌肉训练、营养疗法等,运动锻炼是肺康复的核心内容。近年来,提高肺康复效果的方法有了新发展,主要包括增加运动量、教育管理和心理支持。虽然肺康复传统地应用于稳定期COPD患者,但对于AECOPD患者,感染控制后就可开始早期肺康复。肺康复应当遵循运动量的最大化,并个体化和联合不同方法。     

运动训练对慢性阻塞性肺疾病缓解期患者的影响

目的分析运动训练对缓解期慢性阻塞性肺疾病患者运动耐力、呼吸功能和生活质量的影响。方法对45例临床缓解期的慢性阻塞性肺疾病患者进行系统的步行训练和呼吸体操训练治疗,并在训练前、后分别测量6分钟步行距离、Borg呼吸困难评分及圣·乔治医院呼吸问题调查问卷评分等指标。结果经过系统运动训练的缓解期慢性阻塞性肺疾病患者,运动耐力和生活质量好于未经过系统呼吸训练的COPD患者。结论系统的运动训练能够提高缓解期慢性阻塞性肺疾病患者运动耐力和健康相关生活质量。     

运动训练联合心理干预对慢性阻塞性肺疾病三级预防效果观察

近年来大量临床随机对照试验证实肺康复对慢性阻塞性肺疾病（COPD）患者有显著疗效。2007版ACPP／AcPPR肺康复指南尤其重视患者的运动训练，将视为为肺康复的基石引。本研究通过观察常规运动训练和定期心理干预对稳定期COPD患者的三级预防的效果，并探讨其临床价值.     

慢性阻塞性肺疾病肺康复相关进展与运动心肺功能的应用

慢性阻塞性肺疾病患者,特别是老年患者.运动耐力下降是其主要症状之一,不但严重影响了患者的生活质量,同时带来了沉重的社会家庭经济负担,随着人口老龄化的加深,这一问题愈显突出.很多国外研究已证明肺康复是改善慢性阻塞性肺疾病患者运动耐力的有效手段,且具有良好成本效益.同时越来越多的研究已将运动心肺功能作为其评估技术,并将其广泛运用到日常的诊疗活动中.目前国内对这方面的研究和应用还相对较少.本文将着重就肺康复及这一运动耐力评估方法作一综述.     

慢性阻塞性肺疾病肺康复相关进展与运动心肺功能的应用

慢性阻塞性肺疾病患者,特别是老年患者.运动耐力下降是其主要症状之一,不但严重影响了患者的生活质量,同时带来了沉重的社会家庭经济负担,随着人口老龄化的加深,这一问题愈显突出.很多国外研究已证明肺康复是改善慢性阻塞性肺疾病患者运动耐力的有效手段,且具有良好成本效益.同时越来越多的研究已将运动心肺功能作为其评估技术,并将其广泛运用到日常的诊疗活动中.目前国内对这方面的研究和应用还相对较少.本文将着重就肺康复及这一运动耐力评估方法作一综述.     

Managing chronic obstructive pulmonary disease in the community. A randomized controlled trial of home-based pulmonary rehabilitation for elderly housebound patients

PURPOSE: Pulmonary rehabilitation is essential for managing chronic obstructive pulmonary disease (COPD). Housebound COPD patients are frequently excluded from this treatment because they are unable to access outpatient pulmonary rehabilitation programs because of the severity of their disease. This randomized controlled trial assesses the effects of a 12-week home-based pulmonary rehabilitation program for 60 housebound COPD patients older than 60 years. METHODS: Intervention patients received an individually tailored supervised walking and arm exercise program as well as individual multidisciplinary education sessions on COPD and its management. Outcomes were assessed using the 6-minute walk test, St George's respiratory questionnaire, and Borg score of perceived breathlessness. Healthcare utilization was assessed using hospital admission rates with exacerbation of COPD and average length of stay at readmission. RESULTS: Complete data for 23 patients in each group were available for analysis. There was no significant difference between groups on baseline measures. Compared with the control group, intervention patients demonstrated a significant improvement in 6-minute walk test (P = .023), Borg score of perceived breathlessness (P = .024), St George's respiratory questionnaire total score (P = .020), and impact subscore (P = .024). At 6 months, the intervention group had a significantly shorter average length of stay at readmission to hospital with exacerbation (P = .035). CONCLUSION: A 12-week home-based pulmonary rehabilitation is effective in improving exercise tolerance, perception of breathlessness, and quality of life for housebound COPD patients. To manage COPD in the community more effectively, health services should focus on expanding home-based pulmonary rehabilitation.     

慢性阻塞性肺疾病2种肺康复策略的疗效比较

目的:比较2种不同的肺康复干预策略对慢性阻塞性肺疾病(COPD)患者BODE指数评分、焦虑抑郁及日常生活活动能力的改善及脱落率。方法:采用随机、对照的方法将155例稳定期COPD患者分为3组,肺康复干预Ⅰ组给予康复宣教、有氧呼吸操及体能训练;肺康复干预Ⅱ组仅给予康复宣教及有氧呼吸操,对照组不给予肺康复干预,为期20周。比较康复前后3组患者BODE指数、焦虑抑郁及日常生活活动能力评分及脱落的差异。结果:经过20周的肺康复干预,肺康复干预Ⅰ、Ⅱ组较对照组在焦虑抑郁评分、6 min步行距离、呼吸困难程度评分均明显改善(P<0.01),但脱落率明显高于其他2组(P     

Role of macrolide therapy in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. The Global Burden of Disease study has concluded that COPD will become the third leading cause of death worldwide by 2020, and will increase its ranking of disability-adjusted life years lost from 12th to 5th. Acute exacerbations of COPD (AECOPD) are associated with impaired quality of life and pulmonary function. More frequent or severe AECOPDs have been associated with especially markedly impaired quality of life and a greater longitudinal loss of pulmonary function. COPD and AECOPDs are characterized by an augmented inflammatory response. Macrolide antibiotics are macrocyclical lactones that provide adequate coverage for the most frequently identified pathogens in AECOPD and have been generally included in published guidelines for AECOPD management. In addition, they exert broad-ranging, immunomodulatory effects both in vitro and in vivo, as well as diverse actions that suppress microbial virulence factors. Macrolide antibiotics have been used to successfully treat a number of chronic, inflammatory lung disorders including diffuse panbronchiolitis, asthma, noncystic fibrosis associated bronchiectasis, and cystic fibrosis. Data in COPD patients have been limited and contradictory but the majority hint to a potential clinical and biological effect. Additional, prospective, controlled data are required to define any potential treatment effect, the nature of this effect, and the role of bronchiectasis, baseline colonization, and other cormorbidities.     

COPD肺康复运动处方的研究进展

肺康复作为COPD管理的一项重要内容,能有效减轻COPD患者的呼吸困难症状,提高运动耐量和健康相关生活质量,在国内尚处于起步阶段,对运动训练在COPD肺康复中的具体方式、强度、时间、频率缺乏充分的认识,本文就COPD肺康复运动处方的研究进展进行综述.     

慢性阻塞性肺疾病的肺康复进展

肺康复目前被认为是COPD综合治疗方案中不可或缺的一部分,但对于严重的COPD患者,肺康复的效果似乎还不太明确,一些新的方法被应用以增加肺康复的效果.这篇综述将目前肺康复领域的一些新措施总结如下.     

Chronic obstructive pulmonary disease in non-smokers

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Tobacco smoking is established as a major risk factor, but emerging evidence suggests that other risk factors are important, especially in developing countries. An estimated 25–45% of patients with COPD have never smoked; the burden of non-smoking COPD is therefore much higher than previously believed. About 3 billion people, half the worldwide population, are exposed to smoke from biomass fuel compared with 1·01 billion people who smoke tobacco, which suggests that exposure to biomass smoke might be the biggest risk factor for COPD globally. We review the evidence for the association of COPD with biomass fuel, occupational exposure to dusts and gases, history of pulmonary tuberculosis, chronic asthma, respiratory-tract infections during childhood, outdoor air pollution, and poor socioeconomic status.     

吸烟对慢性阻塞性肺疾病发病机制的影响

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的发病率近年来呈现上升趋势,目前已占到了疾病死亡原因的第4位,预计到2020年将上升到第3位.COPD是一个重要的公众健康问题,它是世界范围内引起高发病率和死亡率的一个重要原因.在我国,40岁以上人群COPD的总患病率达8.2%,呼吸系统疾病(其中COPD占很大部分)在农村处于第3位死因、在城市处于第4位死因,每年有一百万人死亡和五百万人致残.因此,对COPD发病机制的研究显的尤为重要,COPD是一种多因素引起的疾病,既有自身的因素,也有环境因素.在环境因素中,吸烟、空气污染及感染是导致COPD发病的三大危险因素,而其中吸烟是最主要的因素.近年来,吸烟对COPD的影响的研究取得了较大的进展,现综述了近几年吸烟对COPD发病机制的影响,同时希望对COPD发病机制的深入研究有一定的意义.     

社区康复治疗对慢性阻塞性肺疾病稳定期患者预后的影响研究

目的 观察社区康复治疗对慢性阻塞性肺疾病稳定期患者肺功能、生活质量及急性发作次数的影响.方法 将60例稳定期慢性阻塞性肺疾病患者随机分为干预组及对照组各30例,观察时间为半年.干预组进行心理与行为干预、呼吸肌锻炼、家庭氧疗、营养支持等康复治疗措施.治疗前后检测肺功能和生活质量,同时通过电话、复诊、上门随访等方法随访半年...     

Add‐on interventions during pulmonary rehabilitation

Both pulmonary rehabilitation (PR) and chronic obstructive pulmonary disease (COPD) are generic terms and it increasingly becomes clear that rehabilitation programmes need to be tailored to the complexity and circumstances of the individual patient. Indeed, PR is described as a comprehensive, individualized intervention based on thorough assessment of identifiable treatable traits. The current review summarizes ongoing developments regarding additional interventions and tools to facilitate PR and improve outcomes in patients with a chronic respiratory disease.