哮喘联盟

   摘要
   背景：有氧训练是否有利于哮喘的主要特征，如气道高反应性（BHR）和炎症，目前还知之甚少。该研究探索了有氧训练对于气道高反应性（主要结局），血清炎症细胞因子（次要结局），临床控制水平与哮喘生活质量（哮喘生活质量调查问卷（Asthma Quality of Life Questionnaire： AQLQ））（三级结局）的效应。
   方法：58例受试者被随机分为对照组和有氧训练组。对照组（健康宣教+呼吸训练）和试验组（健康宣教+呼吸训练+有氧训练）受试者均随访三个月。在干预前后评估受试者气道高反应性，血清细胞因子，临床控制水平，AQLQ, 诱导痰和呼出气一氧化氮（FeNO）。
   结果：经过12周的干预，43例受试者（对照组21例，试验组22例）完成试验并纳入统计分析。 试验组气道高反应性降低（组胺剂量增加1倍(95% CI 0.3 to 1.7 dd）），白介素-6（IL-6）、单核细胞趋化蛋白1（MCP-1）降低，AQLQ改善，急性发作减少（P < 0.05）。两组间IL-5， IL-8，IL-10，痰细胞结构，FeNO或哮喘控制问卷-7（ACQ-7；P＞0.05）均无统计学差异。对于在基线水平哮喘没有得到较好控制的试验组受试者，其ACQ-6得到改善，且对于气道炎症更重的受试者，其痰嗜酸性粒细胞百分比与FeNO均有所降低。
   结论：有氧训练能够降低中重度哮喘患者的气道高反应性和血清炎症细胞因子，并能够改善其生存质量，减少急性发作。本研究结果提示，在药物治疗基础上加上有氧训练作为辅助治疗能够改善哮喘相关临床特征。
 

(张欣 张红萍 王刚 四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（Thorax. 2015 Jun 10.）

 

Aerobic training decreases bronchial hyperresponsiveness and systemic inflammationin patients with moderate or severe asthma: a randomised controlled trial
 

Andrezza França-Pinto,Felipe A R Mendes,Regina Maria de Carvalho-Pinto,Rosana Câmara Agondi,Alberto Cukier, Rafael Stelmach,Beatriz M Saraiva-Romanholo, Jorge Kalil, Milton A Martins, Pedro Giavina-Bianchi, Celso R F Carvalho.
Thorax. 2015 Jun 10.

ABSTRACT
Background：The benefits of aerobic training for the main features of asthma, such as bronchial hyperresponsiveness (BHR) and inflammation, are poorly understood. We investigated the effects of aerobic training on BHR (primary outcome), serum inflammatory cytokines (secondary outcome), clinical control and asthma quality of life (Asthma Quality of Life Questionnaire (AQLQ)) (tertiary outcomes).
Methods：Fifty-eight patients were randomly assigned to either the control group (CG) or the aerobic training group (TG). Patients in the CG (educational programme+ breathing exercises (sham)) and the TG (same as the CG+ aerobic training) were followed for 3 months. BHR, serum cytokine, clinical control, AQLQ, induced sputum and fractional exhaled nitric oxide (FeNO) were evaluated before and after the intervention.
Results： After 12 weeks, 43 patients (21 CG/22 TG) completed the study and were analysed. The TG improved in BHR by 1 doubling dose (dd) (95% CI 0.3to 1.7 dd), and they experienced reduced interleukin 6(IL-6) and monocyte chemoattractant protein 1 (MCP-1)and improved AQLQ and asthma exacerbation ( p<0.05). No effects were seen for IL-5, IL-8, IL-10, sputum cellularity, FeNO or Asthma Control Questionnaire 7(ACQ-7; p>0.05). A within-group difference was found in the ACQ-6 for patients with non-well-controlled asthma and in sputum eosinophil and FeNO in patientsin the TG who had worse airway inflammation.
Conclusions： Aerobic training reduced BHR and serum proinflammatory cytokines and improved quality of life and asthma exacerbation in patients with moderate or severe asthma. These results suggest that adding exercise as an adjunct therapy to pharmacological treatment could improve the main features of asthma. Trial registration number NCT02033122.