一种高强度肺康复计划对肥胖的哮喘患者短期及长期影响：一项随机对照试验
2021/02/09
摘要：
目的：确定一种高强度肺康复计划对肥胖哮喘患者的哮喘控制、身体组成、肺功能及运动能力的短期和长期影响。
方法：存在肥胖症（BMI＞30kg/㎡）及部分控制哮喘（哮喘控制问卷【ACQ】＞0.75）的患者被随机分配到一个为期3个月的肺康复计划组（PR组）、肺康复计划+一种基于互联网的自我管理支持项目组（PR+SMS组）、常规护理组。PR计划包括高强度间歇训练、营养干预及心理小组会议。常规护理组的患者被建议减重及运动。主要结果为：3个月后，PR组与PR+SMS组的ACQ变化量之间的差异。总随访时间为12个月。
结果：34名患者被纳入本研究（PR组包括14名患者，PR+SMS组包括9名患者，对照组包括11名患者）。在3个月之后，与常规护理组患者相比，PR组患者的BMI显著降低，并且哮喘控制状态、运动能力及有氧工作能力明显改善。在12个月随访期间，这些改善作用持续存在。我们发现：PR+SMS组与PR组的ACQ之间无任何差异。然而，在12个月之后，使用SMS项目的患者的BMI明显比PR组的患者更低。
结论：在病情未得到最佳控制得肥胖哮喘患者中，一种高强度肺康复计划能持续性改善哮喘控制状态、身体成分及运动能力，所以在这些患者的治疗中应该考虑这种高强度肺康复计划。
Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial
Yasemin Türk, Willy Theel, Astrid van Huisstede, Gert-Jan M van de Geijn, Erwin Birnie, Pieter S Hiemstra, Jacob K Sont, Christian Taube, Gert-Jan Braunstahl
Abstract
Objective: To determine the short-term and long-term effects of a high intensity pulmonary rehabilitation programme on asthma control, body composition, lung function and exercise capacity in obese asthma patients.
Methods: Patients with obesity (body mass index (BMI)≥30 kg·m-2) and suboptimal controlled asthma (Asthma Control Questionnaire (ACQ)≥0.75) were randomly assigned to a 3-month pulmonary rehabilitation programme (PR only), pulmonary rehabilitation programme with the use of an internet based self-management support programme (PR+SMS) or usual care. The pulmonary rehabilitation programme included high-intensity interval training, nutritional intervention and psychological group sessions. Patients in the usual care group were advised to lose weight and to exercise. The primary outcome was the difference of change of ACQ between PR only and PR+SMS after 3 months. Total follow-up was 12 months.
Results: 34 patients were included in the study (14 PR only, nine PR+SMS, 11 control). Compared with patients in usual care, patients in the PR only group had a significant reduction in BMI and significant improvements in asthma control, exercise capacity and aerobic capacity after 3 months. These improvements persisted during 12 months of follow-up. No difference in ACQ between PR+SMS and PR only groups was observed. However, users of the SMS programme had a significantly lower BMI after 12 months compared with subjects in the PR only group.
Conclusion: A high-intensity pulmonary rehabilitation programme provides sustained improvements in asthma control, body composition and exercise capacity in obese asthmatics that are not optimally controlled and, therefore, should be considered in the treatment of these patients.
目的：确定一种高强度肺康复计划对肥胖哮喘患者的哮喘控制、身体组成、肺功能及运动能力的短期和长期影响。
方法：存在肥胖症（BMI＞30kg/㎡）及部分控制哮喘（哮喘控制问卷【ACQ】＞0.75）的患者被随机分配到一个为期3个月的肺康复计划组（PR组）、肺康复计划+一种基于互联网的自我管理支持项目组（PR+SMS组）、常规护理组。PR计划包括高强度间歇训练、营养干预及心理小组会议。常规护理组的患者被建议减重及运动。主要结果为：3个月后，PR组与PR+SMS组的ACQ变化量之间的差异。总随访时间为12个月。
结果：34名患者被纳入本研究（PR组包括14名患者，PR+SMS组包括9名患者，对照组包括11名患者）。在3个月之后，与常规护理组患者相比，PR组患者的BMI显著降低，并且哮喘控制状态、运动能力及有氧工作能力明显改善。在12个月随访期间，这些改善作用持续存在。我们发现：PR+SMS组与PR组的ACQ之间无任何差异。然而，在12个月之后，使用SMS项目的患者的BMI明显比PR组的患者更低。
结论：在病情未得到最佳控制得肥胖哮喘患者中，一种高强度肺康复计划能持续性改善哮喘控制状态、身体成分及运动能力，所以在这些患者的治疗中应该考虑这种高强度肺康复计划。
(中日友好医院呼吸与危重症医学科 张清 摘译 林江涛 审校)
(Eur Respir J . 2020 Jul 2;56(1):1901820. doi: 10.1183/13993003.01820-2019)
(Eur Respir J . 2020 Jul 2;56(1):1901820. doi: 10.1183/13993003.01820-2019)
Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial
Yasemin Türk, Willy Theel, Astrid van Huisstede, Gert-Jan M van de Geijn, Erwin Birnie, Pieter S Hiemstra, Jacob K Sont, Christian Taube, Gert-Jan Braunstahl
Abstract
Objective: To determine the short-term and long-term effects of a high intensity pulmonary rehabilitation programme on asthma control, body composition, lung function and exercise capacity in obese asthma patients.
Methods: Patients with obesity (body mass index (BMI)≥30 kg·m-2) and suboptimal controlled asthma (Asthma Control Questionnaire (ACQ)≥0.75) were randomly assigned to a 3-month pulmonary rehabilitation programme (PR only), pulmonary rehabilitation programme with the use of an internet based self-management support programme (PR+SMS) or usual care. The pulmonary rehabilitation programme included high-intensity interval training, nutritional intervention and psychological group sessions. Patients in the usual care group were advised to lose weight and to exercise. The primary outcome was the difference of change of ACQ between PR only and PR+SMS after 3 months. Total follow-up was 12 months.
Results: 34 patients were included in the study (14 PR only, nine PR+SMS, 11 control). Compared with patients in usual care, patients in the PR only group had a significant reduction in BMI and significant improvements in asthma control, exercise capacity and aerobic capacity after 3 months. These improvements persisted during 12 months of follow-up. No difference in ACQ between PR+SMS and PR only groups was observed. However, users of the SMS programme had a significantly lower BMI after 12 months compared with subjects in the PR only group.
Conclusion: A high-intensity pulmonary rehabilitation programme provides sustained improvements in asthma control, body composition and exercise capacity in obese asthmatics that are not optimally controlled and, therefore, should be considered in the treatment of these patients.
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