有氧训练对哮喘患者社会心理及症状的影响
2011/04/15
背景：哮喘症状会限制患者的日常活动，影响他们健康相关的生活质量（health-related quality of life，HRQoL），增加患者的焦虑和抑郁，这些均与哮喘的不良控制相关。已知有氧运动训练可提高对氧的适应、减少哮喘患者的呼吸困难，但其对缓解心理压抑和哮喘症状的影响尚不清楚。我们研究旨在评估有氧训练在改善中重度持续哮喘患者HRQoL（主要目的）和减轻其心理压抑与哮喘症状（次要目的）的作用。
方法：将101例患者随机分为对照组或有氧训练组，该研究在哮喘随访间期进行。对照组（n=51）给予健康教育和呼吸训练，试验组（n=50）给予健康教育和有氧呼吸训练，在3个月期间给予每周两次治疗。HRQoL和焦虑、抑郁程度在治疗前后进行定量测定。哮喘症状每月评估。
结果：3月末，在活动受限、症状发作频率、社会心理方面和HRQoL评分在训练组有明显改善（P<0.001）；无哮喘症状天数、焦虑和抑郁程度亦明显改善（P<.0.001）。此外，供氧能力和无哮喘发作时间有线性关系（r=0.47，P<0.01）。
结论：我们的结果表明，在持续哮喘临床治疗中有氧训练有重要作用。而且，其对有较高程度社会心理压力的患者可能有特别作用。
(王刚 四川大学华西医院中西医结合科呼吸组 610041 摘译)
(Chest. 2010; 138(2):331–337)
Effects of aerobic training on psychosocial morbidity and symptoms in patients with asthma
Mendes F, Gonçalves R, Nunes M, Saraiva-Romanholo B, Cukier A, Stelmach R, Jacob-Filho W, Martins M, Carvalho C.
Chest. 2010; 138(2):331–337
Background: Asthma symptoms reduce patients’ daily activities, impair their health-related quality of life (HRQoL), and increase their reports of anxiety and depression, all of which seem to be related to a decrease in asthma control. Aerobic exercise training is known to improve aerobic fitness and reduce dyspnea in asthmatics; however, its effect in reducing psychologic distress and symptoms remains poorly understood. We evaluated the role of an aerobic training program in improving HRQoL (primary aim) and reducing psychologic distress and asthma symptoms (secondary aims) for patients with moderate or severe persistent asthma.
Methods: A total of 101 patients were randomly assigned to either a control group or an aerobic training group and studied during the period between medical consultations. Control group patients (educational program plus breathing exercises) (n=51) and training group patients (educational program plus breathing exercises plus aerobic training) (n=50) were followed twice a week during a 3-month period. HRQoL and levels of anxiety and depression were quantifi ed before and after treatment. Asthma symptoms were evaluated monthly.
Results: At 3 months, the domains (physical limitations, frequency of symptoms, and psychosocial) and total scores of HRQoL signifi cantly improved only in the training group patients (P<.001); the number of asthma-symptom-free days and anxiety and depression levels also signifi cantly improved in this group (P<.001). In addition, a linear relationship between improvement in aerobic capacity and the days without asthma symptoms was observed (r=0.47; P<.01).
Conclusions: Our results suggest that aerobic training can play an important role in the clinical management of patients with persistent asthma. Further, they may be especially useful for patients with higher degrees of psychosocial distress.
