哮喘联盟

   摘要
   背景：哮喘是一种以可逆性气道受限、炎症和对不同变应原的高反应性为特征的慢性炎症性气道疾病。有氧运动和呼吸运动已被证明有利于哮喘患者;然而，并无证据比较其治疗的有效性。
   方法/设计：这是一项前瞻性、对照、双盲、随机临床试验， 给予2组患者不同的干预措施。优化药物治疗的48例成人哮喘患者随机分为有氧（AG）和呼吸运动组（BG）。患者将进行呼吸或有氧运动，每周两次，持续3个月，总计24次，每次40分钟。干预前，两组患者将完成一个包含2节教育课程的教学计划。干预前后，量化如下参数：临床控制（主要结果），健康相关生活质量，焦虑和抑郁程度，日常生活的体力活动和最大运动能力（次要结果）。过度换气综合征的症状，自律神经失调，胸腹运动，痰中的炎性细胞，呼出气一氧化氮（FENO）所占分数和全身性炎症性细胞因子作为可能的机制也将被评估，以解释这两种干预措施的获益。
   讨论：虽然呼吸和有氧运动的获益已被广泛研究，但两者的比较从未被研究。此外，我们的研究结果将使我们了解其应用及患者的适用性，这将使每一项效果最优化的干预具有更多获益。
 

（林江涛 审校）
BMC Pulm Med. 2014 Oct 17;14(1):160. [Epub ahead of print]
 

Comparison between breathing and aerobic exercise on clinical control in patients with moderate-to-severe asthma: protocol of a randomized trial.
 

Evaristo KB, Saccomani MG, Martins MA, Cukier A, Stelmach R, Rodrigues MR, Santaella DF, Carvalho CR.
 

ABSTRACT
BACKGROUND: Asthma is a chronic inflammatory airway disease characterized by reversible obstruction, inflammation and hyperresponsiveness to different stimulus. Aerobic and breathing exercises have been demonstrated to benefit asthmatic patients; however, there is no evidence comparing the effectiveness of these treatments.
METHODS/DESIGN: This is a prospective, comparative, blinded, and randomized clinical trial with 2 groups that will receive distinct interventions. Forty-eight asthmatic adults with optimized medical treatment will be randomly divided into either aerobic (AG) or breathing exercises (BG). Patients will perform breathing or aerobic exercise twice a week for 3 months, totalizing 24 sessions of 40 minutes each. Before intervention, both groups will complete an educational program consisting of 2 educational classes. Before and after interventions, the following parameters will be quantified: clinical control (main outcome), health related quality of life, levels of anxiety and depression, daily living physical activity and maximal exercise capacity (secondary outcome). Hyperventilation syndrome symptoms, autonomic nervous imbalance, thoracoabdominal kinematics, inflammatory cells in the sputum, fraction of exhaled nitric oxide (FENO) and systemic inflammatory cytokines will also be evaluated as possible mechanisms to explain the benefits of both interventions.
DISCUSSION: Although the benefits of breathing and aerobic exercises have been extensively studied, the comparison between both has never been investigated. Furthermore, the findings of our results will allow us to understand its application and suitability to patients that will have more benefits for every intervention optimizing its effect.
 

BMC Pulm Med. 2014 Oct 17;14(1):160. [Epub ahead of print]