Clini Enrico, Costi Stefania, Lodi Silvano, Rossi Giuseppina
Department of Medical and Surgical Speciales, Section of Respiratory Diseases, University of Modena-Reggio Emilia, Modena-Italy.
Med Sci Monit. 2003 Dec;9(12):RA300-5.
Evidence-based guidelines on treatment of patients with Chronic Obstructive Pulmonary Disease (COPD) have recently been developed. Non-pharmacological therapy of COPD has been receiving more interest and has been evolving rapidly in the last decade as an essential part of COPD treatment. In fact, non-pharmacological treatment is a complementary approach mainly in the advanced stages of COPD. Most of these care options appear to benefit patients in terms of quality of life and cost-effectiveness. The aim of the present review is to survey the most important non-pharmacological treatments for COPD (smoking cessation, rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation, and surgery) and their usefulness based on the currently available evidence. This review is based on an evaluation of the literature using a multimethod approach. A computerized MEDLINE search from 1966 through June 2003 was undertaken using the search terms pulmonary rehabilitation, surgery, smoking cessation, respiratory insufficiency/failure, and lung disease/obstructive. Non pharmacological treatment of COPD is a real option to successfully treat these patients and prevent further deterioration. All the included therapies are based on actual scientific evidence for patient benefits. To date, smoking cessation, comprehensive rehabilitation and long-term oxygen therapy are widely accepted as therapies which may positively impact the long-term management of COPD patients.
近期已制定了关于慢性阻塞性肺疾病（COPD）患者治疗的循证指南。在过去十年中，COPD的非药物治疗受到了更多关注，并作为COPD治疗的重要组成部分迅速发展。事实上，非药物治疗主要是在COPD晚期的一种辅助方法。这些护理选择大多在生活质量和成本效益方面使患者受益。本综述的目的是基于现有证据，探讨COPD最重要的非药物治疗方法（戒烟、康复治疗、长期氧疗、无创正压通气和手术）及其效用。本综述基于使用多方法对文献进行的评估。利用“肺康复”“手术”“戒烟”“呼吸功能不全/衰竭”和“肺病/阻塞性”等检索词，对1966年至2003年6月的MEDLINE进行了计算机检索。COPD的非药物治疗是成功治疗这些患者并防止病情进一步恶化的切实选择。所有纳入的治疗方法均基于对患者有益的实际科学证据。迄今为止，戒烟、综合康复治疗和长期氧疗已被广泛接受为可能对COPD患者长期管理产生积极影响的治疗方法。
