Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences.
Tohoku J Exp Med. 2014 Jan;232(1):1-8. doi: 10.1620/tjem.232.1.
Air pollution in Japan caused respiratory disease, such as chronic bronchitis and asthma, in many individuals in the 1960s. Although air pollution has decreased, many victims of air pollution-related respiratory disease are limited in their activities of daily living because of respiratory symptoms. The purpose of this study was to evaluate the efficacy of pulmonary rehabilitation in victims of air pollution-related chronic bronchitis or asthma. Subjects were enrolled in a 12-week (2-week inpatient followed by 10-week outpatient) pulmonary rehabilitation program. The program comprised conditioning, strength training, endurance training, and patient education. We assessed the Modified Medical Research Council (MMRC) dyspnea grade, pulmonary function, peripheral muscle force, incremental shuttle walk distance (ISWD), and physical activity at baseline and immediately after the program. Twenty-nine subjects (mean age 74.2 ± 10.1 years, 11 males) completed the program, including 11 subjects with COPD and 18 subjects with asthma. Following rehabilitation, the participants (n = 29) showed significant improvements in MMRC dyspnea grade, vital capacity % predicted, quadriceps force and ISWD (all P < 0.05). Sub-group analyses revealed that all these variables were significantly improved in subjects with asthma. In contrast, subjects with COPD showed significant improvements only in quadriceps force and ISWD (both P < 0.05). Thus, pulmonary rehabilitation is an effective method of improving exercise capacity and dyspnea in officially acknowledged victims of air pollution-related asthma. In conclusion, we recommend that patients with chronic bronchitis or asthma, resulting from exposure to air pollution, are referred for pulmonary rehabilitation.
20 世纪 60 年代，日本的空气污染导致许多人患上呼吸道疾病，如慢性支气管炎和哮喘。尽管空气污染有所减少，但许多与空气污染有关的呼吸道疾病的受害者由于呼吸道症状而限制了他们的日常生活活动。本研究的目的是评估肺康复对与空气污染有关的慢性支气管炎或哮喘患者的疗效。研究对象参加了为期 12 周（2 周住院，随后 10 周门诊）的肺康复计划。该计划包括调理、力量训练、耐力训练和患者教育。我们在基线和计划结束后立即评估改良医学研究委员会（MMRC）呼吸困难分级、肺功能、外周肌肉力量、递增穿梭步行距离（ISWD）和身体活动。29 名患者（平均年龄 74.2 ± 10.1 岁，11 名男性）完成了该计划，包括 11 名 COPD 患者和 18 名哮喘患者。康复后，参与者（n = 29）在 MMRC 呼吸困难分级、肺活量预测值、股四头肌力量和 ISWD 方面均有显著改善（均 P < 0.05）。亚组分析显示，哮喘患者的所有这些变量均显著改善。相比之下，COPD 患者仅在股四头肌力量和 ISWD 方面有显著改善（均 P < 0.05）。因此，肺康复是改善已确认的与空气污染有关的哮喘患者运动能力和呼吸困难的有效方法。总之，我们建议因接触空气污染而患有慢性支气管炎或哮喘的患者应接受肺康复治疗。
