van Buul Amanda R, Kasteleyn Marise J, Chavannes Niels H, Taube Christian
Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
Eur Respir Rev. 2017 Jan 3;26(143). doi: 10.1183/16000617.0033-2016. Print 2017 Jan.
Morning symptoms are common in chronic obstructive pulmonary disease (COPD). Many COPD patients consider the morning as the most troublesome part of the day, in which they experience more symptoms and physical activity limitations.To systematically report evidence of the association between morning symptoms and physical activity in COPD patients, a literature search was conducted using relevant MESH terms and text words in PubMed, Embase, Web of Science, COCHRANE, CINAHL and PsycINFO. Quality of the articles was assessed with validated checklists.Eight studies were included. Morning symptoms were present in 39.8-94.4%. In 37.0-90.6% of all COPD patients, there was an association between physical activity and morning symptoms. However, causality could not be proved. Morning symptoms were associated with a sedentary lifestyle (p<0.05). Treatment in line with the guidelines improved the degree of activity limitations due to morning symptoms (p<0.0001).Across all disease stages, COPD patients experience morning symptoms which are negatively associated with physical activity. Physicians should consider morning symptoms as a treatment goal. Pharmacotherapy may improve the degree of activity limitations due to morning symptoms. More objective research should focus on symptoms, activity limitations and physical inactivity of COPD patients, especially in the morning.
晨发症状在慢性阻塞性肺疾病（COPD）中很常见。许多COPD患者认为早晨是一天中最麻烦的时段，在此期间他们会出现更多症状，身体活动也受到更多限制。为了系统地报告COPD患者晨发症状与身体活动之间关联的证据，我们使用PubMed、Embase、Web of Science、COCHRANE、CINAHL和PsycINFO中的相关医学主题词（MESH）和文本词进行了文献检索。通过经过验证的清单对文章质量进行评估。共纳入八项研究。晨发症状的出现率为39.8%至94.4%。在所有COPD患者中，37.0%至90.6%的患者身体活动与晨发症状之间存在关联。然而，无法证明因果关系。晨发症状与久坐不动的生活方式相关（p<0.05）。遵循指南进行治疗可改善因晨发症状导致的活动受限程度（p<0.0001）。在所有疾病阶段，COPD患者都会出现晨发症状，这些症状与身体活动呈负相关。医生应将晨发症状视为治疗目标。药物治疗可能会改善因晨发症状导致的活动受限程度。更多客观研究应关注COPD患者的症状、活动受限和身体不活动情况，尤其是在早晨。
