Engels Michael, Cross Raymond K, Long Millie D
Department of Medicine, Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, NC, USA.
Clin Exp Gastroenterol. 2017 Dec 22;11:1-11. doi: 10.2147/CEG.S120816. eCollection 2018.
Inflammatory bowel diseases (IBDs), including both Crohn's disease (CD) and ulcerative colitis (UC), are chronic autoimmune diseases. Both CD and UC have relapsing and remitting courses. Although effective medical treatments exist for these chronic conditions, some patients do not respond to these traditional therapies. Patients are often left frustrated with incomplete resolution of symptoms and seek alternative or complementary forms of therapy. Patients often search for modifiable factors that could improve their symptoms or help them to maintain periods of remission. In this review, we examine both the published evidence on the benefits of exercise clinically and the pathophysiological changes associated with exercise. We then describe data on exercise patterns in patients with IBDs, potential barriers to exercise in IBDs, and the role of exercise in the development and course of IBDs. While some data support physical activity as having a protective role in the development of IBDs, the findings have not been robust. Importantly, studies of exercise in patients with mild-to-moderate IBD activity show no danger of disease or symptom exacerbation. Exercise has theoretical benefits on the immune response, and the limited available data suggest that exercise may improve disease activity, quality of life, bone mineral density, and fatigue levels in patients with IBDs. Overall, exercise is safe and probably beneficial in patients with IBDs. Evidence supporting specific exercise recommendations, including aspects such as duration and heart rate targets, is needed in order to better counsel patients with IBDs.
炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），是慢性自身免疫性疾病。CD和UC都有复发和缓解的病程。尽管针对这些慢性病存在有效的药物治疗方法，但一些患者对这些传统疗法没有反应。患者常常因症状未完全缓解而感到沮丧，并寻求替代或补充性的治疗方式。患者经常寻找可改变的因素，以改善症状或帮助他们维持缓解期。在本综述中，我们研究了临床上关于运动益处的已发表证据以及与运动相关的病理生理变化。然后，我们描述了IBD患者的运动模式数据、IBD患者运动的潜在障碍以及运动在IBD发生和病程中的作用。虽然一些数据支持体育活动在IBD发生中具有保护作用，但这些发现并不确凿。重要的是，对轻度至中度IBD活动患者的运动研究表明，不存在疾病或症状加重的风险。运动对免疫反应具有理论上的益处，有限的现有数据表明，运动可能改善IBD患者的疾病活动度、生活质量、骨密度和疲劳水平。总体而言，运动对IBD患者是安全的，可能还有益处。为了更好地为IBD患者提供建议，需要有支持特定运动建议的证据，包括运动时长和心率目标等方面。
