Wuxi Medical College of Jiangnan University, Wuxi, China.
Department of Respiratory Disease, Affiliated Hospital of Jiangnan University, Wuxi, China.
Ann Palliat Med. 2022 May;11(5):1774-1785. doi: 10.21037/apm-22-451.
Pulmonary rehabilitation training is an important means of stable chronic obstructive pulmonary disease (COPD). However, some people think that its effect is not satisfactory, and there is a lack of understanding of the effect of pulmonary rehabilitation training on T cell immune function. This study investigated the efficacy and safety of pulmonary rehabilitation training on lung function, quality of life and T cell immune function in stable COPD patients.
Seventy-two stable COPD patients recruited from the Outpatient department of Affiliated Hospital of Jiangnan University and Wuxi Huishan Rehabilitation Hospital, and divided them into experimental group (39 cases) and control group (33 cases) by random number table method. Both groups were received routine drug therapy, COPD knowledge education, and smoking cessation treatment. On this basis, the experimental group received daily pulmonary rehabilitation training, including pursed-lip breathing (PLB) training, abdominal breathing training, skeletal muscle training, and coughing and expectoration training. Lung function [percentage of forced expiratory volume in 1 second (FEV1%) and the percentage of FEV1/forced vital capacity (FEV1/FVC%)], quality of life [6-minute walk test (6MWT), COPD assessment test (CAT score)], and T lymphocyte subsets (CD3+%, CD4+%, CD8+%, and CD4+%/CD8+%) levels were compared by independent sample t-test or paired t-test between the 2 groups before and after 12 weeks of treatment in a double-blind method.
There were no remarkable differences in lung function indexes, 6MWT, CAT score, and T cell immune function between the 2 groups before treatment. After 12 weeks, all indexes in the experimental group (all P<0.01) and T lymphocyte subsets in the control group (CD3+%, CD4+%, CD8+% and CD4+%/CD8+% were 0.010, 0.037, 0.021 and 0.016, respectively) were significantly better than before treatment, and there were no significant differences in lung function,6MWT, and CAT scores in the control group. After 12 weeks, all indexes in the experimental group were significantly better than those in the control group except CD8+% (FEV1%, FEV1/FVC%, 6MWT, CAT score, CD3+%, CD4+% and CD4+%/CD8+% were 0.002, 0.009, <0.001, 0.007, 0.037, 0.046 and <0.001, respectively).
Pulmonary rehabilitation training can improve the lung function, quality of life, and T cell immune function of stable-phase COPD patients. Perhaps the recovery of T-cell immune function is the root of the patient's improvement.
Chinese Clinical Trial Registry ChiCTR2100048419.
肺康复训练是稳定期慢性阻塞性肺疾病（COPD）的重要手段。但有人认为其疗效并不满意，对肺康复训练对 T 细胞免疫功能的影响缺乏了解。本研究旨在探讨肺康复训练对稳定期 COPD 患者肺功能、生活质量和 T 细胞免疫功能的疗效和安全性。
采用随机数字表法将江南大学附属医院和无锡惠山康复医院呼吸科门诊收治的 72 例稳定期 COPD 患者分为实验组（39 例）和对照组（33 例）。两组均给予常规药物治疗、COPD 知识教育和戒烟治疗。在此基础上，实验组每日接受肺康复训练，包括缩唇呼吸（PLB）训练、腹式呼吸训练、骨骼肌训练和咳嗽排痰训练。采用独立样本 t 检验或配对 t 检验比较两组患者治疗前和治疗 12 周后肺功能[第 1 秒用力呼气容积占预计值百分比（FEV1%）和 FEV1/用力肺活量（FEV1/FVC%）]、生活质量[6 分钟步行试验（6MWT）、COPD 评估测试（CAT 评分）]和 T 淋巴细胞亚群（CD3+%、CD4+%、CD8+%和 CD4+%/CD8+%）的差异。
两组患者治疗前肺功能指标、6MWT、CAT 评分和 T 细胞免疫功能无显著差异。治疗 12 周后，实验组各项指标（均 P<0.01）和对照组 T 淋巴细胞亚群（CD3+%、CD4+%、CD8+%和 CD4+%/CD8+%分别为 0.010、0.037、0.021 和 0.016）均明显优于治疗前，对照组肺功能、6MWT 和 CAT 评分无明显差异。治疗 12 周后，实验组除 CD8+%外，各项指标均明显优于对照组（FEV1%、FEV1/FVC%、6MWT、CAT 评分、CD3+%、CD4+%和 CD4+%/CD8+%分别为 0.002、0.009、<0.001、0.007、0.037、0.046 和<0.001）。
肺康复训练可改善稳定期 COPD 患者的肺功能、生活质量和 T 细胞免疫功能。或许 T 细胞免疫功能的恢复是患者改善的根本。
中国临床试验注册中心 ChiCTR2100048419。
