Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Aug 25;52(4):518-525. doi: 10.3724/zdxbyxb-2023-0081.
Bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness. With the development of the whole-life-cycle health concept, the focus of treatment for bronchial asthma in children has gradually shifted from pharmacological control to an integrated management model of functional rehabilitation and pharmacological assistance. As a non-pharmacological integrated approach, pulmonary rehabilitation plays an equally important role in the management of childhood asthma as pharmacological treatments. Breathing techniques such as Buteyko breathing, pursed lip breathing, diaphragmatic breathing training, threshold-pressure inspiratory muscle training and yoga breathing can improve lung function indicators such as forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) in children. Comprehensive pre-exercise assessment, development of exercise prescriptions, and implementation and evaluation of exercise effects can improve physical fitness, neuromuscular coordination, and self-confidence of children with asthma. The comprehensive interventions of health education, psychological support and nutritional intervention can improve the compliance and effectiveness of rehabilitation training. This article reviews the research progress on respiratory training, physical exercise, and comprehensive interventions in the pulmonary rehabilitation of asthmatic children, to provide theoretical basis and practical guidance for the scientific and rational management of pulmonary rehabilitation of asthmatic children in clinical settings.
支气管哮喘是一种异质性疾病,其特征为慢性气道炎症和气道高反应性。随着全生命周期健康理念的发展,儿童支气管哮喘的治疗重点逐渐从药物控制转向功能康复和药物辅助的综合管理模式。作为一种非药物的综合方法,肺康复在儿童哮喘的管理中与药物治疗同样重要。呼吸技术,如布地奈德呼吸、缩唇呼吸、膈式呼吸训练、阈压吸气肌训练和瑜伽呼吸,可以改善儿童的肺功能指标,如第一秒用力呼气量(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF)和最大自主通气量(MVV)。综合的运动前评估、运动处方的制定、以及运动效果的实施和评估,可以提高哮喘儿童的身体素质、神经肌肉协调性和自信心。健康教育、心理支持和营养干预的综合干预可以提高康复训练的依从性和效果。本文综述了支气管哮喘患儿肺康复中呼吸训练、体育锻炼和综合干预的研究进展,为临床中支气管哮喘患儿肺康复的科学、合理管理提供理论依据和实践指导。