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慢性阻塞性肺疾病急性加重的非药物预防

Non-pharmacologic Prevention of Acute Exacerbation Chronic Obstructive Pulmonary Disease.

作者信息

Choi Joon Young

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Tuberc Respir Dis (Seoul). 2025 Jul;88(3):419-430. doi: 10.4046/trd.2024.0155. Epub 2025 Mar 7.


DOI:10.4046/trd.2024.0155
PMID:40051185
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12235297/
Abstract

Chronic obstructive pulmonary disease (COPD) is a major global health issue, as acute exacerbation COPD (AECOPD) significantly worsens outcomes and increases healthcare burden. This review explores non-pharmacologic strategies to prevent AECOPD. Pulmonary rehabilitation consistently demonstrates its effectiveness in reducing exacerbations and mortality, while improving exercise capacity and the quality of life. Lung volume reduction, through both surgical and bronchoscopic methods, has shown promise in select patient groups, leading to improved lung function and reduced exacerbation risk. Smoking cessation remains a critical intervention, while the role of electronic cigarettes remains debatable; some evidence suggests they may help patients unable to quit tobacco smoking. Vitamin D supplementation has shown potential in reducing exacerbations, particularly in patients with severe deficiency, though conflicting results warrant further research. Furthermore, shielding measures, like mask-wearing and social distancing, have gained attention during the coronavirus disease 2019 (COVID-19) pandemic for their role in reducing exacerbation risk. Lastly, vaccination, diet and nutrition, and non-invasive ventilation may be important to prevent AECOPD. These non-pharmacologic approaches should be integrated into comprehensive COPD management to improve outcomes and prevent AECOPD.

摘要

慢性阻塞性肺疾病(COPD)是一个重大的全球健康问题,因为慢性阻塞性肺疾病急性加重(AECOPD)会显著恶化病情并增加医疗负担。本综述探讨了预防AECOPD的非药物策略。肺康复始终证明其在减少急性加重和死亡率方面的有效性,同时提高运动能力和生活质量。通过手术和支气管镜方法进行的肺减容术在特定患者群体中显示出前景,可改善肺功能并降低急性加重风险。戒烟仍然是一项关键干预措施,而电子烟的作用仍存在争议;一些证据表明,它们可能有助于无法戒烟的患者。补充维生素D已显示出减少急性加重的潜力,特别是在严重缺乏维生素D的患者中,尽管相互矛盾的结果需要进一步研究。此外,在2019冠状病毒病(COVID-19)大流行期间,诸如佩戴口罩和保持社交距离等防护措施因其在降低急性加重风险方面的作用而受到关注。最后,疫苗接种、饮食和营养以及无创通气对于预防AECOPD可能很重要。这些非药物方法应纳入COPD的综合管理中,以改善病情并预防AECOPD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfd/12235297/aa4b378fbc19/trd-2024-0155f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfd/12235297/57702b526894/trd-2024-0155f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfd/12235297/aa4b378fbc19/trd-2024-0155f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfd/12235297/57702b526894/trd-2024-0155f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfd/12235297/aa4b378fbc19/trd-2024-0155f2.jpg

相似文献

[1]
Non-pharmacologic Prevention of Acute Exacerbation Chronic Obstructive Pulmonary Disease.

Tuberc Respir Dis (Seoul). 2025-7

[2]
Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.

Cochrane Database Syst Rev. 2017-8-4

[3]
Vitamin D for the management of chronic obstructive pulmonary disease.

Cochrane Database Syst Rev. 2024-9-27

[4]
Sputum colour charts to guide antibiotic self-treatment of acute exacerbation of chronic obstructive pulmonary disease: the Colour-COPD RCT.

Health Technol Assess. 2025-5

[5]
Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease.

Cochrane Database Syst Rev. 2016-12-8

[6]
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Cochrane Database Syst Rev. 2021-8-9

[7]
Immunostimulants versus placebo for preventing exacerbations in adults with chronic bronchitis or chronic obstructive pulmonary disease.

Cochrane Database Syst Rev. 2022-11-14

[8]
Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease.

Cochrane Database Syst Rev. 2017-7-13

[9]
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Cochrane Database Syst Rev. 2017-5-23

[10]
Management of urinary stones by experts in stone disease (ESD 2025).

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本文引用的文献

[1]
Muscle Mass Index Decline as a Predictor of Lung Function Reduction in the General Population.

J Cachexia Sarcopenia Muscle. 2025-2

[2]
Small airways disease in chronic obstructive pulmonary disease.

Expert Rev Respir Med. 2024-7

[3]
Do pulmonary rehabilitation programmes improve outcomes in patients with COPD posthospital discharge for exacerbation: a systematic review and meta-analysis.

Thorax. 2024-4-15

[4]
Sarcopenia and its clinical correlation in elderly chronic obstructive pulmonary disease: a prospective cohort study.

Eur Rev Med Pharmacol Sci. 2023-10

[5]
Pulmonary rehabilitation for acute exacerbations of COPD: A systematic review.

Respir Med. 2023

[6]
Pulmonary Rehabilitation Is Associated With Decreased Exacerbation and Mortality in Patients With COPD: A Nationwide Korean Study.

Chest. 2024-2

[7]
Differences in hospital admissions for acute exacerbations of COPD during the COVID-19 pandemic stratified by stable-state blood eosinophil count.

Eur Respir J. 2023-10-12

[8]
Endobronchial lung volume reduction with valves reduces exacerbations in severe emphysema patients.

Respir Med. 2023-11

[9]
Low Skeletal Muscle Mass and Clinical Outcomes in Chronic Obstructive Pulmonary Disease.

Tuberc Respir Dis (Seoul). 2023-10

[10]
Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline.

Am J Respir Crit Care Med. 2023-8-15

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