Chen Yue, Ran Hong-Min, Wang Yan, Fu Dan-Dan, Yang Na-Na, Cheng Chuan-Li, Liu Rong, Luo Lu-Wen, Luo Ji-Mei, Ma Li-Na, Zeng Hui
The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Nursing School of Zunyi Medical University, Zunyi, Guizhou, China.
Front Med (Lausanne). 2025 Sep 2;12:1620577. doi: 10.3389/fmed.2025.1620577. eCollection 2025.
To evaluate the effects of a 2-week graded exercise rehabilitation program on respiratory function, exercise capacity, inflammatory markers, and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
This is a prospective randomized controlled trial aimed at evaluating the efficacy of the graded exercise rehabilitation therapy based on the GOLD guidelines in patients with AECOPD. We divided the patients into the intervention group and the control group using the random number table method, with 35 patients in each group. The control group received conventional symptomatic treatment and exercise rehabilitation, while the intervention group underwent graded exercise rehabilitation according to the GOLD guidelines, twice a day, each session lasting 30-45 min, for a total duration of 2 weeks. After the treatment, the main indicators included serum inflammatory factors and T lymphocyte subsets. Secondary indicators included exercise endurance (6MWT), disease symptom burden (CAT), dyspnea (mMRC), self-care ability (ADL), and psychological state (HADS). The hospitalization time, duration of non-invasive mechanical ventilation, and the overall incidence of related complications were also evaluated. All evaluations were conducted 2 weeks before and after the rehabilitation treatment.
Baseline characteristics were comparable between groups. Post-intervention, both groups showed significant improvements in all measured parameters ( < 0.05 vs. baseline), with superior outcomes in the intervention group: greater reductions in inflammatory markers (IL-6, IL-8, TNF-, CRP; < 0.05); more favorable immune profile (higher CD3, CD4, CD4/CD8 ratio; lower CD8; < 0.05); better functional outcomes (6MWT, mMRC, CAT, ADL, HADS; < 0.05). The duration of non-invasive ventilation, the length of hospital stay, and the incidence of complications were all reduced.
The GOLD-based graded exercise rehabilitation demonstrates superior clinical efficacy compared to conventional rehabilitation for AECOPD patients, showing significant benefits in reducing systemic inflammation, improving immune function, and enhancing physical and psychological outcomes.
评估为期2周的分级运动康复计划对慢性阻塞性肺疾病急性加重期（AECOPD）患者呼吸功能、运动能力、炎症标志物和免疫功能的影响。
这是一项前瞻性随机对照试验，旨在评估基于GOLD指南的分级运动康复治疗对AECOPD患者的疗效。我们采用随机数字表法将患者分为干预组和对照组，每组35例。对照组接受常规对症治疗和运动康复，而干预组根据GOLD指南进行分级运动康复，每天2次，每次持续30 - 45分钟，共持续2周。治疗后，主要指标包括血清炎症因子和T淋巴细胞亚群。次要指标包括运动耐力（6分钟步行试验）、疾病症状负担（CAT）、呼吸困难（mMRC）、自理能力（ADL）和心理状态（HADS）。还评估了住院时间、无创机械通气时间和相关并发症的总发生率。所有评估均在康复治疗前后2周进行。
两组基线特征具有可比性。干预后，两组所有测量参数均有显著改善（与基线相比，<0.05），干预组效果更佳：炎症标志物（IL - 6、IL - 8、TNF - 、CRP）降低更明显（<0.05）；免疫指标更优（CD3、CD4、CD4/CD8比值更高；CD8更低；<0.05）；功能结局更好（6分钟步行试验、mMRC、CAT、ADL、HADS；<0.05）。无创通气时间、住院时间和并发症发生率均降低。
与传统康复相比，基于GOLD的分级运动康复对AECOPD患者显示出更好的临床疗效，在减轻全身炎症、改善免疫功能以及提高身体和心理结局方面具有显著益处。
