Sutton P P, Pavia D, Bateman J R, Clarke S W
Eur J Respir Dis. 1982 May;63(3):188-201.
Postural drainage enhances mucociliary clearance and produces larger sputum volumes than an equivalent control period in disease characterised by excessive tracheobronchial secretions. Postural drainage, percussion and vibration will improve pulmonary function only in patients with large sputum volumes. There is no evidence that sputum yield is increased by the addition of percussion and vibration. From radioaerosol studies effective cough is limited to central airways. Breathing exercises may be of some immediate value in asthma but are without long term advantages and probably do not alter the ventilation of the underlying lung. IPPB probably does not improve delivery of bronchodilators and is of no benefit (and possible harmful) in the long term treatment of chronic bronchitis. Infective exacerbations of chronic bronchitis not characterised by copious volumes of sputum, uncomplicated pneumonia and routine post-operative states are not indications for chest physiotherapy. The value of regular physiotherapy on ventilation, gas exchange, work of breathing and incidence of infective exacerbations is uncertain but exercise training and rehabilitation of chronic obstructive airways disease improves exercise tolerance and mobility.
在以气管支气管分泌物过多为特征的疾病中，体位引流可增强黏液纤毛清除功能，且比同等对照期咳出更多痰液。体位引流、叩击和振动仅在痰液量多的患者中能改善肺功能。没有证据表明增加叩击和振动会增加痰液排出量。放射性气溶胶研究表明，有效的咳嗽仅限于中央气道。呼吸锻炼对哮喘可能有一些即时价值，但没有长期益处，可能也不会改变肺部的通气情况。间歇性正压通气可能不会改善支气管扩张剂的输送，对慢性支气管炎的长期治疗没有益处（且可能有害）。慢性支气管炎感染性加重但痰液量不多、无并发症的肺炎以及常规术后状态均不是胸部物理治疗的指征。定期进行物理治疗对通气、气体交换、呼吸功和感染性加重发生率的价值尚不确定，但慢性阻塞性气道疾病的运动训练和康复可提高运动耐力和活动能力。
