肺功能监测联合运动减肥对咳嗽变异性哮喘患儿症状控制的影响

doi:10.3760/cma.j.issn.1007-1245.2023.23.029

摘要/Abstract

摘要：

目的　探讨肺功能监测联合运动减肥对咳嗽变异性哮喘患儿症状控制的影响。方法　选取2020年1月至2023年1月韶关市妇幼保健院收治的100例咳嗽变异性哮喘患儿分为观察组、对照组，每组50例。观察组：男性23例、女性27例，年龄5～12（8.09±1.14）岁；对照组：男性28例、女性22例，年龄5～12（7.89±1.54）岁。对照组行常规治疗，观察组在此基础上实施肺功能监测联合运动减肥干预。评估两组临床疗效、症状评分、肺功能指标、炎症因子、预后康复效果。采用独立样本t检验、χ²检验。结果　观察组总有效率为92.00%（46/50），高于对照组的74.00%（37/50）（χ²=5.741，P=0.017）。治疗后，观察组第1秒用力呼气容积（FEV1）、达峰容积比（VPEF/VE）、达峰时间比（TPTEF/TE）均高于对照组（均P<0.05）。治疗后，观察组咳嗽、鼻塞、咽干咽痒、胸闷急促评分均低于对照组（均P<0.05）。治疗后，观察组炎症因子［超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）］水平均低于对照组（均P<0.05）。治疗后，观察组圣乔治呼吸问卷（SGRQ）评分、Borg呼吸困难评分均低于对照组，6 min步行距离（6MWD）高于对照组（均P<0.05）。结论　肺功能监测联合运动减肥对咳嗽变异性哮喘患儿干预效果良好，控制患儿症状，提高肺功能，降低炎症因子水平，促进康复。

关键词:

咳嗽变异性哮喘, 肺功能监测, 运动减肥, 症状控制, 炎症因子, 儿童

Abstract:

Objective　To study the effect of pulmonary function monitoring combined with exercise for weight loss on symptom control in children with cough-variant asthma. Methods　A total of 100 children with cough variant asthma admitted to Shaoguan Maternal and Child Health Care Hospital from January 2020 to January 2023 were divided into an observation group and a control group, with 50 cases in each group. In the observation group, there were 23 boys and 27 girls, aged 5-12 (8.09±1.14) years. In the control group, there were 28 boys and 22 girls, aged 5-12 (7.89±1.54) years. The control group was treated routinely, and the observation group was treated with pulmonary function monitoring and exercise for weight loss on the basis. The clinical efficacy, symptom score, pulmonary function indexes, inflammatory factors, and prognosis of the two groups were evaluated. Independent sample t test and χ² test were used. Results　The total effective rate of the observation group was 92.00% (46/50), which was higher than that of the control group [74.00% (37/50)] (χ²=5.741, P=0.017). After treatment, the forced expiratory volume in the first second (FEV1), peak-to-volume ratio (VPEF/VE), and peak-to-time ratio (TPTEF/TE) in the observation group were higher than those in the control group (all P<0.05). After treatment, the scores of cough, nasal congestion, dry and itchy pharynx, and chest tightness and shortness of breath in the observation group were lower than those in the control group (all P<0.05). After treatment, the levels of inflammatory factors [hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α)] in the observation group were lower than those in the control group (all P<0.05). After treatment, the score of St. George's Respiratory Questionnaire (SGRQ) and Borg dyspnea score in the observation group were lower than those in the control group, and the 6-min walking distance (6MWD) was higher than that in the control group (all P<0.05). Conclusion　Pulmonary function monitoring combined with exercise for weight loss is a good intervention for children with cough variant asthma, which can control the children's symptoms, improve the lung function, reduce the levels of inflammatory factors, and promote the rehabilitation.

Key words:

Cough variant asthma, Pulmonary function monitoring, Exercise for weight loss, Symptom control, Inflammatory factors, Children

谭志勇.

肺功能监测联合运动减肥对咳嗽变异性哮喘患儿症状控制的影响 [J]. 国际医药卫生导报, 2023, 29(23): 3453-3456.

Tan Zhiyong.

Effect of pulmonary function monitoring combined with exercise for weight loss on symptom control in children with cough-variant asthma [J]. International Medicine and Health Guidance News, 2023, 29(23): 3453-3456.

参考文献

[1] 王钇杰,刘璐佳,王有鹏.基于"精准医学"探讨寒地儿科王有鹏治疗小儿咳嗽变异性哮喘的经验[J].中国医药导报,2023,20(15):141-145. DOI:10.20047/j.issn1673-7210. 2023.15.31.
[2] Wu P, Wang Y, Ye Y, et al. Serum fetuin-A and risk of gestational diabetes mellitus: an observational study and mendelian randomization analysis[J]. J Clin Endocrinol Metab, 2022, 107(9):e3841-e3849. DOI: 10.1210/clinem/dgac335.
[3] 王志刚,申改青,黄玉焕.咳嗽变异性哮喘患儿外周血miR-138及RUNX3对Th1/Th2平衡的调节作用[J].中国当代儿科杂志,2021,23(10):1044-1049. DOI:10.7499/j.issn.1008-8830.2107029.
[4] 周炳文,王莎莎,颜世军.三药联合治疗对咳嗽变异性哮喘患儿免疫功能和气道炎症因子水平及肺功能的影响[J].中国医药,2022,17(2):200-204. DOI:10.3760/j.issn.1673- 4777.2022.02.010.
[5] Lin X, Sun Y, Yang S, et al. Omentin-1 modulates macrophage function via integrin receptors αvβ3 and αvβ5 and reverses plaque vulnerability in animal models of atherosclerosis[J]. Front Cardiovasc Med, 2021, 8:757926. DOI: 10.3389/fcvm.2021.757926.
[6] 蒋珊,严正平,王燕.中医揿针疗法联合呼吸功能训练对咳嗽变异性哮喘患者症状控制及生活质量的影响[J].中外医学研究,2022,20(17):5-8. DOI:10.14033/j.cnki.cfmr.2022. 17.002.
[7] 严有敏,班克创,赵日婵.肺功能检测鉴别小儿哮喘和咳嗽变异性哮喘的价值[J].深圳中西医结合杂志,2021,31(7):113-114. DOI:10.16458/j.cnki.1007-0893.2021.07.055.
[8] 中华医学会变态反应分会呼吸过敏学组(筹),中华医学会呼吸病学分会哮喘学组.中国过敏性哮喘诊治指南(第一版,2019年)[J].中华内科杂志,2019,58(9):636-655. DOI:10.3760/cma.j.issn.0578-1426.2019.09.004.
[9] 中华医学会呼吸病学分会哮喘学组.胸闷变异性哮喘诊治中国专家共识[J].中华医学杂志,2023,103(34):2662-2673. DOI:10.3760/cma.j.cn112137-20230704- 01143.
[10] 陈翠仪,吴雷,陈美华.咳嗽变异性哮喘、咳嗽优势性哮喘、典型哮喘临床特征及肺功能对比研究[J].重庆医学,2021,50(20):3474-3477. DOI:10.3969/j.issn.1671-8348.2021. 20.012.
[11] 黄娆,郑光强,陈江,等.支气管激发试验联合基础肺功能检查辅助用于咳嗽变异性哮喘患儿诊断价值研究[J].临床军医杂志,2022,50(1):78-80. DOI:10.16680/j.1671-3826. 2022.01.24.
[12] 毛林林.小儿咳嗽变异性哮喘采用孟鲁司特钠治疗对肺功能指标的影响分析[J].中国现代药物应用,2021,15(20):113-116. DOI:10.14164/j.cnki.cn11-5581/r.2021.20.044.
[13] 赵娟丽,张会侠,刘建军.匹多莫德联合孟鲁司特钠/布地奈德/福莫特罗对儿童咳嗽变异性哮喘肺功能及气道炎症的影响[J].海南医学,2021,32(5):603-606. DOI:10.3969/j.issn.1003-6350.2021.05.017.
[14] 张秀霞.探讨肺功能检测在小儿哮喘和咳嗽变异性哮喘中的价值[J].世界复合医学,2021,7(3):77-79. DOI:10.11966/j.issn.2095-994X.2021.07.03.25.
[15] Gulen ST, Eryilmaz U, Yilmaz M, et al. Left ventricular dysfunction in relation with systemic inflammation in chronic obstructive pulmonary disease patients[J]. Korean J Intern Med, 2019, 34(3):569-578. DOI: 10.3904/kjim.2017.366.
[16] 蒋国路,陈小菊,蒋莉,等.呼出气一氧化氮联合肺功能及外周血嗜酸性粒细胞比例检测在咳嗽变异性哮喘诊断中的价值[J].解放军医学杂志,2022,47(5):486-492. DOI:10.11855/j.issn.0577-7402.2022.05.0486.