锻炼，对于哮喘患者非常非常重要。

公**秋

Exercise May Improve Asthma Symptoms

作为版主，我一直不大习惯转帖，但为了跟大家一起学习，今晚见到这个帖子，务必转过来。NEW YORK (Reuters Health) Sep 07 - Asthma patients may not have to shun exercise for fear of exacerbating their symptoms, a new study suggests.
In fact, exercise could improve their symptoms and quality of life, according to research reported September 2 at the European Respiratory Society's annual conference in Vienna, Austria.
With attention to self management, increased physical activity did not worsen asthma control and in most cases was associated with improvement, said Dr. Carol Mancuso and her team at the Hospital for Special Surgery in New York City, in a presentation at the conference.

The researchers randomized 256 patients to two different exercise regimens for a 12-month period. A control group completed a survey measuring energy expenditure, promised to increase physical activity, received a pedometer and an asthma workbook, and then received bimonthly follow-up phone calls. Intervention patients received this protocol plus small gifts and instructions in fostering positive affect and self-affirmation.

"Participants chose the physical activity they wished -- there was no set protocol, "Dr. Mancuso told Reuters Health by email. "The purpose of the study was to foster adoption of lifestyle activities, that is, activities participations (they) could incorporate into their daily routines, and thus have a greater chance of being maintained over a lifetime."

"The ability to choose the physical activity probably played a role in maintaining asthma control," she said.

The main outcome of the study -- the within-patient change in energy expenditure in kilocalories per week -- was reported earlier this year in Archives of Internal Medicine. In fact, both groups of patients showed similar increases in physical activity, so for purposes of the current **ysis, the researchers pooled the results from both groups.

At baseline, 38% of the patients reported well-controlled asthma on the Asthma Control Questionnaire. After one year of increased exercise, the number had jumped to 60%.

Patients' scores on the Asthma Quality of Life Questionnaire also increased from an average of 5 at baseline to 5.9 by year's end on the seven-point scale.

On mixed effects modeling, variables linked to quality-of-life improvements included male gender, improvement in asthma symptoms, reduction in medications, less depression, and increased physical activity.

It is not clear how much the patients actually increased their physical activity, but the fact that exercise might improve asthma is impressive, said Dr. Simon Bacon, an exercise science and asthma specialist at Concordia University in Montreal, Quebec, who was not involved in the study.

"There is a dearth of data in the field, especially using non-supervised exercise programs and clinically relevant asthma measures," Dr. Bacon told Reuters Health by email. "However, some caution is needed as there was no control group and the asthma measures used are very subjective, so how much of the effect is purely placebo is unclear to me."

As for a take-home message, Dr. Mancuso said, "My recommendations to physicians and patients are that prudently selected increases in physical activity and exercise are very possible for asthma patients. Both should keep in mind that the alternative of a sedentary lifestyle carries many detrimental risks and that for most patients asthma should not be a reason to incur these risks over a lifetime."


   9月7日纽约（路透社健康频道）报道，新研究指出，哮喘患者可以不必因害怕加剧症状而避免锻炼。9月2日奥地利维也纳欧洲呼吸学会年会研究报告称，实际上，运动锻炼可能改善哮喘患者的症状和生活质量。


       纽约市特种外科医院Dr. Carol Mancuso及其研究小组在会上称，只要注意自我管理，增加体育运动不会使哮喘控制变差，在多数情况下它可以改善控制。


       研究人员随机选取256例患者参与两个不同的运动锻炼方案，历时12个月。对照组完成一份能量消耗调查问卷，答应增加体育运动，接受步数计和哮喘业务手册，然后接受两月一次的电话随访。干预组也接受上述方案，并增加小礼物及在培养积极情感和自我肯定方面给予指导。


       “参与者选择自己想要的体育运动――没有固定方案，” Dr. Mancuso在电子邮件中告诉“路透社健康频道”，“研究目的是培养他们把运动锻炼作为生活方式的一部分，也就是说，通过参与锻炼活动（他们）就可以使其成为日常习惯的一部分，因此，维持一生的概率就会更大。”


       “体育运动的选择能力可能在维持哮喘控制中起一定作用，”她说。


       研究的主要结果――患者体内能量消耗变化，以每周千卡为单位――已在今年早些时候的《内科学文献》里报告过。实际上，两组患者所增加的体育运动都差不多，所以，出于当前分析目的，研究人员将两组结果汇集在一起。


       基线时，38%患者在哮喘控制问卷中报告哮喘控制良好。增加运动锻炼一年后，这一数字上升到60%。


       患者的“哮喘生活质量问卷”分数也从基线时的平均5分上升到年末时的5.9分，总分为7分。


       在混合效应模拟中，与生活质量改善相关的变量有，男特性别、哮喘症状改善、用药减少、抑郁减轻及体育运动增加。


       并不清楚患者的体育运动实际增加了多少，但是，运动锻炼可以改善哮喘这一事实令人印象深刻，魁北克蒙特利尔康科迪亚大学运动科学和哮喘专家Dr. Simon Bacon说。她没有参与研究。


       “缺乏这方面的资料，特别是非监督性运动计划使用和临床相关哮喘测量数据方面的资料，”Dr. Bacon在电子邮件中告诉“路透社健康频道”。“不过，一定的谨慎也是需要的，因为没有对照组，所用哮喘测量数据的主观性也很强，所以，对我来说，到底有多少效应是纯安慰剂的，这一点并不清楚。”


       至于必须注意的事项，Dr. Mancuso说，“我对医生和病人的建议是，谨慎地选择性增加体育运动和锻炼，这在哮喘患者是可以允许的。医生和病人都应记住，选择久坐不动的生活方式会带来很多危害，对多数患者来说，哮喘不应成为其一生中蒙受这些风险的理由。”




临床中，现实中，很多很多哮喘病人，尤其是中年哮喘病人，严重缺乏锻炼。很多所谓的顽固性哮喘患者，比如用了舒利迭仍然不能满意控制的患者，很多时候只要早上跑跑步，1个星期就会有效果。
哮喘患者，如果能坚持长期适量运动，绝对是非常有利的。很多患者不懂这个，希望各位同仁向患者宣传这个思想。

满意治疗=药物控制+适量运动

踏**痕

回复 1# 公孙少秋


    全是英文，晕倒了，话说回来，锻炼不单单是对哮喘重要，对很多疾病都很重要，现在的人腿都懒了，到哪里都是开车坐车，很少有人走路和骑自行车了，虽然说明我们的生活水平上去了，但我们的身体水平下降了，锻炼是一剂不用花钱的良药。

公**秋

回复  公孙少秋


    全是英文，晕倒了，话说回来，锻炼不单单是对哮喘重要，对很多疾病都很重要，现在的人腿都懒了，到哪里都是开车坐车，很少有人走路和骑自行车了，虽然说明我们的生活水平上去了，但我们的身体水平下降了，锻炼是一剂不用花钱的良药。
踏雪无痕 发表于 2014-3-7 00:48

                               
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   临床上很多药物控制不满的哮喘病人，只要开始晨跑1个星期，马上就有明显不同。但很多人坚持不下去，城市的患者还好，晨跑较为方便。农村的就不大方便，患者说，怕人家笑，在农村里面跑步，别人是会说三道四的，唉，愚昧至此。

L****I

适当锻炼可以减少哮喘的发作虽然不是什么新观点，但是提出来让大家加深印象也蛮好的

公**秋

适当锻炼可以减少哮喘的发作虽然不是什么新观点，但是提出来让大家加深印象也蛮好的
LINXIANGKAI 发表于 2014-3-8 11:18

                               
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   关键是执行力。我们的经验是：适当锻炼（尤其是晨跑，最好是有适当的冷空气，当然，得随时准备万托林），不光是减少哮喘发作。大部分患者真真是效果非常明显，让我不禁觉得治疗=药物50%+晨跑50%。这似乎有点夸大其词，但只有如此方能表达我赞美晨跑的意义。

执****光

正气存内邪不可干。身体素质提高了，就算感染了病原体也不一定会发病，隐形感染和病源携带体就是最好的例子啊。生命在于运动，古人早就明白了锻炼身体的重要性了，其实大家都明白这个常识，可是能坚持的才是真懂得养生之道，做到了养生之道啊。