运动对慢性阻塞性肺疾病系统性炎症和骨骼肌功能障碍干预效果的系统综述

doi:10.3969/j.issn.1006-9771.2021.12.010

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (12): 1443-1449.doi: 10.3969/j.issn.1006-9771.2021.12.010

运动对慢性阻塞性肺疾病系统性炎症和骨骼肌功能障碍干预效果的系统综述

杨肇宇¹,李培君¹,李健¹,刘晓丹²,吴卫兵¹()

1. 上海体育学院运动科学学院,上海市 200438
2. 上海中医药大学康复医学院,上海市 201203

收稿日期:2021-07-26 修回日期:2021-11-09 出版日期:2021-12-25 发布日期:2021-12-29
通讯作者: 吴卫兵 E-mail:wwb75@126.com
作者简介:杨肇宇(1994-),男,汉族,浙江衢州市人,硕士研究生,主要研究方向：运动心肺康复。
基金资助:
国家自然科学基金项目(81902307);国家自然科学基金项目)(82072551)

Effect of Exercise on Chronic Obstructive Pulmonary Disease Systemic Inflammation and Skeletal Muscle Dysfunction: A Systematic Review

YANG Zhao-yu¹,LI Pei-jun¹,LI Jian¹,LIU Xiao-dan²,WU Wei-bing¹()

1. School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
2. School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Received:2021-07-26 Revised:2021-11-09 Published:2021-12-25 Online:2021-12-29
Contact: WU Wei-bing E-mail:wwb75@126.com
Supported by:
National Natural Science Foundation of China(81902307);National Natural Science Foundation of China(82072551)

摘要/Abstract

摘要：

目的系统综述运动对慢性阻塞性肺疾病(COPD)系统性炎症及骨骼肌功能障碍的干预效果。方法检索建库至2021年6月PubMed、Web of Science、CNKI、维普和万方数据,运动对COPD系统性炎症及骨骼肌功能障碍干预效果的相关文献,并辅以参考文献回溯和手工检索。提取文献内容,对运动改善COPD系统性炎症及骨骼肌功能障碍的效果进行综述。结果共检索到文献192篇,最终纳入8篇,245例被试。运动可以降低促炎因子水平,提高抗炎因子水平;提高COPD患者运动能力,改善骨骼肌结构。运动改善COPD系统性炎症与运动方式、强度以及持续时间有关,可能通过调控炎症反应,影响泛素-蛋白酶、胰岛素样生长因子1/磷脂酰肌醇-3-激酶/Akt等途径,改善骨骼肌功能障碍。结论运动对降低COPD系统性炎症水平、改善骨骼肌功能障碍具有一定效果。

关键词: 慢性阻塞性肺疾病, 骨骼肌功能障碍, 系统性炎症, 运动, 系统综述

Abstract:

Objective To systematically review the effects of exercise on systemic inflammation of chronic obstructive pulmonary disease (COPD) and skeletal muscle dysfunction.Methods The literature about the effect of exercise on COPD systemic inflammation and skeletal muscle dysfunction were retrieved from PubMed, Web of Science, CNKI, VIP and Wanfang data, until June, 2021, supplemented by reference review and manual retrieval.Results A total of 192 literatures were retrieved and eight were included, involving 245 subjects. The comprehensive results showed that exercise could decrease the level of pro-inflammatory factors and increase the level of anti-inflammatory factors. Exercise can improve the motor ability and skeletal muscle structure of patients with COPD. Exercise can improve systemic inflammation of COPD, which is related to the mode, intensity and duration of exercise. Exercise may affect ubiquitin-protease, insulin-like growth factors -1/phosphatidylinositol 3 kinase/Akt and other pathways by regulating the inflammatory response, and improve skeletal muscle dysfunction.Conclusion Exercise has certain effect on reducing systemic inflammation and improving skeletal muscle dysfunction.

Key words: chronic obstructive pulmonary disease, skeletal muscle dysfunction, systemic inflammation, exercise, systematic review

中图分类号:

R562.2

杨肇宇,李培君,李健,刘晓丹,吴卫兵. 运动对慢性阻塞性肺疾病系统性炎症和骨骼肌功能障碍干预效果的系统综述[J]. 《中国康复理论与实践》, 2021, 27(12): 1443-1449.

YANG Zhao-yu,LI Pei-jun,LI Jian,LIU Xiao-dan,WU Wei-bing. Effect of Exercise on Chronic Obstructive Pulmonary Disease Systemic Inflammation and Skeletal Muscle Dysfunction: A Systematic Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(12): 1443-1449.

图/表 2

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表1

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研究文献	n (T/C)	运动方式	运动方案	系统性炎症结局指标	骨骼肌功能及结构结局指标
孙丽等^[35] (2016)	26/25	有氧运动	每次60 min,每天1次,每周4~5 d,共12周	CRP、TNF-ɑ下降;IL-6、Fbg无显著性差异	6分钟步行试验增加
Toledo-Arruda等^[30](2017)	24/24	有氧运动	每次30 min,每天2次,每周5 d,共12周	TNF-α下降;IL-10升高	最大运动速度、运动耐力增加
Menon等^[36] (2012)	17/10	抗阻运动	每组30次,每天5组,每周3 d,共8周	中性粒细胞、CD₁₆₃⁺减少	Ⅱ型肌纤维横截面积、肌卫星细胞增加
Silva等^[31] (2018)	24/11	抗阻运动	每次60 min,每周3次,共12周	IL-6、TNF-α、IL-15下降;IL-10无显著性差异	屈肘、伸膝肌肌力增加
Troosters等^[37](2010)	20(前后对照)	抗阻运动	每次3组,每天8次,共7 d	CRP无显著性差异	股四头肌肌力、6分钟步行试验距离增加;Myogenin mRNA降低;IGF-1、MURF-1、MGF、MyoD、Atrogin-1蛋白表达无显著性差异
Krüger等^[28] (2018)	10/10	高强度间歇运动	每次30 min,每周5次,共8周	IL-1β、TNF-α下降	肌纤维横截面积、Ⅰ型纤维相对比例、IGF-1蛋白表达增加;Atrogin-1、MURF-1 mRNA降低
Vogiatzis等^[20] (2007)	15(前后对照)	高强度间歇运动	每天45 min,每周3 d,共10周	TNF-ɑ、IL-6无显著性差异	肌纤维横截面积,MyoD、IGF-1、MGF mRNA,MyoD、IGF-1蛋白表达增加
Vogiatzis等^[38] (2010)	正常体质量组(n = 19);低体质量组(n = 10)	高强度间歇运动	每天45 min,每周3 d,共10周	TNF-ɑ、IL-6无显著性差异	正常体质量组： Atrogin-1、MURF-1蛋白表达,Ⅱb型纤维占比降低; MyoD、IGF-1蛋白表达增加。低体质量组： Atrogin-1、MURF-1、MyoD、IGF-1蛋白表达增加; Ⅱb型纤维占比降低

运动对慢性阻塞性肺疾病系统性炎症和骨骼肌功能障碍干预效果的系统综述

Effect of Exercise on Chronic Obstructive Pulmonary Disease Systemic Inflammation and Skeletal Muscle Dysfunction: A Systematic Review

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