高强度间歇运动和中等强度持续运动在儿童哮喘管理中的作用

Effects of High-Intensity Interval Training and Moderate-Intensity Continuous Training on Management of Asthmatic Children

目的:对比8周高强度间歇运动(HIT)和中等强度持续运动(MCT)对哮喘儿童疾病控制以及肺功能、运动能力、炎症反应和生长因子的影响,探讨不同运动方式在哮喘管理中的作用。方法:41名轻、中度哮喘儿童分为MCT组(n=14)、HIT组(n=15)以及对照(C)组(n=12)。HIT组以90%最大有氧功率(MAP)进行间歇训练(蹬车30 s,休息1 min,重复4次为1组,共4组,组间间歇4 min),3次/周;MCT组以50%MAP持续蹬车40 min,4次/周;C组保持原有的生活习惯;实验周期为8周。实验前后分别利用哮喘控制问卷(ACQ-6)监测疾病控制水平,记录受试者参加运动的情况以及运动时的不良反应。结果:1)实验后组内与实验前比较,各组肺功能参数、外周血白细胞及其分类计数、血清炎症因子、血清生长因子和Fe NO均无显著性变化(P>0.05);MCT组和HIT组ACQ-6得分降低(P<0.05),6MWT距离增加(P<0.05),6MWT后RPE、SBP、DBP和HR下降(P<0.05),C组各指标均无显著性变化(P>0.05)。实验后组间与C组比较,MCT组和HIT组ACQ-6得分降低(P<0.05),6MWT距离增加(P<0.05),6MWT后RPE、SBP、DBP和HR下降(P<0.05),但各指标在MCT组和HIT组间并无显著性差异(P>0.05)。2)MCT组运动总时间和总做功分别是HIT组的6.7倍和3.1倍,MCT组和HIT组不良反应率分别为3.8%和3.3%。结论:8周HIT或MCT均可改善轻、中度哮喘儿童临床控制和运动能力,但对肺功能、炎症反应和生长因子含量无显著性影响,且不同运动方式的作用效果类似。HIT具有安全、省时、有效等特点。

Objective： This study aimed at comparing the effects of high-intensity interval training（ HIT） and moderate-intensity continuous training（ MCT） on asthma control as well as pulmonary function,exercise capacity,inflammatory reaction and growth factors in asthmatic children,and investigating the role of different exercise mode in asthma management. Methods： Forty-one children with mild or moderate asthma were divided into moderate intensity continuous training group（ MCT,n = 14）,high-intensity interval training group（ HIT,n = 15） and control group（ C,n = 12）. HIT group performed four sessions of HIT（ 4 × 30 s cycling bouts eliciting 90% maximal aerobic power（ MAP）,interspersed with 60 s rest,4 sets interspersed with 4 min） over 8 weeks,3 times/week; MCT group performed 40 min cycling at 50 % MAP over 8 weeks,4 times/week; C group maintained their original life habits. Before and after experiment,the level of asthma control was tested by Asthma Control Questionnaire（ ACQ-6）,and subjects＇ participation in physical activity and adverse reaction during exercise were recorded. Results： 1） Compared with baseline,pulmonary function,peripheral blood leucocyte and its classification and counting,inflammatory factors,growth factors and Fe NO didn＇t change（ P 0. 05） in all groups after experiment; in MCT and HIT groups,ACQ-6 scores reduced（ P 0. 05）,distance of 6MWT increased（ P 0. 05）,RPE,SBP,DBP and HR after 6MWT decreased（ P 0. 05）; all parameters in C group had no significant change（ P 0. 05）. Compared with C group after test,ACQ-6 scores reduced（ P 0. 05）,distance of 6MWT increased（ P 0. 05）,RPE,SBP,DBP and HR after 6MWT decreased（ P 0. 05） in MCT and HIT groups,and there are no significant differences between MCT and HIT groups（ P 0. 05）. 2） Exercise duration and energy expenditure of MCT group were 6. 7 and 3. 1 times higher than those of HIT group,and the rate of adverse reaction in MCT and HIT group was 3. 8% and 3. 3% respectively. Conclusion： Both 8 weeks HIT and MCT can improve clinical management and exercise capacity of children with mild or moderate asthma,but cannot improve pulmonary function,inflammatory reaction and growth factors; both exercise programs have similar effect. HIT has characteristic of safety,time-efficiency and effectiveness. HIT is safety,saving time and efficiency.