生活方式干预对儿童肥胖型哮喘的治疗效果评估

The therapeutic effect of lifestyle intervention on obese asthma in children

目的评估运用生活方式综合干预对儿童肥胖型哮喘的治疗效果。方法选取2016年6月~2017年5月在厦门大学附属妇女儿童医院儿科收治的70例肥胖哮喘患儿,经生活方式综合干预12周,比较干预前后的身体成分、肺功能与症状改善程度。结果干预后体重(52.2±4.8)kg、BMI(25.1±1.5)kg/m2、腰围(74.4±5.6)cm、脂肪重(15.3±2.4)kg和体脂率(29.3±3.1)%均比干预前[(55.7±4.9)kg;(27.1±1.4)kg/m2;(80.7±6.7)cm;(18.7±2.4)kg;(33.9±2.3)%]减少,差异有统计学意义(P<0.05);干预前后肌肉重量无明显变化,差异无统计学意义(P>0.05);干预后用力肺活量(FVC)(2.07±0.30)L、用力呼气流量(PEFR)(2.65±0.31)L/s及第1秒用力呼气容积(FEV1)(1.54±0.19)L均比干预前[(1.40±0.35)L;(2.39±0.12)L/s;(1.33±0.18)L]增加,差异有统计学意义(P<0.05)。70例患儿经生活方式干预,在哮喘症状的改善方面,显效20例,有效32例,无效18例,总有效率74.2%(52/70)。结论生活方式的综合干预能有效地进行患儿体重管理,改善肺功能,促进症状改善,值得推广。

Objective To evaluate the therapeutic effect of comprehensive lifestyle intervention on obese asthma in children.Methods 70 children with obese asthma were selected from the Department of Pediatrics in Women and Children’s Hospital Affiliated to Xiamen University from June 2016 to May 2017.They were given comprehensive lifestyle intervention for 12 weeks.Body composition,pulmonary function and improvement of symptoms were compared before and after intervention.Results After intervention,the body weight,BMI,waist circumference,fat weight and body fat rate were lower than those before intervention,with the statistically significant difference[(52.2±4.8)kg vs(55.7±4.9)kg,(25.1±1.5)kg/m2 vs(27.1±1.4)kg/m2,(74.4±5.6)cm vs(80.7±6.7)cm,(15.3±2.4)kg vs(18.7±2.4)kg,(29.3±3.1)%vs(33.9±2.3)%,P<0.05].There was no significant difference in muscle weight before and after intervention(P>0.05).After intervention,forced vital capacity(FVC),forced expiratory flow(PEFR)and forced expiratory volume(FEV1)were all higher than those before intervention[(2.07±0.30)L vs(1.40±0.35)L,(2.65±0.31)L/s vs(2.39±0.12)L/s,(1.54±0.19)L vs(1.33±0.18)L,P<0.05].In the improvement of asthma symptoms,20 cases were markedly effective,32 cases were effective and 18 cases were ineffective.The total effective rate was 74.2%(52/70).Conclusion The comprehensive lifestyle intervention can effectively manage the weight of children,improve lung function,and promote the improvement of symptoms,which is worthy of promotion.