Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature.
Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature.
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DOI：
10.1097/00008483-200201000-00002
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发表时间：
2002-01-01
期刊：
影响因子：
--
通讯作者：
Hernandez, Edgar D
中科院分区：
文献类型：
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作者：
Cahalin, Lawrence P;Braga, Malinda;Hernandez, Edgar D
横膈呼吸（DB）作为慢性阻塞性肺病患者辅助治疗方式的证据基础是值得怀疑的。本文回顾了有关DB在慢性阻塞性肺疾病（COPD）患者中的疗效的文献，并报道了DB在COPD患者中的有益和有害影响。横膈膜呼吸被描述为主要用横膈膜呼吸，同时尽量减少辅助吸气的附属肌肉的活动。没有单一或综合的患者特征被一致地确定来帮助预测哪些COPD患者可能受益于DB。然而，有研究表明，中度至重度慢性阻塞性肺病患者，肺明显过度膨胀，膈肌运动不充分，肺活量增加，可能不适合进行肺活学指导。相反，慢性阻塞性肺病患者呼吸频率升高，低潮气量在DB期间增加，动脉血气异常，膈肌运动充足，可能受益于DB。在DB期间或之后识别腹部矛盾呼吸模式和恶化的呼吸困难和疲劳是修改或终止DB的标准。慢性阻塞性肺病患者在DB期间表现出腹部矛盾，可能受益于更直立的身体姿势或躯干弯曲。我们将讨论几种检查膈肌运动的方法和成功诊断膈肌的可能性。未来的研究需要更好地确定哪些患者可能受益于DB。
The evidence base for diaphragmatic breathing (DB) as an adjunctive treatment modality for persons with COPD is questionable. This article reviews the literature regarding the efficacy of DB in persons with chronic obstructive pulmonary disease (COPD), and reports on the beneficial and detrimental effects of DB in persons with COPD. Diaphragmatic breathing has been described as breathing predominantly with the diaphragm while minimizing the action of accessory muscles that may assist with inspiration. No single or combined patient characteristic has been identified consistently to help predict which person with COPD may benefit from DB. However, it has been suggested that persons with moderate to severe COPD and marked hyperinflation of the lungs without adequate diaphragmatic movement and increase in tidal volume during DB may be poor candidates for instruction in DB. Conversely, persons with COPD who have elevated respiratory rates, low tidal volumes that increase during DB, and abnormal arterial blood gases with adequate diaphragmatic movement may benefit from DB. Identification of an abdominal paradoxical breathing pattern and worsening dyspnea and fatigue during or after DB are criteria to modify or terminate DB. Persons with COPD demonstrating an abdominal paradox during DB may benefit from a more upright body position or trunk flexion. Several methods to examine diaphragmatic movement and the potential for success with DB will be discussed. Future research is needed to better identify which patients may benefit from DB.