The Efficacy of Pranayama in COPD

调息法对慢性阻塞性肺病的疗效

• 批准号: 8282238
• 负责人: David A Kaminsky
• 金额: $ 21.4万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8282238
• 关键词: Address; Adrenal Cortex Hormones; Adverse effects; Air; Anxiety; Breathing; Breathing Exercises; Bronchodilator Agents; Cause of Death; Chronic Obstructive Airway Disease; Clinical; Controlled Clinical Trials; Data; Disease; Double-Blind Method; Dyspnea; Education; Educational process of instructing; Effectiveness; Erythrocytes; Exercise; Exercise Tolerance; Exhalation; Functional disorder; Future; Glutathione; Health; Hydrogen Peroxide; Inflammation; Inspiratory Capacity; Interleukin-6; Intervention; Learning; Lip structure; Lung; Measures; Mechanics; Methods; Multicenter Trials; Outcome; Outcome Measure; Oxidative Stress; Participant; Patients; Pattern; Performance; Plasma; Proteins; Psychological Stress; Quality of life; Questionnaires; Randomized; Randomized Clinical Trials; Rehabilitation therapy; Research; Respiratory System; Role; Serum; Shortness of Breath; Site; Stress; Symptoms; Techniques; Testing; Time; Training; Walking; Width; Yoga; abstracting; clinical research site; control trial; design; electric impedance; group intervention; improved; indexing; insight; isoprostaglandin F2alpha type-III; pranayama; respiratory; treatment as usual

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, and is currently the third leading cause of death in the United Sates. Patients with COPD mainly complain of shortness of breath with daily activities and exercise. A key mechanism of dyspnea is dynamic hyperinflation, or air trapping, which results from the severe airflow limitation that characterizes the disease. Inhaled bronchodilators and corticosteroids may help, but these therapies are expensive and may have side effects. Pulmonary rehabilitation is very effective at reducing dyspnea and improving exercise tolerance, but it is not widely available to patients. We propose studying the effect of a simple breathing exercise known as pranayama, or yogic breathing. Our hypothesis is that the practice of pranayama will improve exercise tolerance in patients with COPD. We believe that the mechanisms involved will include reduced dynamic hyperinflation as well as beneficial effects on lung mechanics, inflammation and oxidative stress. This hypothesis will be tested in a randomized, double blind, controlled trial of pranayama vs. usual care (education) in COPD patients. In Specific Aim 1, we will determine the effect of pranayama on exercise tolerance as measured by 6 min walk distance; in Specific Aim 2, we will determine the effect of pranayama on dynamic hyperinflation as measured by changes in inspiratory capacity before and after exercise; and in Specific Aim 3, we will determine the effect of pranayama on oxidative stress (exhaled breath H202, 8-isoprostane, glutathione), systemic inflammation (serum c-reactive protein, interleukin-6, glutathione and red cell distribution width), dyspnea level (Borg scale, MRC scale, BDI/TDI, CRQ), the BODE index, and quality of life (St. George Respiratory Questionnaire). The study is designed to be applicable to a wide variety of clinical settings, since it will involve two diverse clinical sites (Burlington, VT and Houston, TX), require minimal direct intervention, and engage participants in self- learning and practice. The data from this study will provide fundamental new insights into the mechanisms of action of pranayama, and will be critical in designing a large, multicenter trial to test the effectiveness of pranayama in patients with COPD. PUBLIC HEALTH RELEVANCE: Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, and patients mainly suffer from severe shortness of breath with exercise. This study will investigate the effects of the practice of the yogic breathing method pranayama on exercise tolerance in patients with COPD. This intervention may prove to be an important adjunct to COPD therapy, since it is simple, inexpensive, and widely available. (End of Abstract)

描述（由申请人提供）： 慢性阻塞性肺部疾病（COPD）是全球主要的健康问题，目前是联合国患者的第三大死亡原因。患有COPD的患者主要抱怨日常活动和运动呼吸急促。呼吸困难的关键机制是动态过度充气或空气捕获，这是由于疾病的严重气流限制而产生的。吸入的支气管扩张剂和皮质类固醇可能会有所帮助，但是这些疗法很昂贵，可能会产生副作用。肺部康复非常有效地减少呼吸困难和改善运动耐受性，但对患者并未广泛使用。我们建议研究一种称为pranayama或瑜伽呼吸的简单呼吸运动的效果。我们的假设是，pranayama的实践将提高COPD患者的运动耐受性。我们认为，涉及的机制将包括减少动态性过度充电以及对肺部力学，炎症和氧化应激的有益作用。该假设将在COPD患者的Pranayama与常规护理（教育）的随机，双盲，对照试验中进行检验。在特定目标1中，我们将确定pranayama对运动耐受性的影响，如6分钟步行距离所测量；在特定的目标2中，我们将确定pranayama对运动前后的吸气能力的变化来衡量的pranayama对动态过度充电的影响； and in Specific Aim 3, we will determine the effect of pranayama on oxidative stress (exhaled breath H202, 8-isoprostane, glutathione), systemic inflammation (serum c-reactive protein, interleukin-6, glutathione and red cell distribution width), dyspnea level (Borg scale, MRC scale, BDI/TDI, CRQ), the BODE index, and quality of life （圣乔治呼吸问卷）。该研究旨在适用于多种临床环境，因为它将涉及两个不同的临床部位 （伯灵顿，弗吉尼亚州和德克萨斯州休斯顿）需要最少的直接干预，并让参与者参与自我学习和实践。这项研究的数据将提供基本的新见解 Pranayama的作用机制，对于设计大型多中心试验至关重要 测试pranayama在COPD患者中的有效性。 公共卫生相关性： 慢性阻塞性肺疾病（COPD）是全球主要的健康问题，患者主要遭受运动呼吸急促。这项研究将研究瑜伽呼吸方法Pranayama对COPD患者运动耐受性的实践的影响。由于简单，便宜且广泛使用，因此这种干预可能被证明是COPD治疗的重要辅助。 （抽象的结尾）