| 艾钰,姜林鸿,刘博雅,张佳驰,李培君,段宏霞,何宇辰,刘晓丹.体外膈肌起搏及其联合疗法治疗慢性阻塞性肺疾病的研究进展[J].中国康复,2026,41(3):172-176 |
| 体外膈肌起搏及其联合疗法治疗慢性阻塞性肺疾病的研究进展 |
| Research progress of external diaphragm pacing and its combination therapy in the treatment of chronic obstructive pulmonary disease |
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| DOI：10.3870/zgkf.2026.03.009 |
| 中文关键词: 体外膈肌起搏 慢性阻塞性肺疾病 联合疗法 |
| 英文关键词: external diaphragm pacing chronic obstructive pulmonary disease combination therapy |
| 基金项目:国家自然科学基金(82372573、82072551)；上海市卫生健康委员会卫生健康学科带头人项目（2022XD044）；上海市“超级博士后”资助项目（2022510） |
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| 中文摘要: |
| 慢性阻塞性肺疾病（COPD）是一种以持续性气流受限和进行性呼吸困难为主要特征的慢性呼吸系统疾病，全球发病率持续上升，已成为严重的公共卫生问题。现有治疗主要依赖药物干预，但在改善呼吸肌功能和提升生活质量方面效果有限，亟需探索新的非药物治疗策略。本文旨在系统综述体外膈肌起搏（EDP）在COPD管理中的研究进展，重点评估其独立应用及联合干预的临床效果与潜在机制，为临床提供新的治疗思路与循证依据。系统检索PubMed、Web of Science、CNKI数据库中2019~2025年间发表的相关中英文文献，筛选关键词包括“体外膈肌起搏”、“慢性阻塞性肺疾病”、“联合治疗”等，归纳EDP的应用现状与研究成果。EDP通过经皮电刺激膈神经，增强膈肌收缩功能，改善肺功能指标（如第1秒用力呼气量、用力肺活量）、调节呼吸驱动和优化通气-血流比例，从而提升运动耐力和生活质量。与肺康复、无创通气、中医传统功法等联合应用具有协同增效作用，有助于增强呼吸肌耐力、减少住院率、改善心理状态等。但其临床应用仍存在参数个体化设定、长期疗效评估和成本效益分析等挑战。EDP作为一种前景广阔的非药物干预手段，在COPD治疗中显示出良好潜力。未来应加强基础机制研究，优化联合干预策略，并开展高质量、多中心的随机对照试验，推动其规范化和个体化临床应用。 |
| 英文摘要: |
| Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by persistent airflow limitation and progressive dyspnea. Its global incidence continues to rise and has become a serious public health problem. Existing treatments mainly rely on drug interventions, but they are limited in improving respiratory muscle function and improving quality of life. It is urgent to explore new non-drug treatment strategies. This article aims to systematically review the research progress of external diaphragmatic pacing (EDP) in the management of COPD, focusing on evaluating its clinical effects and potential mechanisms of independent application and combined intervention, and providing new treatment ideas and evidence-based basis for clinical practice. Relevant Chinese and English literature published in PubMed, Web of Science, and CNKI databases from 2019 to 2025 were systematically searched, and keywords including “external diaphragmatic pacing”, “chronic obstructive pulmonary disease”, “combined therapy” were screened to summarize the application status and research results of EDP. EDP can enhance diaphragmatic contraction function, improve lung function indicators (such as FEV1, FVC), regulate respira-tory drive, and optimize ventilation-perfusion ratio through transcutaneous electrical stimulation of the phrenic nerve, thereby improving exercise endurance and quality of life. Combined with pulmonary rehabilitation, non-invasive ventilation, traditional Chinese medicine exercises, etc., it has a synergistic effect, which helps to enhance respiratory muscle endurance, reduce hospitalization rate, improve psychological state, etc. However, its clinical application still faces challenges such as individualized parameter setting, long-term efficacy evaluation and cost-effectiveness analysis. EDP, as a promising non-drug intervention, shows good potential in the treatment of COPD. In the future, we should strengthen the basic mechanism research, optimize the combined intervention strategy, and carry out high-quality, multi-center randomized controlled trials to promote its standardized and individualized clinical application. |
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