| Objective:To explore the effect of limb linkage training on lung rehabilitation and TRX/TXNIP antioxidative mechanism in patients with chronic obstructive pulmonary disease(COPD),thus providing new programs and ideas for pulmonary rehabilitation and its mechanism in patients with COPD.Method:1.Sixty-six patients with stable COPD were evenly divided into control group(Group A),lower limb exercise training group(Group B)and limb linkage training group(Group C),with 22 patients in each group.On the basis of medical treatment for COPD patients,the patients of Group A had the daily activities;In the case of daily activities,the patients of Group B and C received respectively 30 minutes of lower limb exercise training and limb linkage training twice a week,lasting 8 weeks.2.Pulmonary function,dyspnea degree(mMRC score,Borg score),health-related quality of life(CAT score),exercise endurance(6MWD)and BODE index of the three groups were respectively evaluated before and after intervention;TRX and TXNIP protein expression in peripheral blood plasma were detected by ELISA;TRX and TXNIP mRNA expression levels in peripheral blood mononuclear cells(PBMCs)were detected by real-time PCR.Results:1.Assessment related to pulmonary rehabilitation(1)Lung function assessment:? FEV1/FVC(%):Before intervention,group A(50.46±16.37)%,group B(44.03±10.16)%,group C(46.60±11.49)%;after intervention,group A(51.03±14.72)%,group B(47.22±8.58)%,group C(47.62±11.55)%.After intervention,the FEV1/FVC(%)of the three groups had no significant changes compared to that before intervention,and the difference was not statistically significant(.P>0.05);through comparison among groups,there was no significant difference in FEV1/FVC(%)among groups after intervention(P>0.05).?FEV1%pred:Before intervention,group A(39.51 ± 14,47)%,group B(35.74±13.55)%,group C(42.79±12.34)%;after intervention,group A(40.62±13.28)%,group B(36.06±12.66)%,group C(43.71 ± 13.73)%.After intervention,the FEV1%pred of the three groups had no significant changes compared to that before intervention,and the difference was not statistically significant(P>0.05);Comparing among groups,there was no significant difference in FEV1/FVC(%)among groups after intervention(P>0.05).(2)Dyspnea degree assessment:?mMRC score:mMRC scores of Groups B and C after intervention(1.90±0.31,1.15 ±0.37)were lower than those before intervention(2.85 ± 0.37,2.85 ± 0.37),and the difference was statistically significant(P<0.05);through comparison among groups,the mMRC scores of groups B and C after intervention(1.90±0.31,1.15±0.37)were lower than that of Group A(2.65±0.49).Compared with that of Group B,the mMRC score of Group C was lower(Group C<Group B<Group A).The difference was statistically significant(P<0.05).?Borg score:the Borg scores of Groups B and C after intervention(4.05±0.39,3.25± 0.64)were lower than those before intervention(5.90±0.64,5.80± 0.41),and the difference was statistically significant(P<0.05);Compared among groups,the Brog scores of Groups B and C after intervention(4.05±0.39,3.25±0.64)were lower than that of group A(5.75±0.44).Compared with that of Group B,the Brog score of Group C was lower(group C<group B<group A).The difference was statistically significant(P<0.05).(3)Health-related quality of life assessment(CAT score):After intervention,CAT scores of Group B and Group C(17.05±1.28,13.55±2.33)were both lower than that before intervention(20.35±1.04,20.00±1.18),and the difference was statistically significant(P<0.05).Through comparison among groups,the CAT scores of Groups B and C(17.05±1.28,13.55±2.33)were lower than that of Group A(21.20±1.61)after the intervention.And CAT score of Group C was lower than that of Group B(Group C<Group B<Group A).The difference was statistically significant(P<0.05).(4)Exercise endurance assessment(6MWD):The 6MWD in Groups B and C after intervention(375.00±40.44,421.45±51.94)were higher than that before intervention(339.50±47.46,350.90±48.00),and the difference was statistically significant(P<0.05);Through comparison among groups,the 6MWDs in Groups B and C after intervention(375.00±40.44,421.45±51.94)were higher than that in Group A(336.55±50.69).And 6MWD of Group C was higher than that of Group B(Group C>Group B>Group A).The difference was statistically significant(P<0.05).(5)Assessments of the severity of patients with chronic obstructive pulmonary disease(BODE indexes):BODE indexes in Groups B and C(3.65±0.67,2.55±0.69)after intervention were lower than that before intervention(5.00±0.32,4.90±0.45),and the difference was statistically significant(P<0.05);Through comparison among the groups,compared with group A(4.80±0.70),BODE indexes in Groups B and C(3.65±0.67,2.55±0.69)decreased significantly after intervention.In addition,BODE index of Group C was lower than that of Group B(Group C<Group B<Group A).The difference was statistically significant(P<0.05).2.The expression of TRX and TXNIP protein in peripheral plasma:?TRX protein:The expressions of TRX protein:in Groups B and C(73.85±28.33,64.76±23.47)after intervention were significantly higher than that before intervention(45.6618.26,45.64±10.34),and the difference was statistically significant(P<0.05);through comparison among the groups,the expressions of TRX protein in Groups B and C after intervention(73.85±28.33,64.76±23.47)were higher than that in Group A(45.59±8.90),and the difference was statistically significant(P<0.05).?TXNIP protein:The expressions of TXNIP protein in Groups B and C(38.47±14.97,43.91±15.73)decreased significantly after intervention compared with that(60.71 ± 16.23,64.15± 12.30)before intervention,and the difference was statistically significant(P<0.05);Through the comparison among the groups,compared with Group A,the TXNIP protein expressions in Groups B and C(38.47±14.97,43.91±15.73)both decreased significantly(60.28±13.88),and the difference was statistically significant(P<0.05).3.The expressions of TRX and TXNIP mRNA in PBMCs of peripheral blood:? TRX mRNA:The expressions of TRX mRNA in Groups B and C(2.96±0.98,2.56±0.79)after intervention were significantly higher than that before intervention(1.30±0.38,1.16±0.19),and the difference was statistically significant(P<0.05);Through comparison among groups,compared with Group A(1.32±0.25),the expressions of TRX mRNA in Groups B and C(2.96±0.98,2.56±0.79)after intervention were both increased,and the difference was statistically significant(P<0.05).?TXNIP mRNA:The expressions of TXNIP mRNA in Groups B and C after intervention(0.37±0.11,0.40±0.09)were significantly lower than that before intervention(0.86±0.22,0.90±0.21),and the difference were statistically significant(P<0.05);Through the comparison among groups,after intervention,the expressions of TXNIP mRNA in Groups B and group C(0.37± 0.11,0.40 ± 0.09)were significantly lower than that in Group A(0.91± 0.39),and the difference was statistically significant(P<0.05).Conclusions:1.Compared with lower limb training,limb linkage training is more effective in alleviating the breathing difficulties of patients with COPD and enhancing the exercise endurance,to improve the quality of life and bring more benefits to COPD patients.2.Limb linkage training may make COPD patients have antioxidant effect by promoting the expression of TRX,namely inhibiting TXNIP expression,hence providing new theoretical basis for pulmonary rehabilitation mechanism. |
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