Effect Of NAC Combined With Aerobic Exercise On The Serum Oxidative Stress Factors And The Quality Of Life In Patients With Stable COPD

BackgroundChronic obstructive pulmonary disease（COPD）is mainly characterized by chronic bronchitis,emphysema,and/or asthma.The common phenotype is airflow obstruction.Studies have shown that oxidative stress runs through the entire course of COPD.Therefore,antioxidant therapy is an important part of COPD treatment.N-acetylcysteine（NAC）is a strong reducing agent,which can relieve oxidative stress and inhibit airway remodeling.However,studies have found that the simple antioxidant strategy is a failure,and the combination therapy may benefit from the treatment of COPD.In recent years,lung rehabilitation exercise has gradually been recognized.Regular aerobic exercise can relieve symptoms such as dyspnea and improve the quality of life.Therefore,it is speculated that the addition of NAC on the basis of conventional therapy and proper aerobic exercise are beneficial to the treatment of COPD.ObjectiveTo explore the combination therapy of NAC and aerobic exercise,to understand its antioxidant level,to improve lung function,and to assess exercise endurance,and ultimately whether it can improve the quality of life.MethodsA total of 63 patients with stable COPD were selected from October 2016 to October 2017 in the First Affiliated Hospital of Xinxiang Medical University.The patients were randomly divided into A（basic treatment group）,B（aerobic exercise group）,and C group（NAC combined with aerobic exercise group）,with 21 cases in each group.In group A,salmeterol was administered by inhalation.Each inhalatio n（50μg of salmeterol and 250μg of fluticasone propionate）was given twice a da y,the patients in group B was given aerobic exercise on the basis of group A,wa lking at a uniform rate every day,1 or 2 times,every 20 to 30 minutes,the patients in group C was given 0.6g of NAC effervescent tablets on the basis of group B,orally once daily for 12 weeks.The levels of serumglutathione peroxidase(GSH-P _X),superioxide dismutase（SOD）were detected by spectrophotometry,the level of seru m malondialdehyde（MDA）was measured by thiobarbital before and after treatment in the two groups.The forced vital capacity（FVC）,forced expiratory volume in o ne second（FEV₁）and forced expiratory volume in one second/forced vital capacity（FEV₁/FVC）were tested by pulmonary function test apparatus.The quality of life was evaluated by the St George’s respiratory questionnaire（SGRQ）.The exercise endurance was evaluated by the 6 minutes walking test（6MWT）.Results1.There was no significant difference in the levels of serum GSH-Px,SOD,MDA,SGRQ score,6MWT,FVC,FEV₁ and FEV₁/FVC between the three groups before treatment（P>0.05）.2.After 12 weeks of treatment,the levels of serum GSH-Px,SOD,and 6MWT in the three groups were significantly higher than before treatment,and the level of seurm MDA and SGRQ were significantly lower than before treatment,and the differences were statistically significant（P<0.05）.There was no significant difference between FVC,FEV₁,FEV₁/FVC and pretreatment（P>0.05）.3.After 12 weeks of treatment,the levels of serum GSH-Px,SOD and 6MWT in group B and C were higher than those in group A,the level of serum MDA and SGRQ scores were lower than in group A,and the difference was statistically significant（P<0.05）.（P<0.05）.In group C,the serum levels of GSH-Px,SOD,and 6MWT were significantly higher in patients than in group B.the level of serum MDA and SGRQ scores were significantly lower than in group B,and the difference was statistically significant（P<0.05）.After 12 weeks of treatment,There was no significant difference in FVC,FEV₁,FEV₁/FVC between the three groups（P>0.05）.ConclusionNAC combined aerobic exercise,although the effect is not significant in improving pulmonary function,but its by eliminating serum oxidation product,improve the level of antioxidant and exercise endurance,both create synergies and jointly improve the patient’s quality of life.