ty -jour t1-腰椎经外电神经刺激以改善COPD患者的运动表现JF-欧洲呼吸杂志JO -EUR RESSIR J DO -10.1183/139993003.00784-2019 VL -54 IS -6 SP -1900784 AU -BONNEVIE，TRISTAN AU-- TRISTAN AU-- TRISTAN AU-Gravier，Francis -Edouard au -Prieur，Guillaume au -combret，Yann au -debeaumont，David Au -Patout，Maxime Au -Lamia -Lamia -Lamia，Bouchra，Muir -Muir，Jean -Françoisau -Médrinal -Médrinal，Clement au -cuvelier，antoine y1 -y1 -2019 Y1 -2019 -2019/12/01 UR -http：//www.qdcxjkg.com/content/54/6/1900784.abstract N2-肌肉组III（Aδ纤维）（Aδ纤维）和IV（C纤维）感官传入与心脏探索有关适应运动的感官传入[1，2]。它们在脊髓背侧角中用鞘内芬太尼的抑制作用以阻断其皮质投影，从而在健康运动员受试者中降低了高强度的恒定工作耐力性能，因为对运动的心脏呼吸反应钝。在这种情况下，有高代谢需求的情况下，由于几乎最大程度的招标而没有任何补偿性策略，通风或血液动力学的任何减少都会损害性能。相反，Gagnon等人。[3]已经发表了使用芬太尼的脊柱麻醉，其目的是抑制慢性阻塞性肺疾病（COPD）患者的肌肉III和IV纤维，改善了呼吸困难和耐力能力。这种改善是由于对运动的通气反应钝化所致，该反应改善了生理死亡空间，通气效率以及呼吸困难。此外，与健康受试者相比，在相对较低的外部工作量下，心输出量和外周氧气提取不是最大的，并且通过增加外围肌肉氧气提取的增加（如果有的话）可以克服心脏输出（如果有的话）[3]。高频率或低频透射性电神经刺激（TENS）提供了一种侵入性较小的替代方案，可激活阿片类药物受体，尤其是位于脊髓背角的受体[1，4，5]。 This approach deserves to be studied during exercise and over a course of pulmonary rehabilitation in these patients. We performed a randomised double-blind study (clinicaltrials.gov NCT03312322) to assess whether high-frequency or low-frequency lumbar TENS could improve endurance exercise capacity in patients with COPD. Secondary objectives were to assess the influence of lumbar TENS on perceived exertion, ventilatory pattern and muscle oxygenation. We hypothesised that endurance capacity would be improved with lumbar TENS due to a blunted response in exercise ventilation, which would contribute to improve ventilatory efficacy and reduce exercise dyspnoea. Conversely, we hypothesised that any mitigation in cardiac output (if any) would be compensated by an increase in peripheral muscular oxygen extraction.Lumbar transcutaneous electrical nerve stimulation aimed to block muscle group III–IV sensory afferents does not improve endurance exercise capacity in patients with COPD http://bit.ly/2lZr6Mt ER -