特发性肺纤维化患者肺康复护理的研究进展与实践策略

Research Progress and Practical Strategies of Pulmonary Rehabilitation Nursing for Patients with Idiopathic Pulmonary Fibrosis

摘要: 本文旨在概述特发性肺纤维化(IPF)患者肺康复护理的循证依据、国内外研究现状及临床实践问题，并结合肺微循环障碍的临床特点，融入呼吸导引、穴位按摩、中医情志调护等中医特色护理技术，提出优化实践策略，以期为心脑肺血管病领域的临床护理工作提供参考。系统检索PubMed、CNKI、Web of Science等数据库中2019~2025年发表的指南、系统评价、随机对照试验及专家共识，重点分析高等级文献证据。结果显示：近年来IPF肺康复护理的循证依据日益完善；ATS/ERS/JRS/ALAT (2022)、中国IPF诊疗专家共识(2024)及多项高质量RCT研究证实，肺康复对合并肺微循环障碍的IPF患者安全且有效，能够改善患者的运动耐力与生活质量；2025年国内最新研究在护士主导的延续性护理、远程呼吸康复技术优化等领域亦取得新进展，进一步丰富了临床循证依据。当前临床实践中仍存在多学科合作不足、专业人才短缺、远程康复覆盖有限、患者依从性偏低等问题；以护士为主导的多学科协作、互联网 + 远程康复、社区–家庭一体化模式及数字化督导机制是当前的研究热点。结论认为，肺康复护理联合中医特色护理应作为IPF这类肺微循环相关性疾病的常规非药物干预手段。未来需加快制定本土化肺康复护理标准，推动数字健康技术与康复服务及中医适宜技术深度融合，强化社区康复资源配置，并结合最新研究成果探索特色化康复路径，从而提升IPF肺康复护理的可及性与可持续性。

Abstract: This paper aims to summarize the evidence-based basis, research status at home and abroad, and clinical practice problems of pulmonary rehabilitation nursing for patients with idiopathic pulmonary fibrosis (IPF), and to propose optimized practical strategies based on the clinical characteristics of pulmonary microcirculation disorders and integrated traditional Chinese medicine (TCM) nursing techniques, so as to provide a reference for clinical nursing in the field of cardio-cerebro-pulmonary vascular diseases. Guidelines, systematic reviews, randomized controlled trials, and expert consensuses related to pulmonary rehabilitation nursing for IPF were systematically retrieved from databases such as PubMed, CNKI, and Web of Science, with a focus on high-level evidence published between 2019 and 2025. The results show that the evidence base for IPF pulmonary rehabilitation nursing has been increasingly improved. The ATS/ERS/JRS/ALAT (2022), the Chinese expert consensus on the diagnosis and treatment of IPF (2024), and several high-quality RCTs have confirmed that pulmonary rehabilitation is safe and effective for IPF patients with pulmonary microcirculation disorders, improving exercise tolerance and quality of life. The latest domestic studies in 2025 have also made progress in nurse-led continuous care and the optimization of remote respiratory rehabilitation techniques. However, clinical practice still faces challenges such as insufficient multidisciplinary collaboration, a shortage of professionals, limited coverage of remote rehabilitation, and low patient compliance. In conclusion, pulmonary rehabilitation nursing combined with TCM characteristic nursing should be adopted as a routine non-pharmacological intervention for IPF. Future efforts should accelerate the development of localized pulmonary rehabilitation nursing standards, promote deep integration of digital health technologies with rehabilitation services and TCM therapies, strengthen community rehabilitation resources, and explore tailored rehabilitation pathways, thereby improving the accessibility and sustainability of pulmonary rehabilitation nursing for IPF.