Effects of Nutritional Support Combined With Respiratory Training on Pulmonary Function in Patients With Obliterative...

Obliterative bronchiolitis (OB) is a chronic, progressively obstructive lung disease characterized by fixed airflow limitation and a high burden of malnutrition. At present, whether a personalized regimen combining nutritional support with respiratory training could improve obliterative bronchiolitis patient outcomes remains unclear. Thus, this study aimed to explore the clinical efficacy of a comprehensive intervention combining nutritional support with respiratory training in OB patients, with a particular focus on assessing their pulmonary function.

A retrospective analysis was conducted on 101 patients with OB who received treatment in The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital) from January 2022 to March 2025. According to the type of intervention, the subjects were divided into the experimental group (56 cases, receiving comprehensive intervention) and the control group (45 cases, receiving nutritional support only). Propensity score matching was used to balance the baseline data at a 1:1 ratio, and 44 pairs of patients were successfully matched. Pre- and post-intervention data on pulmonary function indicators, nutritional indicators, oxidative stress and inflammatory indicators, as well as quality of life and symptom indicators of the included patients, were compared. Multiple linear regression analysis was performed to determine the independent factors affecting the changes in pulmonary function indicators before and after the intervention.

Regarding the nutritional status, the experimental group exhibited significant post-intervention improvement only in the Nutritional Risk Screening 2002 (NRS-2002) score when compared with the pre-intervention score (p < 0.05). After the intervention, the forced expiratory volume in the first second (FEV₁; p = 0.002) and forced vital capacity (FVC; p < 0.001) in the experimental group were significantly higher than those in the control group, while the malondialdehyde (p < 0.001), C-reactive protein (p = 0.005) and procalcitonin (p < 0.001) in the experimental group were significantly lower than those in the control group. The number of patients with modified British Medical Research Council (mMRC) dyspnea scale score <2 in the experimental group was significantly higher than that in the control group (p = 0.006), and the improvements in 6-minute walk distance (6MWD) and World Health Organization Quality of Life-Brief (WHOQOL-BREF) version scores were greater in the experimental group than in the control group. In addition, multiple linear regression analysis showed that compared with nutritional support alone, the comprehensive intervention was independently associated with greater improvements in FEV₁ (p = 0.002) and FVC (p = 0.001) but had no independent effect on improvements of FEV₁/FVC (p = 0.556).

Comprehensive intervention combining nutritional support with respiratory training effectively improves the pulmonary function, oxidative stress, inflammatory status, quality of life, and respiratory symptoms in OB patients, with outcomes superior to those achieved with nutritional support alone.