肺康复训练对不同严重度稳定期慢性阻塞性肺疾病的影响

摘要

Objective To investigate the effect of lung rehabilitation training on patients with chronic obstructive pulmonary disease (COPD) with different severity. Method Forty-two patients with COPD who were treated in Beijing Huairou Hospital from March 2014 to September 2015 were divided into moderate group (n=90), severe group (84 cases) and severe group (66 cases) according to their severity. In accordance with the principle of randomization, each group will be divided into reference group and study group. In the reference group, routine treatment was performed and the study group was trained on lung rehabilitation for 6 months. The number of acute episodes before and after treatment was compared with that of FEV1% pred, mMRC, SGRQ and 6MWD. Result There was no significant difference in the number of acute episodes between the reference group and the study group (t=0.15, P>0.05). The number of acute episodes (2.32±0.40) in the study group was significantly lower than that in the control group (3.45±1.02), and the difference was significant (t=4.66, P<0.05). There was no statistically significant difference in the number of acute episodes between the reference group and the study group (t=0.23, P>0.05). The levels of mMRC, SGRQ and 6MWD were significantly improved in the patients with severe treatment, and the difference was significant (P<0.05). Conclusion The rehabilitation of lung rehabilitation can help reduce the number of acute exacerbations in patients with severe COPD and alleviate the difficulty of breathing in patients with severe stress. It is highly efficient and economical and deserves clinical promotion.%目的 探析肺康复训练对不同严重度稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的影响.方法 将2014年3月至2015年9月北京怀柔医院收治的240例COPD患者根据严重程度分为中度组(90例)、重度组(84例)和极重度组(66例),再按照随机原则,将每组分成对照组与观察组.对照组进行常规治疗,观察组在此基础上开展肺康复训练,时间为6个月.对比各组治疗前后的急性发作次数、第1秒用力呼气容积占预计值百分比(FEV1%pred)、改良呼吸困难评分(mMRC)、圣乔治呼吸问卷(SGRQ)评分、6分钟步行距离(6MWD).结果 中度COPD患者对照组与观察组的急性发作次数差异无显著性(t=0.15,P>0.05).重度COPD患者观察组的急性发作次数[(2.32±0.40)次]低于对照组[(3.45±1.02)次],差异有显著性(t=4.66,P<0.05).极重度COPD患者对照组和观察组的急性发作次数差异无显著性(t=0.23,P>0.05).中度、重度和极重度观察组患者治疗后mMRC、SGRQ、6MWD均较治疗前明显改善,差异有显著性(P<0.05),而治疗前后FEV1%pred比较差异无显著性(t=0.10,P>0.05).结论 肺康复训练有助于减少重度COPD患者急性发作的次数,并可缓解极重度COPD患者的呼吸困难情况,值得临床推广.