五禽戏鸟戏联合简易呼吸操对慢性阻塞性肺疾病患者生活质量及免疫功能的影响

摘要

[目的]观察五禽戏中的鸟戏联合简易呼吸操对慢性阻塞性肺疾病(COPD)患者生活质量及免疫功能的影响.[方法]采用非随机临床对照研究,根据患者意愿将68例患者分为观察组32例和对照组36例.对照组给予舒利迭联合噻托溴铵常规吸入基础治疗,观察组在上述基础治疗上应用五禽戏的鸟戏及简易呼吸操锻炼.比较2组干预治疗前后BODE指数[体质量指数(BMI)、气流阻塞(FEV1%)、呼吸困难评分、运动能力(6 min步行试验)]及COPD评估量表(CAT)评分,T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8及血清免疫球蛋白IgM、IgA、IgG水平的变化情况.[结果](1)干预治疗后,观察组呼吸困难评分较治疗前改善(P<0.01),对照组BODE指数中的各项指标均无明显变化(P>0.05),观察组对呼吸困难评分及6 min步行试验的改善作用优于对照组(P<0.05或P<0.01).(2)干预治疗后,观察组BODE指数及CAT评分均较治疗前改善(P<0.01),对照组BODE指数也较治疗前改善(P<0.05),观察组对BODE指数及CAT评分的改善作用均优于对照组(P<0.05或P<0.01).(3)干预治疗后,观察组T淋巴细胞亚群CD3及CD4水平及血清免疫球蛋白IgM、IgA、IgG水平升高(P<0.05或P<0.01),对照组IgA水平也较治疗前升高(P<0.05),观察组对CD3、CD4水平的升高作用优于对照组(P<0.05或P<0.01).(4)2组不良事件比较,差异无统计学意义(P>0.05).[结论]在常规吸入治疗基础上加五禽戏鸟戏联合简易呼吸操锻炼,可改善COPD患者的呼吸困难、6 min步行距离、BODE指数和CAT评分,提高CD3、CD4、IgM、IgG水平.%Objective To evaluate the effect of the bird exercises of Wuqinxi bird exercises combined with simple breath exercises on the quality of life and immune function in patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-eight COPD patients were allocated into observation group (N=32) and control group (N=36)according to the intention of the patients. The control group was given conventional inhalation of Seretide and Tiotropium Bromide,and the observation group did Wuqinxi bird exercises and simple breath exercises plus the conventional inhalation therapy. Before and after treatment,we compared the BODE indexes such as body mass index (BMI), air flow obstruction index of forced expiratory volume in one second (FEV1%), dyspnea scores,exercise capacity (6-min walking distance)as well as COPD assessment test (CAT)scores between the two groups before and after treatment. Meanwhile, the changes of T lymphocyte subtype CD3, CD4, CD8, CD4/CD8 levels and serum immunoglobulin M (IgM),IgA,IgG levels were also monitored. Results(1)After intervention, dyspnea scores of the observation group were obviously improved (P < 0.01), while the control group showed no obvious changes in dyspnea scores (P > 0.05). The observation group had better effect on improving dyspnea scores and 6-min walking distance than the control group (P < 0.05 or P <0.01).(2)After intervention,BODE index and CAT scores were improved in the observation group(P<0.01),BODE index was improved in the control group (P < 0.05), and the improvement of BODE index and CAT scores in the observation group was superior to that in the control group (P < 0.05 or P < 0.01). (3)After intervention, T lymphocyte subtype CD3 and CD4 levels as well as the serum IgM, IgA, IgG levels in the observation group were increased (P < 0.05 or P < 0.01),and IgA level in the control group was also increased (P < 0.05). The observation group had stronger effect on increasing T lymphocyte subtype CD3 and CD4 levels than the control group(P < 0.05 or P < 0.01).(4)The difference of adverse reaction incidence was insignificant between the two groups (P > 0.05). Conclusion Application of Wuqinxi bird exercises and simple breath exercises based on conventional inhalation therapy is effective on improving dyspnea, 6-min walking distance, BODE index and CAT scores, and on increasing T lymphocyte subtype CD3 and CD4 levels as well as the serum IgM and IgG levels of COPD patients.