摘要
目的探究经皮穴位电刺激(TEAS)联合下肢运动训练在慢性阻塞性肺疾病(COPD)患者肺康复中的应用效果。方法随机数表法将湖南省人民医院2022年6月-2023年1月就诊的60例COPD稳定期患者分为实验组(n=30)与对照组(n=30),分别接受TEAS+下肢运动训练、单一下肢运动训练干预,均干预4周。比较2组干预前后呼吸功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、最大吸气压(MIP)、最大呼气压(MEP)]、相关症状评分[改良英国医学研究学会呼吸困难指数(mMRC)、COPD自我评估测试(CAT)、主观体力感等级量表(Brog)、肺康复评定指数(BODE)]、运动耐力[通过6 min步行距离(6MWD)]、炎症因子[白细胞介素-6(IL-6)、IL-8、高敏C反应蛋白(hs-CRP)]。结果干预前,2组FEV1、FVC、FEV1/FVC、MIP、MEP、mMRC、CAT、Brog、BODE、6MWD、IL-6、IL-8、hs-CRP水平比较差异均无统计学意义(P均>0.05)。干预4周后,2组FEV1、FVC、FEV1/FVC、MIP、MEP、6MWD比干预前明显升高,mMRC、CAT、Brog、BODE评分以及IL-6、IL-8、hs-CRP水平比干预前明显降低,差异均有统计学意义(P均<0.05);且实验组FEV1、FVC、FEV1/FVC、MIP、MEP、6MWD[(2.00±0.29)L、(2.75±0.38)L、(72.88±6.13)%、(8.50±0.99)Pa、(9.69±1.06)Pa、(482.52±29.98)m]高于对照组[(1.67±0.26)L、(2.37±0.39)L、(69.06±4.21)%、(7.44±0.60)Pa、(8.55±0.88)Pa、(416.14±26.15)m],mMRC、CAT、Brog、BODE评分以及IL-6、IL-8、hs-CRP水平[(1.27±0.52)分、(15.40±3.23)分、(2.10±0.76)分、(2.30±0.65)分、(2.04±0.48)μg/L、(3.03±0.55)μg/L、(2.70±0.53)mg/L]低于对照组[(1.70±0.47)分、(19.13±3.56)分、(2.67±0.71)分、(3.00±0.74)分、(2.46±0.43)μg/L、(3.89±0.83)μg/L、(3.68±0.19)mg/L],差异均有统计学意义(t=4.656、3.885、2.810、5.042、4.544、9.139、-3.396、-4.252、-2.984、-3.881、-3.564、-4.685、-4.661,P均<0.05)。结论TEAS联合下肢运动训练用于COPD稳定期患者肺康复,能明显减轻其临床症状及炎症反应,改善肺功能,提高运动耐力。
Objective To explore the effect of transcutaneous electrical acupoint stimulation(TEAS)combined with lower limb exercise training in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD).Methods A total of 60 cases of stable COPD patients treated in the Hunan Provincial People's Hospital from June 2022 to January 2023 were divided into experimental group(n=30)and control group(n=30)by the random number table method.They were intervened by TEAS+lower limb exercise training and lower limb exercise training alone,respectively,and were both intervened for 4 weeks.Respiratory function[forced expiratory volume one second(FEV1),forced vital capcacity(FVC),FEV1/FVC,maximum inspiratory pressure(MIP),maximal expiratory pressure(MEP)],scores of associated symptoms[modified medical research council(mMRC)],COPD assessment test(CAT),subjective physical sensation rating scale(Brog),body mass index,airflow obstruction,dyspnea,exercise capacity(BODE)],exercise endurance[6-minutes walk distance(6MWD)],inflammatory factor[interleukin-6(IL-6),IL-8,high-sensitive C-reactive protein(hs-CRP)]were evaluated before and after intervention.Results Before intervention,there were no significant differences in FEV1,FVC,FEV1/FVC,MIP,MEP,mMRC,CAT,Brog,BODE,6MWD,IL-6,IL-8,hs-CRP levels between the two groups(all P>0.05).After 4 weeks of intervention,the levels of FEV1,FVC,FEV1/FVC,MIP,MEP,6MWD were significantly increased;the scores of mMRC,CAT,Brog,BODE and the levels of IL-6,IL-8,hs-CRP were significantly decreased in both groups,with statistically significant differences(all P<0.05);the levels of FEV1,FVC,FEV1/FVC,MIP,MEP,6MWD in the experimental group[(2.00±0.29)L,(2.75±0.38)L,(72.88±6.13)%,(8.50±0.99)Pa,(9.69±1.06)Pa,(482.52±29.98)m]were higher than those in the control group[(1.67±0.26)L,(2.37±0.39)L,(69.06±4.21)%,(7.44±0.60)Pa,(8.55±0.88)Pa,(416.14±26.15)m];the scores of mMRC,CAT,Brog,BODE and the levels of IL-6,IL-8,hs-CRP in the experimental group[(1.27±0.52)score,(15.40±3.23)score,(2.10±0.76)score,(2.30±0.65)score,(2.04±0.48)μg/L,(3.03±0.55)μg/L,(2.70±0.53)mg/L]were lower than those in the control group[(1.70±0.47)score,(19.13±3.56)score,(2.67±0.71)score,(3.00±0.74)score,(2.46±0.43)μg/L,(3.89±0.83)μg/L,(3.68±0.19)mg/L],with statistically significant differences(t=4.656,3.885,2.810,5.042,4.544,9.139,-3.396,-4.252,-2.984,-3.881,-3.564,-4.685,-4.661,all P<0.05).Conclusion TEAS combined with lower limb exercise training could significantly reduce clinical symptoms and inflammatory reactions,improve lung function and exercise endurance in stable COPD patients.
作者
谷静
朱黎明
彭艳萍
张泓
GU Jing;ZHU Liming;PENG Yanping;ZHANG Hong(College of Acupuncture,Massage and Rehabilitation,Hunan University of Chinese Medicine,Changsha,Hunan 410000,China;Department of Respiratory Medicine,Hunan Provincial People′s Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha,Hunan 410208,China)
出处
《热带医学杂志》
CAS
2023年第9期1198-1202,1211,共6页
Journal of Tropical Medicine
基金
湖南省卫健委科研立项课题(20201498)
关键词
慢性阻塞性肺疾病
经皮穴位电刺激
下肢运动训练
肺康复
Chronic obstructive pulmonary disease
Transcutaneous electrical acupoint stimulation
Lower limb exercise training
Pulmonary rehabilitation