综合肺部康复训练联合布地奈德对老年慢性支气管哮喘患者肺功能和临床症状的影响

Effects of Comprehensive Lung Rehabilitation Training Combined with Budesonide on Lung Function and Clinical Symptoms in Elderly Patients with Chronic Bronchial Asthma

目的探讨综合肺部康复训练联合布地奈德对老年慢性支气管哮喘(CBA)患者肺功能和临床症状的影响.方法选取2020年2月—2022年2月济宁市任城区人民医院呼吸内科收治的88例老年CBA患者为研究对象,按随机数字表法分为两组,各44例.对照组采用布地奈德雾化吸入干预,观察组在对照组基础上配合综合肺部康复训练干预.比较两组肺功能、临床症状消失时间、运动耐力、哮喘症状改善情况以及临床疗效.结果干预前1d,两组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)、6 min步行试验(6MWT)距离以及哮喘控制测试量表(ACT)评分比较,组间差异无统计学意义(P>0.05);干预后3d,相比干预前1d,两组FVC、FEV1和PEF均增大,6MWT距离均延长,ACT评分均升高,且观察组FVC(2.68±0.52)L、FEV1(1.79±0.28)L、PEF(3.53±0.67)L/s均大于对照组的(2.35±0.41)L、(1.45±0.22)L、(2.67±0.75)L/s,6MWT距离(469.27±30.72)m长于对照组的(411.08±28.71)m,ACT评分(20.75±3.61)分高于对照组的(17.36±5.04)分,组间差异有统计学意义(P<0.05).观察组胸闷、咳嗽、气喘以及肺部干湿啰音消失时间均短于对照组,组间差异有统计学意义(P<0.05).观察组治疗总有效率95.45%高于对照组的75.00%,差异有统计学意义(P<0.05).结论老年CBA患者采用布地奈德雾化吸入联合综合肺部康复训练进行干预,可以有效改善肺功能,提高运动耐力,促进症状缓解,值得临床应用.

Objective To investigate the effects of comprehensive lung rehabilitation training combined with budesonide on lung function and clinical symptoms in elderly patients with chronic bronchial asthma(CBA).Methods 88 elderly CBA patients admitted to the department of respiratory medicine of Jining Rencheng District People's Hospital from February 2020 to February 2022 were selected as the research objects and divided into two groups according to random number table method,with 44 cases in each group.The control group was given budesonide aerosol inhalation intervention,and the observation group was combined with comprehensive pulmonary rehabilitation training on the basis of the control group.Lung function,duration of clinical symptom disappearance,exercise endurance,improvement of asthma symptoms and clinical efficacy were compared between the two groups.Results One day before intervention,there were no significant differences in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),6 min walk test(6MWT)distance and asthma control test(ACT)scores between the two groups(P>0.05);three days after intervention,compared with one day before intervention,FVC,FEV1 and PEF were increased,6MWT distance were extended,and ACT scores were increased in both groups,in addition,the FVC,FEV1 and PEF in the observation group were(2.68±0.52)L,(1.79±0.28)L and(3.53±0.67)L/s,respectively,which were greater than(2.35±0.41)L,(1.45±0.22)L and(2.67±0.75)L/s in the control group,the 6MWT distance of the observation group was(469.27±30.72)m,which was longer than(411.08±28.71)m of the control group,the ACT score of the observation group was(20.75±3.61)points,which was higher than(17.36±5.04)points of the control group,and the differences between the groups were statistically significant(P<0.05).The disappearance time of chest tightness,cough,asthma and wet and dry rales of the lungs in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).The total effective rate of the observation group was 95.45%,which was higher than 75.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion The intervention of budesonide aerosol inhalation combined with comprehensive lung rehabilitation training in elderly CBA patients can effectively improve lung function,improve exercise endurance and promote symptom relief,which is worthy of clinical application.