Effects of modified pulmonary rehabilitation on patients with moderate to severe chronic obstructive pulmonary disease:A randomized controlled trail

改良肺康复训练对中度以上慢性阻塞性肺疾病患者的效果评价

Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.

目的评价改良肺康复训练对中度以上慢性阻塞性肺疾病患者呼吸困难症状肺功能运动耐力、生活质量的影响。方法选择2014年9月至2015年12月在常州市第--人民医院呼吸内科病房出院的中度以上慢性阻塞性肺疾病患者125例为研究对象,采用随机数字表,将患者分为试验组和对照组,其中试验组63例,对照组62例。对照组给予常规治疗护理措施,以及缩唇呼吸和腹式呼吸锻炼。试验组给予常规治疗护理措施,以及改良肺康复训练计划。共实施12周。比较两组千预前后呼吸困难症状、肺功能指标、生活质量和6分钟步行试验(6MWT)的差异。其中,生活质量采用圣乔治呼吸问卷(St.George's Respiratory Questionnaire,SGRQ)测量。呼吸困难采用改良呼吸困难评分(Modified British Medical Research,mMRC)。结果共112例患者完成了12周的训练计划,对照组54例,试验组58例。试验组干预后SCRQ总分(54.655±10.681)分,呼吸症状(54.933±11.900)分,活动受限(52.644±14.334)分,疾病影响(55.400±9.905)分,与干预前比较,均显著降低,差异有统计学意义(P<0.05);对照组干预前后SGRQ各部分评分及总分比较,差异无统计学意义(P>0.05)。试验组干预后6MWT[(372.089±67.149)min]较干预前显著提高,差异有统计学意义(P<0.01),对照组干预前后.6MWT比较,差异无统计学意义(P>0.05)。试验组干预后mMRC与干预前比较显著降低,差异有统计学意义(P<0.05)。对照组干预前后mMRC比较,差异无统计学意义(P>0.05)。试验组和对照组干预前后肺功能指标(FVC FEV1、FEV1/FVC、FEV1%、PEF)比较,差异均无统计学意义(P>0.05)。结论对中度以上慢性阻塞性肺疾病患者实施改良家庭肺康复计划,可改善其呼吸困难症状,提高机体活动能力,改善生活质量,可作为其缓解期康复治疗的有效手段。