呼吸训练和沙美特罗替卡松干粉剂治疗对慢性阻塞性肺疾病患者肺功能和生活质量的影响

Effects of seretide and respiratory training on pulmonary function and quality of life in patients with chronic obstructive pulmonary disease

目的:观察呼吸训练对慢性阻塞性肺疾病(chronicobstructivepulmonarydisease,COPD)患者的肺功能和生活质量的影响,寻求提高康复效果的有效途径。方法:本实验于2002-06/2003-12在湛江中心人民医院呼吸内科完成。同期本院呼吸内科门诊COPD患者160例。符合标准患者70例,最终纳入分析60例,采用随机数字法将患者分为治疗组和对照组,各30例。治疗组每天进行2次呼吸操训练并吸入沙美特罗替卡松干粉剂2次,对照组应用常规呼吸内科对症治疗和一般的肢体活动。治疗前及治疗24周后检查两组患者肺功能,并进行生活质量评估。结果:治疗前两组肺功能、生活质量评分差异无显著性意义(P>0.05)。治疗组治疗后肺功能较治疗前及对照组治疗后明显改善(P<0.05～0.01)。治疗组治疗后生活质量评分(日常生活能力:2.03±0.56,社会活动能力:2.18±0.51,抑郁:2.04±0.48,焦虑:1.92±0.51,生活质量总均分:2.04±0.52)较治疗前(2.58±0.62,2.74±0.54,2.57±0.68,2.42±0.56,2.58±0.60)及对照组治疗后(2.55±0.61,2.72±0.62,2.56±0.68,2.45±0.43,2.57±0.59)明显改善(P<0.01)。结论:呼吸训练和沙美特罗替卡松干粉剂治疗能够明显改善COPD患者的肺功能和提高生活质量。

AIM:To observe the effects of seretide and respiratory training on pulmonary function and quality of life(QOL) in patients with chronic obstructive pulmonary disease(COPD), and explore the effective methods to improve rehabilitation efficacy. METHODS:The study was finished in the Department of Respiratory Diseases, Central People's Hospital of Zhanjiang from June 2002 to December 2003. At the same time, there were 160 COPD patients in the Department of Respiratory Diseases and 70 cases of them coincided with the standard. Sixty cases were brought into the study and randomly divided into two groups: treatment group (30 cases) and control group (30 cases). The treatment group inhaled seretide twains and respiratory training twice a day. The control group received the treatment of routine respiratory diseases and general activity of extremities. Pulmonary function and QOL were evaluated before and 24 weeks after treatment. RESULTS:There was no significant difference in pulmonary function and QOL that between the two groups before treatment (P >0.05). After treatment, pulmonary function in treatment group improved significantly than that pretreatment and that in control group after treatment (P< 0.05-0.01). QOL that in treatment group after treatment (ability of daily life: 2.03±0.56; ability of social activities:2.18±0.51; depression:2.04±0.48; anxiety:1.92±0.51; total average mark of QOL:2.04±0.52)improved significantly than that before treatment after treatment (2.58±0.62, 2.74±0.54,2.57±0.68,2.42±0.56,2.58±0.60)and control group(2.55±0.61,2.72±0.62, 2.56±0.68,2.45±0.43,2.57±0.59) ( P< 0.01). CONCLUSION:Seretide cures and respiratory training can significantly improve pulmonary function and significantly improve the quality of life of COPD patients.