家庭肺康复运动训练方案在慢性阻塞性肺病发展中作用的研究

Study of home-based pulmonary rehabilitation program in development of chronic obstructive pulmonary disease

目的:探讨一种简单的家庭肺康复运动训练方案是否能提高慢性阻塞性肺病(COPD)患者的运动能力,改善患者的生存质量。方法:19例COPD患者完成了6周简单的家庭肺康复训练,康复前后测患者的生存质量,6min步行距离(6MWD),静态肺功能,运动心肺功能,进行配对分析。结果:①患者肺康复运动训练6周后平均6MWD从384m增加到451m(P<0.001)。②康复前患者心肺联合运动实验最大运动功率、峰值氧耗量、峰值二氧化碳排除量、峰值通气量、通气无氧阈、氧脉搏分别为55.36W、0.99L/min、0.84L/min、24.11L/min、0.73L/min、8.24ml/beat,康复后分别为60.57W、1.23L/min、1.03L/min、28.26L/min、0.92L/min、10.12ml/beat,前后比较差异有显著性意义(P<0.05)。③CRQ的改善差异有显著性意义。④FEV1虽然从1.18L增加至1.22L,比较差异无显著性意义(P>0.05)。结论:以6min步行距离作为患者运动康复的强度设置是可行的,方案提高了COPD患者的运动能力,改善其生存质量,且简单、经济。

Objective：To explore the effect of a simple home pulmonary rehabilitation exercise training program on the exercise capacity and quality of life in patients with chronic obstructive pulmonary disease（COPD）.Method： Nineteen patients with COPD took part in a six week,simple home pulmonary rehabilitation. The outcome measurement included CRQ,6MWD,static pulmonary function, cardiopulmonary exercise testing.Result：Mter 6 weeks exercise rehabilitation, 6MWD of patients with COPD was increased from 384 meters to 451 meters.The maximal work power, the peak oxygen consumption, the carbon dioxide output, the peak minute ventilation, the ventilation anaerobic threshold and the oxygen pulse of patients were： 60.57W, 1.23L/min, 1.03L/min,28.26L/min,0.92L/min,10.12m]/beat after exercise training and 55.36W,0.99L/min,0.84L/min,24.11L/min,0.73L/min, 8.24 ml/beat before, respectively,in cardiopulmonary exercise testing,compared with before：P〈0.05.The improvments of CRQ reached to statistically and clinically significant improvements. Although FEVI of patients increased from 1.18Lto 1.22L,there was no significant difference （P〉0.05）.Conclusion：6MWD as the intensity layout of pulmonary rehabilitation was available, simple and economic. The program improved the exercise capacity and quality of life in patients with COPD.