70岁以上慢性阻塞性肺疾病患者运动训练的康复效果研究

The effectiveness of exercise training of elderly outpatients with chronic obstructive pulmonary disease

目的探讨70岁以上老年慢性阻塞性肺疾病(COPD)患者运动训练前、后肺功能、6 min步行试验(6MWT)及症状评分的变化。方法选择34例稳定期COPD患者,进行运动训练,包括呼吸训练、上肢肌力训练及全身有氧耐力训练,康复治疗前和6个月后分别测定用力肺活量(FVC)、第一秒用力肺活量(FEV1.0)、最大通气量(MVV)、残气量(RV)、肺总量(TLC)及6MWT运动距离;并进行症状评价。结果(1)运动训练后,6MWT运动距离[(357．5±16．6)m]较运动训练前[(326．2±19．3)m]提高,其差异有非常显著统计学意义(P=0．002);(2)与运动训练前相比, FVc、FEV1.0、MVV等指标有所改善,但差异无统计学意义(P>0．05);(3)运动训练后,咳嗽、咳痰、呼吸困难症状均有所改善。结论对70岁以上老年COPD患者进行低强度、简单的运动训练,可提高运动耐力,减轻症状,但不能显著提高患者的肺通气功能。

Objective To estimate the effectiveness of exercise training of elderly outpatients with chronic obstructive pulmonary disease（COPD）. Methods Thirty-four elderly outpatients with COPD were enrolled to take a 6 month exercise training. Pulmonary function test and 6 minutes walk test （6MWT） were performed before and after exercise training. Forced vital capacity （FVC）, forced expiratory volume in one second （FEV1 .0 ）, maximal voluntary ventilation （MVV）, residual volume （RV）, and total lung capacity （TLC） were measured. The symptoms and the physically active ability were also evaluated. Results （1） The walking distances in the 6MWT were significantly increased after exercisetraining[（357.5±16.6）mvs （326.2±19.3）m]（P=0.002）. （2） FVC, FEV1.0, MVV were improved after exercise training, but no statistic difference was found（P〉0.05）. （3） The symptoms were ameliorated and the physically active ability was improved after 6 months exercise training. Conclusions Although the pulmonary function is not significantly improved, but the symptoms and the exercise endurance are improved after 6 months exercise training in the elderly outpatients with COPD.