摘要
Abstract Objective To evaluate the effects of breathing training (Qigong) on the exercise test, resistance breathing as well as quality of life in chronic obstructive pulmonary disease (COPD) patients and to elucidate its mechanism. Methods Ten patients with COPD were assigned to 16 week rehabilitation program of Qigong. Their lung function was as follows: FEV 1 1109±34.4 ml, FEV 1/FVC 56.9±6.5% , RV/RV Pred 171.8±46.7%, RV/TLC 58.9±6.5%. The patients did the breathing exercise for 45 minutes twice a day. The efficacy of practice was checked by the respiratory inductive plethysmograph (RIP) once a week. Before and after the program, the patients were examined as follows: 1, Incremental exercise test, subjects exercised on a bicycle ergometer for 6 minutes. The workload (Watt) was increased 1/70 FEV 1 (ml) every a minute. The breath rate, tidal volume and oxygen saturation were monitored. 2, Estimating dyspnea, during the incremental exercise test the subjects were asked to quantify their feeling of breathlessness every a minute using a modified Borg scale. Borg score 0.5 was defined as the threshold of dyspnea. 3, Evaluation of quality of life (QOL), a questionnaire of QOL for COPD was used to evaluate the change of QOL contained 4 parts, namely daily activity, social activity, depression and anxiety. 4, Resistance breathing test, the rib cage (RC) and abdominal (AB) belts of the respiratory inductive plethysmograph Department of Pulmonology, Zhong Shan Hospital, Shanghai 200032 China (Liang YJ, Cai YY and Wang ZX)were positioned around the chest and the abdomen respectively . Tidal volume, breath rate, TCD/VT (TCD; total compartmental displacement) were recorded at resting and resistance breathing with 60% maximal inspiratory pressure as the inspiring pressure load. Results After the program, the breath rates decreased (P<0.05) during incremental exercise test in comparison with those before program. At the fifth degree of workload the heart rate reduced (P<0.05) and oxygen saturation increased (P<0.05). Borg scores improved at the 2nd, 3rd, 4th and 5th degree (P<0.05). The threshold of dyspnea increased from degree 1.7±0.48 to degree 2.4± 0.52 (P<0.01). After 16 week training the tidal volume increased at resting (P<0.05). Both breath rate and tidal volume did not change significantly at resistance breathing. Interestingly, TCD/VT decreased significantly (from 1.49±0.19 to 1.27±0.12, P<0.05) during resistance breathing, indicating the improved synchronization of thoracic and abdominal respiration. The scores of QOL were also improved statistically (P<0.001). Conclusions It was suggested that Qigong could improve the breathing pattern at resting and during incremental exercise, abate the extent of paradoxical thoraco abdominal motion at the resistance breathing. Therefore Qigong could ameliorate dyspnea, raise the threshold of dyspnea. It might be physiological basis of the improvement of QOL in the patients with COPD after the program.
Abstract Objective To evaluate the effects of breathing training (Qigong) on the exercise test, resistance breathing as well as quality of life in chronic obstructive pulmonary disease (COPD) patients and to elucidate its mechanism. Methods Ten patients with COPD were assigned to 16 week rehabilitation program of Qigong. Their lung function was as follows: FEV 1 1109±34.4 ml, FEV 1/FVC 56.9±6.5% , RV/RV Pred 171.8±46.7%, RV/TLC 58.9±6.5%. The patients did the breathing exercise for 45 minutes twice a day. The efficacy of practice was checked by the respiratory inductive plethysmograph (RIP) once a week. Before and after the program, the patients were examined as follows: 1, Incremental exercise test, subjects exercised on a bicycle ergometer for 6 minutes. The workload (Watt) was increased 1/70 FEV 1 (ml) every a minute. The breath rate, tidal volume and oxygen saturation were monitored. 2, Estimating dyspnea, during the incremental exercise test the subjects were asked to quantify their feeling of breathlessness every a minute using a modified Borg scale. Borg score 0.5 was defined as the threshold of dyspnea. 3, Evaluation of quality of life (QOL), a questionnaire of QOL for COPD was used to evaluate the change of QOL contained 4 parts, namely daily activity, social activity, depression and anxiety. 4, Resistance breathing test, the rib cage (RC) and abdominal (AB) belts of the respiratory inductive plethysmograph Department of Pulmonology, Zhong Shan Hospital, Shanghai 200032 China (Liang YJ, Cai YY and Wang ZX)were positioned around the chest and the abdomen respectively . Tidal volume, breath rate, TCD/VT (TCD; total compartmental displacement) were recorded at resting and resistance breathing with 60% maximal inspiratory pressure as the inspiring pressure load. Results After the program, the breath rates decreased (P<0.05) during incremental exercise test in comparison with those before program. At the fifth degree of workload the heart rate reduced (P<0.05) and oxygen saturation increased (P<0.05). Borg scores improved at the 2nd, 3rd, 4th and 5th degree (P<0.05). The threshold of dyspnea increased from degree 1.7±0.48 to degree 2.4± 0.52 (P<0.01). After 16 week training the tidal volume increased at resting (P<0.05). Both breath rate and tidal volume did not change significantly at resistance breathing. Interestingly, TCD/VT decreased significantly (from 1.49±0.19 to 1.27±0.12, P<0.05) during resistance breathing, indicating the improved synchronization of thoracic and abdominal respiration. The scores of QOL were also improved statistically (P<0.001). Conclusions It was suggested that Qigong could improve the breathing pattern at resting and during incremental exercise, abate the extent of paradoxical thoraco abdominal motion at the resistance breathing. Therefore Qigong could ameliorate dyspnea, raise the threshold of dyspnea. It might be physiological basis of the improvement of QOL in the patients with COPD after the program.
