中西医结合康复训练对慢性阻塞性肺疾病患者运动能力及生活质量的影响:随机对照临床试验

Efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of patients with chronic obstructive pulmonary disease in stable phase:a randomized controlled trial

背景:慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的患病率和死亡率均较高,探讨中西医结合呼吸康复训练对COPD患者稳定期的运动能力及生活质量的影响具有积极的临床意义。目的:研究中西医结合呼吸康复训练对轻中度COPD患者稳定期运动能力及生活质量的影响。设计、场所、对象和干预措施:收集来自郧阳医学院太和医院呼吸内科住院及门诊COPD患者共80例。将其随机均分为A、B、C、D 4组,A组给予常规药物治疗,B组在常规药物治疗基础上联合传统中医气功训练,C组在常规药物治疗基础上联合现代呼吸康复训练,D组在常规药物治疗基础上联合中西医结合呼吸康复训练。主要结局指标:治疗前及治疗1、3、6个月和1年后行慢性呼吸疾病生活质量问卷(chronic respiratoryquestionnaire,CRQ)调查及6分钟步行距离测试,并行运动后Borg呼吸困难评分。结果:A组治疗前后CRQ评分、6分钟步行距离以及Borg呼吸困难评分均无明显改善(P>0.05)。B、C、D组训练1个月后,6分钟步行距离、Borg呼吸困难评分无明显改善(P>0.05),训练3个月后则明显改善(P<0.05),CRQ评分训练3个月后仍无明显改善(P>0.05);B、C、D组训练6个月后各指标均明显优于治疗前(P<0.05)。D组训练6个月和1年后各指标明显优于A、B、C组(P<0.05)。结论:现代及传统呼吸康复技术及中西医结合呼吸康复治疗方案均能很好地改善轻中度COPD患者的运动能力及生活质量,但中西医结合呼吸康复治疗方案优于单纯现代及传统呼吸康复技术。呼吸康复训练具有时间依赖性及累积效应,需要长期坚持才能见效。

Background：Chronic obstructive pulmonary disease（COPD） is an important clinical disease,and its global prevalence and mortality rates are high.It is meaningful to investigate the efficacy of integrative respiratory rehabilitation training in quality of life and respiratory physiology of COPD patients in stable phase. Objective：To observe the efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of COPD patients in stable phase. Design,setting,participants and interventions：Eighty outpatients and inpatients with COPD from Department of Respiratory Medicine,Taihe Hospital,Yunyang Medical College were randomly divided into 4 groups,with 20 patients in each group.The patients in group A only received drug therapy,the patients in group B received traditional qigong training,the patients in group C received modern rehabilitation training,and the patients in group D received integrative respiratory rehabilitation training. Main outcome measures;Chronic respiratory questionnaire（CRQ）,6-minute walking distance and Borg score in each group were examined before and after one-,three-,and six-month and one-year treatment. Results：The 6-minute walking distance,Borg score and CRQ score in group A had no significant changes after treatment（P〈0.05）.After one-month treatment,there were no significant differences in 6-minute walking distance and Borg score in groups B,C and D as compared with those before treatment（P〈0.05）. After three-month treatment,6-minute walking distance and Borg score were improved in groups B,C and D （P〈0.05）.After six-month and one-year treatment,6-minute walking distance,Borg score and CRQ score in groups B,C and D were improved as compared with those before treatment（P〈0.05）,and there were significant differences between group D and any of groups A,B and C（P〈0.05）. Conclusion：Modern rehabilitation training,traditional qigong training and integrative respiratory rehabilitation training programs all can improve the quality of life and exercise ability of COPD patients,and integrative respiratory rehabilitation training program is better than modern rehabilitation training and traditional qigong training programs.The efficacy of respiratory rehabilitation training is time-dependent,and need long-time adherence to the therapy.