太极拳运动对慢性阻塞性肺疾病患者BODE指数和SGRQ评分的影响

The Effects of Taijiquan Practice on the BODE and SGRQ of COPD Patients

目的:评估太极拳运动对慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)稳定期患者BODE指数(body mass index,airflow obstruction,dyspnea,and exercise capacityindex)和圣乔治(The St George’s Respiratory Questionnaire,SGRG)评分的影响。方法:112例COPD稳定期患者随机分为太极拳组、锻炼组和对照组。3组患者均接受12周训练,每周7天,每天锻炼1小时。太极拳组进行24式杨式太极拳锻炼,锻炼组进行缩唇腹式呼吸和健步走锻炼,对照组进行平日常规活动。分别于训练前、训练6周和12周,给受试者发放SGRQ评分问卷,测定体重指数(BMI)、第一秒用力呼气容积占预计值百分比(FEV1%预计值)、呼吸困难指数(mMRC)、6分钟步行试验(6MWT),计算BODE指数和SGRQ评分。结果:⑴训练6周,太极拳组FEV1%预计值较本组训练前显著升高(P<0.05),mMRC显著降低(P<0.05),BODE指数显著下降(P<0.01),但BMI和6MWT变化不明显(P>0.05)。同期比较,太极拳组FEV1%预计值显著高于同期锻炼组及对照组(P<0.01),mMRC和BODE指数显著低于同期锻炼组和对照组(P<0.01),BMI和6MWT无显著性差异(P>0.05)。训练12周,太极拳组FEV1%预计值、6MWT较训练前及同期锻炼组、对照组均显著升高(P<0.01);BODE指数和mMRC较训练前及同期锻炼组、对照组均显著下降(P<0.01);BMI较训练前及同期对照组显著下降(P<0.05),与同期锻炼组相比无显著性差异(P>0.05)。⑵训练6周,太极拳组SGRQ评分中的活动分及影响分较训练前显著降低(P<0.05),且显著低于同期对照组(P<0.01),但与同期锻炼组相比无显著性差异(P>0.05);症状分、总分与训练前及同期对照组相比显著降低(P<0.01),与同期锻炼组相比无显著性差异(P>0.05)。训练12周,太极拳组症状分显著低于训练前及同期对照组(P<0.01),与同期锻炼组相比无显著性差异(P>0.05);太极拳组活动分、影响分和总分均显著低于训练前及同期对照组和锻炼组(P<0.01)。结论:太极拳与缩唇呼吸、步行锻炼均能改善COPD稳定期患者BODE指数及SGRQ评分,减轻患者症状,提高生存质量,两种方案相比,太极拳运动对各项指标的改善效果更明显。

Objective To evaluate the effects of Taijiquan practice on the BODE index （body mass index, airflow obstruction,dyspnea,and exercise capacity index） and SGRQ（The St George＇s Respiratory Questionnaire） of patients with chronic obstructive pulmonary disease （COPD）. Methods 112 patients with stable phase COPD were randomly assigned into following three groups：Taijiquan （TJQ） group, exercise group and control group. All of them underwent an exercise program consisting of seven 60-min sessions each week for 12 weeks. Subjects in TJQ group practiced 24 Yang-style Taijiquan. Subjects in exercise group were taught to practice breathing techniques combined with brisk walking. Subjects in control group were instructed to maintain there usual activities. Data was collected before exercise （baseline）,at week 6 and week 12,including BMI,FEVl%Pre,mMRC （modified medical research council dyspnea scale） and 6MWT（six-minute walk test）. Results （1）After 6-week training,as compared with baseline,FEVl%Pre in TJQ group significantly increased,and mMRC significantly decreased （P 〈 0.05） ;BODE index significantly decreased （P 〈 0.01 ）,while BMI and 6MWT changed insignificantly（P 〉 0.05）. The FEV1%Pre, mMRC and BODE index in TJQ group improved significantly as compared with that in exercise group and control group（P 〈 0.01 ）,while there was no significant difference in BMI and 6MWT among the three groups. After 12-week training,the FEV1%Pre ,6MWT, BODE index and mMRC in TJQ group significantly improved comparing to baseline, and the other two groups（P 〈 0.01 ）,and BMI significantly declined as compared to baseline and control group （P 〈 0.05）,while there was no obvious difference from exercise group （P 〈 0.05）. （2） After 6-week training,the activity mark,daily life influence mark, symptom scores and total SGRQ scores in TJQ group improved significantly comparing to baseline and control group（P 〈 0.01 or P 〈 0.05） ,while there was no significant difference between TJQ and exercise groups. After 12-week training,activity mark,daily life influence mark,and total SGRQ scores in TJQ group improved significantly as compared with baseline and the other two groups （P 〈 0.01）,except the symptom mark （P 〉 0.05）. Conclusion Taijiquan practice yields noticeable improvement in health of COPD patients with respect to BODE index and SGRQ in comparison with the combination of breathing techniques and walking exercise.