综合康复治疗对老年慢性阻塞性肺疾病患者肺功能和运动耐力的影响

Effect of comprehensive rehabilitation on lung function and exercise tolerance in geriatric patients with chronic obstructive pulmonary disease

目的 观察综合康复治疗对老年慢性阻塞性肺疾病（COPD）患者肺功能和运动耐力的影响. 方法 入选老年COPD患者51例,治疗组34例进行常规内科治疗和综合康复治疗,康复治疗包括健康宣教、呼吸操、上肢肌力训练和有氧运动训练.1年后进行肺功能和6 min步行试验（6MWT）测定;对照组17例患者在常规内科治疗1年前后分别进行肺功能测定. 结果 治疗组治疗1年后测量肺功能中肺活量（VC）、用力肺活量（FVC）、1 s用力肺活量（FEV1）、FEV1占预计值的百分比（FEV1％）和6MWT分别为（2.94±0.67）L、（2.88±0.70）L、（1.89±0.79）L、（80.7±28.3）％和（426.4±71.3）m,较治疗前（2.62±0.65）L、（2.58±0.65）L、（1.60±0.67）L、（67.7±25.9）％和（326.2±110.8）m提高（均P＜0.05）,而对照组治疗1年后肺功能变化较治疗前差异无统计学意义;康复治疗1年后治疗组与对照组比较,仅FEV1％提高[（80.7±28.3）％比（71.9±16.5）％,t=9.88,P=0.000]. 结论 对老年COPD患者进行综合康复治疗可以改善患者的肺功能和运动耐力.

Objective To observe the influence of comprehensive rehabilitation on lung function and exercise tolerance in geriatric patients with chronic obstructive pulmonary disease （COPD）.Methods Totally 51 patients with COPD were enrolled in this study and divided into two groups：treatment group and control group.For treatment group,each patient was given health education about COPD and the rehabilitation program with medication therapy.The program included aerobic exercises,breathing exercises and upper limb strength training.The control group was given medication therapy only.The treatment group was tested by 6 minute walking distance （6MWT） and both groups had lung function examination before the program started,and were retested 1 year later.Results In the treatment group,lung function including vital capacity （VC）,forced expiratory volume in one second （FEV1）,FEV1 ％,and 6MWT were significantly improved after 1 year of treatment as compared with those indices before treatment [（2.94±0.67）L vs.（2.62±0.65） L,（2.88±0.70）L vs.（2.58±0.65）L,（1.89±0.79）L vs.（1.60±0.67）L,（80.7±28.3）％ vs.（67.7 ±25.9）％,（426.40±71.37）m vs.（326.23±110.80）m,t=2.86,2.27,4.28,4.73,-3.639,respectively,P=0.006,0.027,0.000,0.000,0.001].There was no significant difference in lung function before versus 1 year after intervention in the control group.After 1 year of intervention,the only difference was in FEV1 ％ between the treatment and control groups [（80.7±28.3）％ vs.（71.90± 16.5） ％,t=9.88,P=0.000].Conclusions Comprehensive rehabilitation can improve the lung function and exercise tolerance in geriatric patients with COPD.