耐力训练结合肌力训练对慢性阻塞性肺疾病患者运动耐力及生存质量的影响

Comparison of effects of endurance training and strength training on exercise endurance and quality of life of patients with chronic obstructive pulmonary disease

目的:研究耐力训练结合肌力训练对慢性阻塞性肺疾病(COPD)患者肺功能、肌力、运动耐力以及生存质量(QOL)的影响。方法:选择符合入选标准的COPD患者45例,随机分为,耐力训练组、肌力训练组和混合训练组(耐力与肌力训练相结合)各15例。三组均接受常规药物的治疗,在此基础上,分别进行耐力训练、肌力训练和耐力联合肌力训练12周,每周3次。干预前、后分别对3组受试者的肺功能、肌力、心肺运动功能、6min步行距离(6MWD)和QOL进行评估。结果:干预前,3组间各项指标比较差异均无显著性意义(P>0.05)。干预12周后,3组的肌力、VO2max、最大功率、力竭时间、6MWD和SGRQ得分较治疗前均有明显提高,组内比较差异均有显著性意义(P<0.05);干预12周后组间比较,3组的肌力、6MWD和SGRQ得分差异均有显著性意义(P<0.05);组间两两比较显示:肌力训练组和混合训练组的各肌群肌力优于耐力训练组(P<0.05),但是肌力训练组和混合训练组除胸大肌的肌力外,其余差异均无显著性意义(P>0.05);混合训练组6MWD及SGRQ得分优于耐力训练组和肌力训练组(P<0.05)。结论:耐力训练结合肌力训练改善COPD患者的运动耐力和肌力,进而改善患者的QOL,为COPD患者临床治疗制定合理的运动方案提供依据。

Objective： To compare the effects of different exercise training modalities including endurance training（ET）, progressive strength training（ST） and the combination of ST and ET（CT） on exercise endurance and quality of life（QOL） of patients with chronic obstructive pulmonary disease（COPD）.Method： Forty-five COPD patients were randomized divided into three groups： ET（n=15）, ST（n=15）, and CT（n=15）. Pulmonary function testing, muscle strength testing, cardiopulmonary exercise testing, 6-min walking distance（6MWD） and QOL were assessed before and after a 12-week training period.Result： Muscle strength,VO2 max, Wmax, exhaust time, 6MWT, and QOL improved significantly in all three training groups; In both CT and ST group,muscle strength improved significantly compared to the ET group（P0.05）, There was no statistically significant difference in the increases of muscle strength between CT and ST group except for pectoralis major（butterfly）. In CT group 6MWD and QOL improved significantly compared to ET group and ST group（P0.05）.Conclusion： Both endurance training and strength training are effective interventions to improve exercise capacity, muscle strength and QOL. The combination of endurance training and strength training seems an adequatetraining strategy for COPD patients.