综合性肺康复治疗对稳定期慢性阻塞性肺疾病患者运动能力与生存质量影响

The effect of comprehensive pulmonary rehabilitation therapy on exercise capacity and quality of life in patients with stable chronic obstructive pulmonary disease

目的:探讨稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者门诊肺康复综合治疗的临床价值,分析肺康复综合治疗对稳定期COPD患者运动耐力及生存质量等方面的影响。方法:选取2012年11月—2013年10月医院收治的200例稳定期COPD患者为研究对象,随机分为对照组与观察组,对照组给予常规门诊康复训练:呼吸功能训练(缩唇呼吸、腹式呼吸)结合氧疗,观察组给予门诊综合康复训练(运动、呼吸肌、长期家庭氧疗、营养支持、健康教育、心理与行为干预),训练前测定COPD生存质量评分、6min步行距离、Borg评分及St George呼吸问卷(SGRQ)评分,1秒用力呼气容积(FEV1)与最大肺活量(FVC),计算FEV1/FVC,分别与训练2周、1个月、3个月、6个月、1年、2年复测上述指标,并进行比较。结果:观察组患者训练6个月、1年、2年后生存质量评分、SGRQ明显优于训练前(P<0.05),观察组优于对照组(P<0.05);观察组患者训练3个月、6个月、1年、2年后6min步行距离、Borg评分明显优于训练前(P<0.05),观察组明显优于对照组(P<0.05),两组训练6个月、1年、2年患者FEV1/FVC与训练前比较显著升高(P<0.05)。结论:稳定期COPD患者行门诊综合康复治疗可显著改善运动能力,提高生存质量,呈现一定时间累积效应,长期训练效果更好。

Two hundred patients with stable COPD, hospitalized from November 2012 to October 2013 in the hospital were selected, and they were randomly divided into control group and observation group. Patients in the control group received conventional rehabilitation training in outpatient service, which training in respiratory function （contraction lip breathing, abdominal breathing） combined with oxygen therapy, while patients in the observation group received comprehensive rehabilitation training in outpatient service, including（exercise, respira- tory muscle, long-term home oxygen therapy, nutritional support, health education, psychological and behavioral interventions）. The quality of life scores, 6min walking distance, Borg score and St George＇s respiratory ques- tionnaire （SGRQ） score, forced expiratory volume in first second（FEVi） and forced vital capacity （FVC）, FEV1/FVC before training were measured before training and 2 weeks, 1 month, 3 months, 6 months, 1 year, 2 years after training these indicators were retested and compared respectively. Result： The quality of life scores, SGRQ in observation group after 6 months, 1 year, 2 years training were significantly better than that before training （P〈 0.05）, and the observation group was better than the control group （P 〈 0.05）. The 6min walking distance, Borg score in the observation group after 3 months, 6 months, 1 year, 2 years training were significantly better than that before the exercise （P〈 0.05）, the observation group was significantly better than that in the control group （P〈 0.05）. FEV1/FVC in two groups after training 6 months, 1 year, and 2 years significantly increased compare before training （P 〈 0.05）. Conclusion： The results show that comprehensive rehabilitation therapy in outpatient service in treatment of sta- ble patients with COPD can significantly improve exercise capacity and quality of life, for stable patients with COPD, It shows certain time cumulative effect, long-term training with better efficacy.