运动训练对慢性阻塞性肺疾病患者活动耐受力的影响

Effect of quantitative walking exercise on exercise tolerance of patients with chronic obstructive pulmonary disease at stable stage

目的探讨运动训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者活动耐受力的影响。方法选择2014年1月—2015年6月就诊于上海交通大学附属第一人民医院的中重度COPD缓解期患者78倒,随机分为观察组40例和对照组38例。观察组采用定量步行运动训练,对照组不接受任何形式的运动训练。干预3个月后比较两组患者干预前后的肺功能情况、生活质量、6分钟步行运动距离和呼吸困难指数。结果两组患者FEV1%升高差异无统计学意义(P>0.05)。观察组患者CAT评分由(23.4±6.3)分降至(15.6±5.4)分,6分钟步行距离由(238.0±36.6)m增至(386.0±48.2)m,m MRC评分由(3.3±1.6)分降至(2.8±1.4)分,均较干预前明显改善(P<0.05),同时明显优于对照组(P<0.05)。结论定量步行运动训练能有效改善中重度COPD患者的活动耐受力和生活质量,对COPD患者康复具有积极意义。

Objective To investigate the effect of quantitative walking exercises on exercise tolerance of the patients with chronic obstructive pulmonary disease （COPD） at stable stage. Methods A total of 78 COPD patients in Shanghai First People＇ s Hospital, Shanghai Jiao Tong University hospitalized from January 2014 to June 2015 were randomly divided into the exercise training group （n =40） and control group （n = 38）. The patients in the exercise training group completed quantified walking exercise twice a day, while the patients in the control group did not perform any kind of exercise training. The changes in FEV1%, modified Medical Research Council （mMRC） dyspnea score, COPD Assessment Test （CAT） score and walking distance were evaluated after 3 months. Results In the exercise training group, mMRC and CAT scores significantly decreased after exercise training （3.3 ± 1.6 vs. 2.8± 1.4, 23.4 ± 6.3 vs. 15.6 ±5.4, respectively, P 〈 0.05 ） ,while 6 minute walk distance significantly increased after exercise training [ （ 238.0 ± 36.6 ） m vs. （386.0 ± 48.2） m, P 〈 0.05 ]. The exercise training group had better outcomes than the control group. But the increase in FEV1% was not significantly different in both two groups （P 〉 0. 05 ）. Conclusion Quantitative walking exercise can improve the exercise tolerance and quality of life of the patients with COPD.