间歇运动与持续运动肺康复方案的比较

Continuous versus interval trainings for patients with chronic obstructive pulmonary disease

目的比较慢性阻塞性肺疾病（COPD）患者间歇运动与持续运动肺康复的效果。方法共35例COPD患者进入康复计划，将其随机分到间歇组和持续组，6例患者脱落，29例完成康复计划，其中间歇组14例，持续组15例；另设对照组9例。试验前后分别进行肺功能检查、6min步行试验及圣乔治呼吸问卷（SGRQ）。采用功率自行车进行下肢耐力训练，持续组运动过程中保持BORG指数4分（中度气促）左右，运动30min。间歇组以尽可能高的强度运动30s，休息30s，交替进行，共30min。均每周2次，共3个月。对照组不进行运动康复。结果康复前各组肺功能比较差异均无统计学意义（均P〉0．05），康复后间歇组和持续组6min步行距离分别提高了（63．8±72．3）m和（61．5±68．7）nl（均P〈0．05），较康复前分别提高（24±27）％和（22±23）％，两组改善率比较差异无统计学意义（z=-0．180，P=0．859）。康复后间歇组和持续组SGRQ总分均获得显著改善（P值分别为0．022，0．003），两组的改善程度差异无统计学意义（Z=-0．540，P=0．589）。而对照组康复前后6min步行距离及SGRQ评分均无显著改善。结论间歇运动与持续运动均能提高COPD患者运动能力及生活质量，且改善效果相似。

Objective To explore the effects of continuous versus interval trainings for patients with chronic obstructive pulmonary disease （COPD）. Methods This was a controlled, prospective randomized study. 35 patients with COPD took part in the rehabilitation program and were randomly divided into a continuous group and an interval group. Among the 35 patients, 29 completed the rehabilitation program, 15 in the continuous group and 14 in the interval group. 9 patients were set as a control group. Bicycle exercise training were conducted 2 days each week for 12 weeks. The continuous group trained with the intensity corresponding to Borg scale 4 （moderate dyspnea） for 30 min constantly. The interval group trained with a tolerance for the highest level intensity for 30 seconds, then had a break for 30 seconds, alternatively. The control group took no exercise training. The main assessments included lung function test, six-minutes walking distance, and St George＇s Respiratory Questionnaire, being evaluated before and after the pulmonary rehabilitation programme. Results There were statistical differences in FVC, FEV1, FVC%pred, FEV1%pred, and MVV between before and after the rehabilitation in both groups （ all P 〉 0.05 ） . After the rehabilitation, the interval group＇s six-minutes walking distance was （63.8±72.3） and increased （24±27） % （ P 〈 0.05 ） and the continuous group＇s was （61.5±68.7） meters and increased （22±23）% （ P 〈 0.05 ） , but with no statistical difference between these two groups （ z=- 0.180, P=0.859 ） . The total score of SGRQ was improve in the interval group （P=0.022） and in the continuous group （P=0.003） after the rehabilitation, but with no statistical difference between these two groups （ z=- 0.540, P=0.589 ） . The control group＇s six-minntes walking distance and total score of SGRQ got no obvious improvement （ both P 〉 0.05 ） . Conclusion Continuous and interval trainings both can improve the exercise capacity and health status of patients with COPD and have similar improvement effects.