穴位按摩联合六字诀呼吸操在慢性阻塞性肺疾病稳定期患者中的应用

Effectiveness of acupoint massage combining six healing sounds(Liu-Zi-Jue)respiratory exercise in stable patients with chronic obstructive pulmonary disease(COPD)

目的探讨穴位按摩联合六字诀呼吸操治疗慢性阻塞性肺疾病稳定期患者的临床疗效。方法将75例慢性阻塞性肺疾病稳定期患者随机分为治疗组(38例)与对照组(37例)。对照组采取常规治疗及护理,同时配合缩唇呼吸及腹式呼吸康复锻炼3个月。治疗组在常规治疗及护理基础上行穴位按摩干预14d,同时配合六字诀呼吸操干预3个月。观察两组治疗前后中医证候积分、改良英国医学研究委员会呼吸困难量表(mMRC)评分、焦虑抑郁评分、慢性阻塞性肺疾病评估测试(CAT)评分以及第一秒钟用力呼气容积与用力肺活量的比值(FEV1/FVC)变化。结果干预3个月后,治疗组中医证候积分、mMRC评分、CAT评分、焦虑抑郁评分显著优于对照组(均P<0.01),两组FEV1/FVC比较,差异无统计学意义(P>0.05)。结论穴位按摩联合六字诀呼吸操能改善慢性阻塞性肺疾病稳定期患者症状,减轻焦虑抑郁情绪。

Objective To observe the effectiveness of acupoint massage in combination with Liu-Zi-Jue respiratory exercise in stable COPD patients. Methods Seventy-four stable COPD patients were randomly assigned to one of two groups. Subjects in the control group（n=37） were given conventional treatment and care, and were asked to perform mouth breathing exercise and abdominal breathing exercise for 3 months. Participants in the treatment group（n= 38） received acupoint massage intervention for 14 days in addition to conventional treatment and care, and were asked to conduct Liu-Zi-Jue respiratory exercise for 3 months. The TCM syndrome score, modified Medical Research Council Dyspnea scale （mMRC scale） score, COPD assessment test （CAT） score, Hamilton Anxiety Rating Scale（HAMA） and Hamilton Depression Rating Scale （HAMD） scores, as well as the ratio of forced ex- piratory volume in one second to forced vital capacity （FEV1/FVC） were compared between the two groups. Results After 3 months of intervention, the scores of the former 5 indicators were significantly lower in the treatment group compared with the control group （P〈0.01 for all）. There was no significant difference in FEV1/FVC between the two groups （P〉0.05）. Conclusion Acupoint massage combined with Liu-Zi-Jue respiratory exercise can mitigate syndromes of stable COPD patients, and alleviate their anxiety and depression.