24式简化太极拳在慢性阻塞性肺疾病稳定期肺康复中的疗效评价

The effect of 24 simplified Taichi on pulmonary rehabilitation in patients with stable chronic obstructive pulmonary disease

目的:本课题将24式简化太极拳应用于慢性阻塞性肺疾病稳定期患者的肺康复,观察患者的生存质量、临床症状及肺功能指标的变化,评价24式简化太极拳治疗慢性阻塞性肺疾病稳定期患者的临床疗效。方法:本试验于2015年8—12月,纳入四川大学华西医院中西医结合科门诊慢性阻塞性肺疾病稳定期患者46例,通过随机数字表随机将受试者分为太极拳组和对照组,太极拳组23例,对照组23例。对照组仅给予基础治疗;太极拳组给予基础治疗和24式简化太极拳;其中基础治疗包括常规药物治疗和健康教育。太极拳治疗疗程8周,每次30min,每周3次。观察指标:分别在治疗前、治疗8周后进行评估。主要疗效指标:圣乔治呼吸问卷(SGRQ)评价生存质量;次要疗效指标:6分钟步行距离(6MWT)评价运动耐力,肺功能测量评价肺功能,慢性阻塞性肺疾病评估测试(CAT)评价临床症状和日常运动情况,医院焦虑抑郁量表(HAD)评价焦虑抑郁状态。结果:太极拳组组内比较,SGRQ总分、症状部分、活动能力部分、疾病对日常生活的影响部分,CAT评分,HAD抑郁量表,6MWT在治疗8周后改善明显(P<0.05),肺功能指标(FVC、FEV1、FVC%、FEV1%)、HAD抑郁评分组内比较无显著性差异(P>0.05)。对照组各项指标治疗前后对比无明显差异(P>0.05)。太极拳组和对照组在治疗8周后两组间对比,SGRQ症状评分及CAT评分的差异有显著性意义(P<0.05),两组间SGRQ总分、SGRQ活动能力部分评分、SGRQ疾病对日常生活的影响部分评分、6MWT评分、HAD焦虑量表评分的对比,差异均无显著性意义(P>0.05)。结论:24式简化太极拳可以改善慢阻肺稳定期患者的生存质量,减轻呼吸困难症状,提高患者的运动耐力,改善慢阻肺稳定期患者的抑郁状态。24式简化太极拳肺康复对慢阻肺稳定期患者来说是一项有效的运动康复手段。

Objective： In this paper, the 24 simplified Taichi was applied in patients with stable COPD pulmonary rehabilitation. We observe the change of patients＇ quality of life, clinical symptoms and pulmonary function index, and evaluate the clinical efficacy of 24 simplified Taichi in the treatment of patients with stable chronic obstructive pulmonary disease. Method： This trial recruited 46 patients with stable chronic obstructive pulmonary disease in department of Integrated Traditional Chinese and Western Medicine of West China Hospital, Sichuan University from August 2015 to December 2015. The patients were randomly divided into two groups： Taichi group and control group, 23 cases in Taichi group and 23 cases in control group. Patients in the control group were given basic treatment, and at the same time patients in the Taichi group were given basic treatment and 24 simplified Taichi. The basic treatment included conventional medicine treatment and health education. Taichi treatment course lasted for 8 weeks, 30 minutes every time, 3 times a week. Outcome measures： Before intervention, 8 weeks after the intervention, the patients were assessed. Main outcome measures： St George＇s Respiratory Questionnaire （SGRQ） was used to evaluate the quality of life; Secondary outcome measures： 6 minutes walk distance （6MWT） for evaluation of exercise endurance, lung function measurements evaluation for lung function, chronic obstructive pulmonary disease assessment test （CAT） for assessment of the clinical symptoms and daily exercise, Hospital Anxiety and Depression Scale （HAD） for assessment of the state of anxiety and depression. Result： Compared with the group of Taichi, SGRQ score, symptoms, activity ability, the impact of disease on daily life, CAT score, HAD depression scale, 6MWT improved significantly after 8 weeks of treatment （P〈0.05） There were no significant differences in pulmonary function indexes （FVC, FEV1, FVC%, FEV1%） and HAD scores （P〉0.05）. The indicators in the control group before and after treatment had no significant difference （P〉0.05）. There was significant difference in SGRQ scores and CAT scores between the two groups （P〈0.05）. There were significant differences in SGRQ score, SGRQ activity score and SGRQ score between the two groups The scores of 6MWT and HAD were not significantly different between the two groups （P〉0.05）. Conclusion： 24 simplified Taichi can improve the quality of life of patients with chronic obstructive pulmonary disease, reduce the symptoms of dyspnea, improve the patient＇s exercise tolerance and the depression status of patients with COPD. 24 simplified Taichi pulmonary rehabilitation for patients with stable COPD is an effective means of exercise rehabilitation.