呼吸康复操与健身气功六字诀结合西医常规疗法治疗慢性阻塞性肺疾病临床研究

Research of the respiratory rehabilitation and TCM exercises combined with conventional western medicine therapy on the lung function for the patients with COPD

目的 评价呼吸康复操与健身气功六字诀结合西医常规疗法治疗COPD的疗效。方法 将符合入选标准的84例COPD患者采用随机数字表法分为2组，每组42例。对照组给予西医常规疗法治疗，观察组在对照组基础上结合呼吸康复操与健身气功六字诀。2组均观察1年。采用肺功能仪检测患者一秒用力呼气容积（forced expiratory volume in one second, FEV1）、第1秒用力呼气容积与用力肺活量的比值（forced expiratory volume in one second/forced vital capacity, FEV1/FVC）、最大呼气流量（peak expiratory flow, PEF）；采用便携式脉氧仪检测患者心率、血氧饱和度（pulse oxygen saturation, SpO2）；评估患者中医证候、汉密顿焦虑量表（Hamilton Anxiety Scale, HAMA）及汉密顿抑郁量表（Hamilton Depression Scale, HAMD）积分，并对可能影响疗效的因素进行Logistic回归分析。结果 治疗后，观察组FEV1[（1.58±0.21）L比（1.33±0.22）L，t＝8.092]、FEV1/FVC[（82.92±8.42）%比（62.81±8.94）%，t＝10.013]、PEF[（358.27±27.03）L/min比（324.13±32.03）L/min，t＝6.272]、SpO2[（99.58±2.72）%比（91.92±2.89）%，t＝10.142]水平高于对照组（P＜0.05）；中医证候积分[（6.3±2.2）分比（9.2±2.0）分，t＝4.625]、HAMA评分[（6.0±1.7）分比（9.0±2.0）分，t＝4.563]、HAMD评分[（6.1±2.0）分比（8.7±1.7）分，t＝5.094]低于对照组（P＜0.05）。Logistic回归分析提示，患者治疗方法、病程与疗效之间存在相关性（P＜0.05）。结论 呼吸康复操与健身气功六字诀结合西医常规疗法可减少COPD患者焦虑、抑郁等不良情绪，改善临床症状。

Objective To observe the effect of the respiratory rehabilitation and TCM exercises combined with conventional western medicine therapy for the patients with COPD. Methods A total of 84 patients with COPD were randomized into the control group and observation group, 42 in each group. The control group were treated with conventional Western medicine treatment, and the observation group was treated with traditional Chinese exercises ＂sixth tactic＂ treatment on the basis of control group treatment. All patients were taken one year course of treatment. The changes in lung function, AECOPD occurrence, changes in symptom scores, Hamilton heart questionnaire integration were observed; and possible changes in the factors affecting the efficacy was analyzed by Logistic regression. Results There were not significant differences in FEV1, FEV1/FVC, PEF and SpO2 between the two groups before treatment. After 1 year of treatment, the FEV1 （1.58 ± 0.21 L vs.1.33 ± 0.22 L, t=8.092）, FEV1/FVC （82.92% ± 8.42% vs. 62.81% ± 8.94%, t=10.013）, PEF （358.27 ± 27.03 L/min vs. 324.13 ± 32.03, t=6.272）, SpO2 （99.58% ± 2.72% vs. 91.92% ± 2.89%, t=10.142） in the observation group were significantly higher than those in the control group （P〈0.05）. After treatment, Chinese medicine syndrome scores （6.3 ± 2.2 vs. 9.2 ± 2.0, t=4.652）, HAMA score （6.0 ± 1.7 vs. 9.0 ± 2.0, t=4.563）, HAMD score （6.1 ± 2.0 vs. 8.7 ± 1.7, t=5.094） in the observation group were superior to the subcontrol group （P〈0.05）. Regression analysis showed that there was a linear correlation between patient group, course of disease and outcome effect （P〈0.05）. Conclusions The respiratory rehabilitation and traditional Chinese medicine exercises ＂sixth tactic＂ combined with conventional treatment could release anxiety, depression and negative emotions, and improve clinical symptoms of the patients with COPD.