肺康复锻炼对COPD稳定期患者肺功能及生活质量的影响

Impacts of pulmonary rehabilitation exercise on lung function and QOL of patients with COPD in stable phase

目的探究肺康复锻炼对慢性阻塞性肺疾病(COPD)稳定期患者肺功能及生活质量的影响。方法随机将288例COPD稳定期患者分为观察组和对照组,各144例。对照组在常规治疗基础上给予低剂量茶碱缓释片,观察组在对照组基础上进行肺康复锻炼,测定治疗前后第1秒用力呼吸容积(FEV1)、第1秒用力呼吸容积(FEV1)/用力肺活量(FVC)、呼吸中枢驱动(P0.1)、吸气肌功能(PImax)及呼气肌功能(PEmax)等肺功能指标;比较治疗前后两组6 min步行距离(6MWD)和生活质量。结果治疗后,两组FEV1、FEV1/FVC、PImax、PEmax及6MWD均升高(P <0.05),P0.1均降低(P <0.05),且观察组各指标改善显著优于对照组(P <0.05);两组临床症状积分、圣乔治呼吸问卷(SGRQ)各维度分值及总分均显著降低(P <0.05),观察组下降幅度大于对照组(P <0.05)。结论肺康复训练辅助低剂量茶碱缓释片治疗COPD稳定期患者,可显著改善患者动静态肺功能,改善患者临床症状和生活质量,疗效优于单一茶碱缓释片治疗。

Objective To explore the impacts of pulmonary rehabilitation exercise on the lung function and quality- of life （QOL） of patients with chronic obstructive pulmonary disease （COPD） in stable phase. Methods A total of 288 patients with COPD in stable phase were randomly divided into an observation group and a control group （u=144, respectively）. The control group was treated with a low dose of theophylline sustained release tablets on the basis of conventional therapy. The observation group was additionally treated with pulmonary rehabilitation exercise. Such pulmonary function indexes as the force expiratory volume in the first second （FEV,）, FEVJforced vital capacity- （FVC）, respiratory center drive （P0.1）, inspiratory muscle function （PImax） and expiratory muscle function （PEmax） before and after the treatment were detected. The 6-min walking distance （6MWD） and the quality- of life （QOL） were compared between the two groups. Resttlts After the treatment, the FEV1、 FEV1/FVC, PImax, PEmax and 6MWD in the two groups increased （P 〈 0.05） but P0.1 decreased （P 〈 0.05）, and the improvement in the observation group was significantly better than that in the control group （P 〈 0.05）; the clinical symptom scores and the dimension scores and total scores in St.George＇s Respiratory Questionnaire （SGRQ） decreased significantly in both groups （P 〈 0.05）, and the decrease in the observation group was greater than that in the control group （P 〈 0.05）. Conclusion Pulmonary rehabilitation exercise combined a low dose of theophylline sustained release tablets can significantly improve the dynamic and static pulmonary function, clinical symptoms and QOL and has better effects than single theophylline sustained release tablets in the treatment of patients with COPD in stable phase.