慢性病自我管理项目对改善慢性阻塞性肺疾病患者肺康复的应用

The application value of chronic disease self-management project in promoting pulmonary rehabilitation of patients with chronic obstructive pulmonary disease

目的探讨慢性病自我管理项目(CDSMP)在促进人群中慢性阻塞性肺病(COPD)患者的肺康复方面的作用。方法于2017年6月至2018年12月,选取同期在山东大学齐鲁医院健康管理中心进行体检的体检者,筛选其中的COPD患者纳入研究,共380人。随机平均分为试验组和对照组,每组各190人。研究结束时,共有17例失访,5例自动退出研究。最终试验组和对照组各有175、183名患者完成研究。试验组患者应用为期6个月的CDSMP,对照组采取常规护理措施。比较两组患者干预前后的肺功能及血气分析结果、肺康复相关指标、健康调查简表(SF-36)评分。计量资料用±s表示,两组间比较采用t检验。计数资料用频数及构成比(%)表示,组间比较采用χ2检验或秩和检验。结果 CDSMP干预后,与对照组比较,试验组患者的6分钟步行测试距离、每周中等强度锻炼时间、每周中等强度锻炼频率、自主锻炼效能评分均明显升高,单次运动持续时间较长,差异有统计学意义(P<0.05)。与对照组比较,试验组患者的生理功能评分、一般健康评分、身体精力评分、精神健康评分、总评分均较高,差异均有统计学意义(P<0.05)。结论 CDSMP在促进COPD患者肺康复中可能具有一定的效果。

Objective To explore the role of chronic disease self-management program(CDSMP)in promoting pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD).Methods In June 2017 and December 2018,380 COPD patients were selected from the health management center of Qilu Hospital of Shandong University during the same period.They were randomly divided into the experimental group and the control group.At the end of the study,17 cases were lost to follow-up and 5 cases were withdrawn from the study.Finally,175 and 183 patients in the experimental group and the control group completed the study.The experimental group was treated with CDSMP for 6 months,while the control group was not intervened.Lung function and blood gas analysis results,lung rehabilitation related indicators and SF-36 scores were compared between the two groups before and after intervention.The measurement data were expressed by Mean±SD,and the comparison between the two groups was performed by t test.The count data were expressed by frequency and constituent ratio(%).Chi square test or rank sum test was used for comparison between groups.Results After CDSMP intervention,compared with the control group,the 6MWD,weekly moderate intensity exercise time,weekly moderate intensity exercise frequency and self exercise efficacy score of the experimental group were significantly increased,and the single exercise duration was longer,the difference was statistically significant(P<0.05).The physiological function score,general health score,physical energy score,mental health score and total score of the experimental group were higher,and the differences were statistically significant(P<0.05).Conclusion CDSMP may have a certain effect in promoting lung rehabilitation in COPD patients.