肺康复疗法改善慢性阻塞性肺疾病运动和呼吸功能的临床研究

Pulmonary rehabilitation can improve the exercise capacity and dyspnea of patients with chronic obstructive pulmonary disease

目的观察肺康复疗法改善慢性阻塞性肺疾病(COPD)患者运动能力和呼吸困难的临床效果。方法选取2014年至2018年收治的COPD患者100例,采用随机数字表法将其随机分为对照组(n=50)和观察组(n=50)。对照组患者给予常规药物治疗,观察组患者在此基础上增加包含健康指导、氧疗、呼吸生理治疗和运动训练的肺康复疗法。于治疗3个月后(治疗后)对2组患者进行疗效评价和生活质量评估,并于治疗前和治疗后测定2组患者的一秒用力呼气容积(FEV1)和一秒用力呼气容积百分比(FEV1%),并分别采用6 min步行训练、酶联免疫吸附法(ELISA)和免疫比浊法评估2组患者的运动功能和血清炎症因子表达水平。结果治疗后,观察组患者临床有效率为96.00%,显著高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,观察组患者的FEV1L、FEV1%和6 min步行距离均显著优于组内治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,观察组患者血清中的CRP、IL-6、TNF-α表达水平均显著低于组内治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,观察组患者的CRQ评分总分和情感、疲劳、喘息、病情控制能力等维度评分均高于对照组,组间差异均有统计学意义(P<0.05)。结论常规药物治疗联合肺康复疗法可有效地改善COPD患者的肺功能指标、运动能力和生活质量,并降低其血清炎性因子表达水平。

Objective To investigate the effect of pulmonary rehabilitation therapy on the exercise capacity and dyspnea of persons with chronic obstructive pulmonary disease(COPD).Methods One hundred COPD patients were randomly divided into a control group and an observation group,each of 50.Both groups were given routine medication,while the observation group was additionally provided with health guidance,oxygen therapy,respiratory physiological therapy and exercise for 3 months.Before and after the intervention,both groups′forced expiratory volume in 1 second(FEV1)and the first and second forced expiratory volume as a percentage of FEV(FEV1%)were measured.The subjects′motor functioning was evaluated using the 6-minute walk test.Enzyme-linked immunosorbent assays and immunoturbidimetry quantified their expression of inflammatory factors.And their ability in the activities of daily living(ADL)was evaluated using the Barthel index.The COPD quality of life questionnaire(CRQ)was also used to assess their life quality.Results After the intervention,the average clinical efficacy in the observation group was 96%,significantly higher than that of the control group(80%).Moreover,the average FEV1,FEV1%,6-minute walk test time of the former group were all significantly better than before the intervention and better than the control group′s results after the intervention.Their average CRP,IL-6 and TNF-αlevels were all significantly lower as well.After the intervention,the observation group′s average total CRQ score and its average scores on the instrument′s emotion,fatigue,wheezing and disease control components were all better than the control group′s averages.The observation group′s average ADL score was also significantly higher than that of the control group.Conclusions Supplementing conventional medication with pulmonary rehabilitation therapy can effectively improve the lung function,motor functioning and life quality of COPD patients.It can also lower their level of serum inflammatory factors.