太极锻炼联合呼吸训练器在中重度COPD稳定期患者的肺康复中的应用价值

Application value of Taichi exercise combined with respiratory trainer in lung rehabilitation of moderate and severe COPD patients at stable stage

目的探讨太极联合呼吸训练器对中重度COPD稳定期患者肺康复中的应用价值。方法前瞻性纳入2018年10月至2019年10月就诊于河南省人民医院呼吸内科门诊或经住院治疗好转出院的稳定期COPD患者40例,采用随机数表法分组分为两组(n=20)。分别采用常规药物治疗+常规肺康复训练(常规组),常规药物治疗+太极锻炼+呼吸训练器训练(联合组)。分别于1个月,3个月,6个月,12个月测定肺功能指标(FEV1%、FVC、FEV1/FVC)、CAT评分、6MWT及HAD焦虑评抑郁评分。结果随访中两组FEV1%、FVC、CAT及6MWT值均持续改善。联合组第3、6、12个月随访时FEV1%值较治疗前有统计学意义(P<0.05),常规组第6、12个月随访时FEV1%值较治疗前有统计学意义(P<0.05)。两组FVC,CAT,6MWT均于第3、6、12个月随访时较治疗前改善,差异有统计学意义(P<0.05)。从第3个月开始,联合组的FEV1%值、FVC,CAT,6MW值均较常规组改善明显,差异有统计学意义(P<0.05)。常规组焦虑、抑郁评分在任何时段随访时改善均较治疗前无统计学意义(P>0.05),联合组在第3、6、12个月随访时改善明显,差异均有统计学意义(P<0.05)。任何时段随访时两组FEV1/FVC均呈升高趋势,较治疗前差别均无统计学意义(P=0.995),但第3、6、12个月时联合组较常规组明显升高,差异有统计学意义(P<0.05)。结论 COPD稳定期患者使用太极联合呼吸训练器进行肺康复训练较传统训练方法相比,可短时间内改善患者的症状及肺功能指标,进行维持锻炼和重复肺康复能使患者长期获益,对COPD稳定期患者具有一定的应用前景。

Objective To explore the application value of Tai Chi combined with respiratory trainer in lung rehabilitation of moderate and severe COPD patients during stable period.Methods Forty stable COPD patients who were treated in the respiratory department outpatient department of Henan Provincial People’s Hospital or were discharged after hospital treatment from October 2018 to October 2019 were prospectively included. They were divided into two groups by random number table method(n=20). Routine drug therapy + conventional pulmonary rehabilitation training(conventional group) and conventional drug therapy + Tai Chi exercise + respiratory trainer training(combined group) were used, respectively. Lung function index(FEV1%, FVC, FEV1/FVC), CAT score, 6 MWT and HAD anxiety score were measured at 1 month, 3 months, 6 months and 12 months.Results During follow-up, FEV1%, FVC, CAT and 6 MWT were improved continuously in both groups. The FEV1% value at the 3 rd, 6 th and 12 th month follow-up of the combined group was statistically significant compared with that before treatment(P<0.05), and the FEV1% value at the 6 th and 12 th month follow-up of the conventional group was statistically significant compared with that before treatment(P<0.05). FVC, CAT and 6 MWT of the two groups were improved at the 3 rd, 6 th and 12 th month follow-up compared with those before treatment, with statistical significance(P<0.05). From the 3 rd month, the FEV1% value, FVC, CAT and 6 MW values of the combined group were significantly improved compared with the conventional group, with statistical significance(P<0.05). The improvement of anxiety and depression scores in the conventional group at any period of follow-up was not statistically significant compared with that before treatment(P>0.05), while the improvement was significant in the combined group at the 3 rd, 6 th and 12 th month follow-up, with statistically significant differences(P<0.05). During any period of time are in rising trend, the two groups of FEV1/FVC difference than before treatment had no statistical significance(P=0.995), but when 3, 6, 12 months joint group increased significantly in the normal group, the difference was statistically significant(P<0.05).Conclusion Compared with traditional training methods, Tai Chi combined with respiratory trainer for pulmonary rehabilitation training in stable COPD patients can improve the symptoms and pulmonary function indexes in a short time, and maintenance exercise and repeated pulmonary rehabilitation can bring long-term benefits to patients, which has a certain application prospect for patients in stable COPD.