家用呼吸训练器在稳定期慢性阻塞性肺疾病患者肺康复中的应用

Application of household breathing trainer in pulmonary rehabilitation of patients with stable phase chronic obstructive pulmonary disease

目的探讨家庭用呼吸训练器在稳定期慢性阻塞性肺疾病(COPD)患者肺康复中的应用价值。方法选取2017年1月至2019年12月就诊于河北医科大学第二医院呼吸与危重症医学科的48例稳定期COPD患者进行前瞻性研究。根据肺康复方法不同分为试验组(22例)和对照组(26例),2组患者均在常规药物治疗的基础之上联合肺康复治疗,试验组采用"缩唇呼吸+腹式呼吸+空中踏车+家庭用呼吸训练器"的锻炼方式,对照组采用"缩唇呼吸+腹式呼吸+空中踏车"的锻炼方式。分别在1、3、6个月末评测患者圣乔治呼吸调查问卷(SGRQ)、慢性阻塞性肺疾病评估测试(CAT)评分、第1秒用力呼气容积占预计值百分比(FEV1%pred)、6分钟步行试验(6MWT)和改良版英国医学研究委员会呼吸困难量表(mMRC)。结果2组患者基线资料间差异均无统计学意义(P值均>0.05)。2组患者FEV1%pred、6MWT均随时间延长而增加,mMRC、SGRQ、CAT评分则随时间延长而降低。组间比较显示在6个月时,试验组FEV1%pred[(64.55±7.90)%]高于对照组[(58.65±8.49)%],而mMRC、SGRQ和CAT评分低于对照组,且组间差异均有统计学意义(P值均<0.05)。组内比较显示试验组FEV1%pred在3个月、6个月,SGRQ评分在6个月,mMRC在6个月时均较基线有好转,且差异均有统计学意义(P值均<0.05);对照组仅FEV1%pred在3个月、6个月时较基线差异有统计学意义(P值均<0.05)。结论稳定期COPD患者坚持家庭用呼吸训练器进行肺康复锻炼,可有效改善肺功能及呼吸肌功能。

Objective To explore the application value of household breathing trainer in pulmonary rehabilitation of patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 48 patients with stable COPD in the respiratory department of the Second Hospital of Hebei Medical University from January 2017 to December 2019 for prospective study.According to different pulmonary rehabilitation methods,patients were divided into an experimental group(22 cases)and control group(26 cases).Two groups of patients were on the basis of conventional drug therapy combined with pulmonary rehabilitation treatment.The experimental group adopted the training methods of"contracted lips breathing+abdominal breathing+aerial bicycle+household breathing trainer".The control group adopted the training methods of"contracted lips breathing+abdominal breathing+aerial bicycle".At the end of 1,3 and 6 months,all patients were evaluated with St George′s breath Questionnaire(SGRQ),COPD associated test(CAT),forced expiratory volume in the first second in percent predicted values(FEV1%pred),6-minute walking test(6MWT),and modified Medical Research Council(mMRC).Results There was no significant difference in baseline data between the two groups(all P>0.05).In both groups,FEV1%pred value and 6MWT increased time,but mMRC,SGRQ,CAT decreaseed with time.The comparison between groups showed that at the end of 6 months,the FEV1%pred value of the experimental group[(64.55±7.90)%]was higher than that of the control group[(58.65±8.49)%],while the mMRC,SGRQ and CAT scores were lower than those of the control group.And the difference between groups was statistically significant(all P<0.05).The comparison within the experimental group showed that the FEV1%pred value at 3,6 months.SGRQ score at 6 months,and mMRC at 6 months were better than the baseline,with significant differences(all P<0.05).In the control group,only FEV1%pred expected value was very different from the baseline at 3 and 6 months(both P<0.05).Conclusions Stable phase COPD patients insist on household breathing trainer for pulmonary rehabilitation exercises,which can effectively improve lung function and respiratory muscle function.