运动训练干预对尘肺稳定期患者康复的作用

Effects of exercise training intervention on rehabilitation of patients with stable pneumoconiosis

目的:探讨运动训练为主的康复治疗的临床疗效,为煤工尘肺(CWP)的康复训练提供科学标准与依据。方法:将100例CWP稳定期患者随机分为试验组和对照组。试验组采用常规治疗与运动训练相结合的治疗手段,而对照组仅采用常规治疗,并在治疗前后对两组患者的运动能力、呼吸状况、生存质量以及机体炎症反应进行评估。结果:经治疗后,试验组患者BMI、6min步行距离(6MWD)、肺活量(VC)、用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC比值、呼气峰值流速(PEF)、圣乔治呼吸问卷(SGRQ)评分、健康调查简表(SF-36)得分,以及血清瘦素(LP)水平均有所改善(P<0.05),而对照组患者仅BMI、SGRQ问卷中呼吸状况、活动能力及疾病影响以及SF-36量表中躯体疼痛、精神健康和生理职能分数发生变化(P<0.05)。同时治疗后的试验组患者6MWD、VC、FVC、SGRQ评分、SF-36得分、LP和C-反应蛋白水平均优于对照组(P<0.05)。其中,6MWD与SGRQ呈负相关,SGRQ与VC呈负相关,6MWD与VC成正相关。结论:运动训练为主的康复治疗可提高煤工尘肺患者的运动能力和耐力,还可以改善其呼吸状况和肺健康,减少疾病对生活的困扰,提高生存质量。

Objective:The aim of this thesis was to explore the clinical efficacy of exercise training-based rehabilitation,and provided the scientific standards and evidence for the rehabilitation of coal worker’s pneumoconiosis(CWP).Method:Totally 100 patients with CWP stable period were randomly divided into test group and control group.The test group received a combination of conventional therapy and exercise training,while the control group only received conventional therapy.The exercise capacity,respiratory status,quality of life,and inflammatory response of the two groups were evaluated before and after treatment.Result:After treatment,BMI,6-minute walking distance(6 MWD),vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC ratio,peak expiratory flow rate(PEF),St.George’s Respiratory Questionnaire(SGRQ)score,the health survey summary(SF-36)score,and serum leptin(LP)levels were all improved(P<0.05).While in the control group,BMI,respiratory condition,activity ability and disease effect in the SGRQ questionnaire changed,and scores of bodily pain,mental health and role-emotional in the SF-36 scale changed(P<0.05).At the same time,the 6 MWD,VC,FVC,SGRQ score,SF-36 score,LP and C-reactive protein levels were better in the experimental group than those in the control group(P<0.05).Among them,6 MWD was negatively correlated with SGRQ,SGRQ was negatively correlated with VC,and 6 MWD was positively correlated with VC.Conclusion:Exercise-based rehabilitation could improve the exercise capacity and endurance of coal workers with pneumoconiosis,improve their respiratory status and lung health,reduce the risk of life and improve the quality of life.