肺康复治疗对IPF患者与慢阻肺患者的疗效对比研究

Comparative Study on the Effect of Pulmonary Rehabilitation on Patients with IPF and COPD

目的将肺康复治疗对特发性肺间质纤维化(IPF)患者与慢阻肺患者的疗效进行对比,为IPF患者的治疗提供依据。方法于2015年3月—2019年9月对来自泰安市二级、三级及社区医院的IPF患者及慢阻肺患者进行前瞻性招募。A组(IPF组)招募80例患者,B组慢阻肺患者招募80例患者。对A、B两组患者进行肺康复治疗,肺康复治疗的实施包括每周进行两次监督性肺康复治疗,共8周(16个监督阶段)。其中受监督阶段由1 h的运动和45~60 min的教育构成。对比两组患者的肺功能、健康相关生活质量等。结果肺康复治疗后A组患者肺功能指标(FEV1)(3.48±0.56)L、FEV1%(74.22±13.16)%、FVC(3.88±1.26)L、TLC(4.28±1.18)L、Cdyn(0.19±0.01)L/cmH2O均高于B组,差异有统计学意义(P<0.05)。肺康复治疗后A组患者CRQ总分(22.63±2.81)分及CRQ-呼吸困难(5.61±1.01)分、CRQ-情感功能(5.62±1.14)分、CRQ-疾病控制(5.71±1.34)分、CRQ-疲劳症状评分(5.58±1.14)分均高于B组患者,差异有统计学意义(t=6.056,3.720,2.196,3.723,4.424,P<0.05)。结论肺康复治疗对IPF患者的治疗效果佳于慢阻肺患者,值得推广。

Objective To compare the effects of pulmonary rehabilitation therapy on patients with idiopathic pulmonary interstitial fibrosis(IPF)and COPD,and provide a basis for the treatment of patients with IPF.Methods From March 2015 to September 2019,prospectively recruited IPF patients and COPD patients from secondary,tertiary and community hospitals in Tai'an City.Group A(IPF group)recruited 80 patients,and group B COPD patients recruited 80 patients.Patients in groups A and B were treated with pulmonary rehabilitation.The implementation of pulmonary rehabilitation included supervised pulmonary rehabilitation twice a week for a total of 8 weeks(16 supervised stages).The supervised stage consists of 1 hour of exercise and 45-60 min of education.The lung function and health-related quality of life of the two groups of patients were compared.Results After pulmonary rehabilitation,the pulmonary function indexes FEV1(3.48±0.56)L,FEV1%(74.22±13.16)%,FVC(3.88±1.26)L,TLC(4.28±1.18)L,Cdyn(0.19±0.01)L/cmH2O of patients in group A were higher than those in group B,the difference was statistically significant(P<0.05).After treatment,patients in group A had CRQ total score(22.63±2.81)points,CRQ-dyspnea(5.61±1.01)points,CRQ-emotional function(5.62±1.14)points,CRQ-disease control(5.71±1.34)points,CRQ-fatigue symptom score(5.58±1.14)points were higher than those in group B,the difference was statistically significant(t=6.056,3.720,2.196,3.723,4.424,P<0.05).Conclusion The effect of pulmonary rehabilitation therapy on patients with IPF is better than that on patients with chronic obstructive pulmonary disease,and it is worthy of promotion.