简化“六字诀”联合体外膈肌起搏对COPD稳定期患者肺康复的疗效评价

Efficacy evaluation of simplified Six-word formula'combined with extracorporeal phrenic pace-making in pulmonary rehabilitation of patients with COPD stable period

目的探究简化"六字诀"联合体外膈肌起搏在慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)稳定期患者肺康复治疗中的应用效果。方法选取2017年7月-2019年6月浙江中医药大学附属第三医院收治的120例COPD稳定期患者,按照随机数字表法分为4组,A组给予基础治疗,B组在A组基础上给予简化"六字诀"功法训练,C组在A组基础上给予体外膈肌起搏干预,D组在A组基础上给予简化"六字诀"功法训练联合体外膈肌起搏干预,每组30例,各组干预周期均为3个月。对比4组患者中医证候积分、BODE指数、生活质量、半年内急性加重次数。结果干预后,4组患者中医证候积分[(6.82±1.57)分、(5.26±1.34)分、(5.63±1.28)分、(4.52±1.15)分]、生活质量各维度评分及总分[(44.21±9.07)分、(37.91±8.65)分、(39.92±7.83)分、(32.42±8.26)分]、半年内急性加重次数[(4.25±1.26)次、(3.32±0.87)次、(3.86±1.03)次、(2.62±0.79)次]等指标均较干预前降低,D组明显低于A、B、C组,差异有统计学意义(P<0.05);干预后4组BODE指数均较干预前下降,D组BODE指数[(4.21±1.04)分]均低于A、B、C组[(5.32±1.67)分、(4.84±1.40)分、(5.23±1.35)分],与A、C组比较差异有统计学意义(均P<0.05)。结论简化"六字诀"联合体外膈肌起搏用于COPD稳定期患者肺康复治疗中可有效缓解患者临床症状,增强肺功能,减少急性发作次数,降低BODE指数,提升生活质量。

Objective To explore the effect of simplified ’six-word formula’ combined with extracorporeal phrenic pace-making in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD) stable period. Methods A total of 120 patients with COPD stable period in our hospital were selected from July 2017 to June 2019, and they were randomly divided into four groups, with 30 cases in each group. Group A was given basic treatment, group B was given the simplified ’six-word formula’ training on the basis of group A, group C was given extracorporeal phrenic pace-making on the basis of group A, and group D was given simplified ’six-word formula’ training combined with extracorporeal phrenic pace-making on the basis of group A. The intervention period of each group was 3 months. The TCM syndrome score, BODE index, quality of life and times of acute exacerbation in half a year of the four groups were compared. Results After intervention, the scores of TCM syndromes(6.82±1.57, 5.26±1.34, 5.63±1.28, 4.52±1.15), the score of quality of life in each dimension and total scores(44.21±9.07, 37.91±8.65, 39.92±7.83, 32.42±8.26), and the number of acute exacerbations(4.25±1.26, 3.32±0.87, 3.86±1.03, 2.62±0.79) in half a year in the four groups of patients were decreased compared with those before the intervention. Group D had the lowest scores, and the difference was statistically significant(all P<0.05). After the intervention, the BODE index of the four groups decreased. The BODE index of group D(4.21±1.04) was lower than that of group A, B and C(5.32±1.67, 4.84±1.40, 5.23±1.35, respectively), and the difference was statistically significant(all P<0.05). Conclusion The simplified ’six-word formula’ combined with extracorporeal phrenic pace-making in pulmonary rehabilitation can effectively alleviate the clinical symptoms of COPD stable period patients, enhance the pulmonary function, reduce the number of acute attacks, reduce the BODE index and improve the quality of life of COPD patients.