水中肺康复对慢性阻塞性肺疾病稳定期患者肺功能的效果

Effect of Water-based Pulmonary Rehabilitation on Stable Chronic Obstructive Pulmonary Disease

目的观察水中肺康复在慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法2020年2月至2021年2月,本院COPD稳定期患者50例根据训练方法分为对照组(n=25)和试验组(n=25),分别接受陆上和水中肺康复8周。治疗前后,采用肺功能仪测量患者第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占预计值的百分比(FEV_(1)%)、第1秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC),采用表面肌电图测量膈肌和右腹横肌肌电均方根(RMS),采用改良版英国医学研究委员会呼吸困难量表(mMRC)、6分钟步行试验(6MWT)、成人COPD生活质量量表(COPD-QOL)进行评定。结果治疗后,两组FEV_(1)、FEV_(1)%、FEV_(1)/FVC、膈肌和腹横肌RMS、6MWT距离和COPD-QOL评分均提高(t>2.08,P<0.05),试验组均较对照组提高更多(t>2.27,P<0.05);两组mMRC评分均减少(t>2.09,P<0.05),试验组较对照组减少(t=2.13,P<0.05)。结论在水中进行肺康复训练,可显著改善COPD患者的肺功能,增强呼吸肌肌力,改善呼吸困难,提高运动耐量,改善生活质量。

Objective To observe the effect of water-based pulmonary rehabilitation on stable chronic obstructive pulmonary disease(COPD).Methods From February,2020 to February,2021,50 patients with stable COPD in our hospital were divided into control group(n=25)and experimental group(n=25),who accepted pulmonary rehabilitation training on land and in water,for eight weeks.They were measured forced expiratory volume in first second(FEV_(1)),percents of forced expiratory volume in first second for prediction(FEVl%)and ratio of forced expiratory volume in first second in forced vital capacity(FEV_(1)/FVC)with pulmonary function instrument;measured root mean square(RMS)of electromyogram of diaphragm and right transversus abdominis with surface electromyography;and assessed with modified breathlessness measurement of British Medical Research Council(mMRC),6-minute walk test(6 MWT)and quality of life scale for COPD adults(COPD-QOL)before and after treatment.Results FEV1,FEVl%,FEV1/FVC,RMS of diaphragm and transversus abdominis,and 6 MWT distance and COPD-QOL score increased in both group(t>2.08,P<0.05),and increased more in the experimental group than in the control group(t>2.27,P<0.05);while mMRC score decreased(t>2.09,P<0.05),and decreased more in the experimental group than in the control group(t=2.13,P<0.05).Conclusion Water-based pulmonary rehabilitation training can further improve lung function,strength of respiratory muscles,dyspnea,tolerance and quality of life for patients with COPD.