渐进抗阻呼吸肌训练对慢性阻塞性肺疾病患者呼吸功能及运动能力的临床疗效

Clinical effect of progressive obstructive respiratory muscle training on respiratory function and motor capacity in patients with chronic obstructive pulmonary disease

目的探讨渐进抗阻呼吸肌训练对慢性阻塞性肺疾病患者呼吸功能及运动能力的疗效。方法将符合纳入标准的慢性阻塞性肺疾病患者50例随机分为试验组和对照组,每组各25例。两组患者均给予常规呼吸训练,1次/d,每周5次,30min/次,持续6周;试验组在常规呼吸训练的基础上给予渐进抗阻呼吸肌训练,1次/d,每周5次,10min/次,持续6周,分别于治疗前、治疗3周后、治疗6周后评定患者呼吸功能,评价指标包括用力肺活量(FVC)、1秒钟用力呼气量(FEV1)、一秒率(FEV1/FVC)、呼气流速峰值(PEF),采用膈肌超声对患者膈肌运动进行评估,每天对患者进行1次6分钟步行试验,取每位患者的步行距离平均值。结果治疗3周及治疗6周后,两组患者FVC、PEF、膈肌动度及6分钟步行距离均较治疗前有明显改善(P<0.05);且试验组提高更明显。与治疗前相比,两组FEV1/FVC(%)均无统计学意义,治疗6周后两组组间比较FEV1差异有统计学意义。结论渐进抗阻呼吸肌训练结合呼吸训练对于改善慢性阻塞性肺疾病患者的呼吸功能作用更加显著,优于单纯传统呼吸训练,值得临床推广。

Objective To investigate the effect of progressive anti-obstructive respiratory muscle training on respiratory function and exercise capacity in patients with chronic obstructive pulmonary disease.Methods 50 patients with chronic obstructive pulmonary disease(COPD)meeting the inclusion criteria were randomly divided into experimental group and control group,with 25 patients in each.Both groups were given routine breathing training,once a day,5 times a week,30min/time,lasting for 6 weeks.The experimental group was given progressive resistance respiratory muscle training on the basis of routine breathing training,once a day,5 times a week,10min/time,for 6 weeks.Respectively before treatment,3 weeks after treatment and 6 weeks after treatment,the patient's respiratory function was assessed with forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),the rate of one second(FEV1/FVC),and peak expiratory flow(PEF)as main evaluation index.,The diaphragm ultrasound was adopted to evaluate patients diaphragmatic muscle movement,each patient given a 6-minute walk test once a day,and the average distance walked by each patient was taken.Results After 3 weeks of treatment and 6 weeks of treatment,FVC,PEF,diaphragm movement and 6-minute walking distance in 2 groups were significantly improved(P<0.05),and the experimental group increased more obviously.Compared with before treatment,FEV1/FVC(%)of the two groups showed no statistical significance.Comparison between the two groups showed no statistical significance in FEV1 after 3 weeks of treatment,but significant difference in FEV1 after 6 weeks of treatment.Conclusion The traditional breathing training and progressive resistance training well combined with the traditional breathing exercises can both improve the respiratory function of patients with COPD and exercise capacity,and the effect of progressive resistance training well combined with breathing exercises to improve the respiratory function of patients with COPD is more significant,better than the traditional simple breathing exercises and thus valuable for clinical promotion.