有氧运动结合健康信念干预在老年慢性阻塞性肺疾病中的应用

Effect of aerobic exercise combined with health belief in elderly patients with chronic obstructive pulmonary disease

目的探讨在老年慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)患者中实施有氧运动结合健康信念干预的作用。方法选取2018年2月-2021年2月首都医科大学附属北京潞河医院收治的70例老年COPD患者,按随机数字表法分为对照组和研究组,每组35例。两组均接受常规治疗及健康信念干预,研究组在此基础上实施有氧运动,连续干预12周。比较两组患者干预前后心肺功能与生活质量变化。结果干预后两组患者第1秒用力呼气容积(Forced expiratory volume second,FEV1)[(54.03±8.02)mL vs(48.82±8.15)mL]及FEV1占预计值百分比(FEV1 percentage of estimated value,FEV1%_(pred))[(64.58±9.10)vs(60.22±8.20)]均增加,且研究组均高于对照组(P<0.05)。干预后两组最大摄氧量(Maximal oxygen uptake,VO_(2)max)[(5.80±1.00)mL/min vs(5.22±1.10)mL/min]、相对VO_(2)max(VO_(2)max/kg)[(5.22±0.95)mL·min^(-1)·kg^(-1)vs(4.50±0.85)mL·min^(-1)·kg^(-1)]、峰值氧脉搏(VO_(2)/peak heart rate,VO_(2)/HR_(peak))[(14.78±2.20)mL vs(12.42±2.00)mL]、最大心率(Peak heart rate,HR_(peak))[(161.02±14.02)min vs(152.03±13.82)min]均增加,且研究组均高于对照组(P<0.05)。干预后两组呼吸道疾病问卷修订版量表(Ariways questionnaire 20-rised,AQ20-R)呼吸道症状、生活能力及病情对生活影响的评分均较治疗前降低,且研究组均低于对照组(P<0.05)。结论在老年COPD患者中实施有氧运动结合健康信念干预可改善患者心肺储备功能,提高生活质量,具有推广价值。

Objective To evaluate the effect of aerobic exercise combined with health belief intervention in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 70 elderly COPD patients admitted from February 2018 to February 2021 were selected and randomly divided into the two groups,with 35 cases each in the control group and the study group.Both groups received normal routine treatment and health belief intervention,while the study group received aerobic exercise on the basis of normal routine treatment and health belief intervention,and both treatment routine received continuous intervention for 12 weeks.Compared with the changes in cardiopulmonary function,blood oxygen index,psychological state and quality of life were compared between the two groups before and after the intervention.Results After the intervention,the forced expiratory volume in the first second(FEV1)[study group(54.03±8.02)vs control group(48.82±8.15)ml]and the percentage of FEV1 in predicted value(FEV1%pred)[study group(64.58±9.10)vs control group(60.22±8.20)]of the two groups were increased,and the study group were higher than those of the control group(P<0.05).After the intervention,the maximal oxygen uptake(VO_(2) max)[study group(5.80±1.00)vs control group(5.22±1.10)ml/min],relative maximal oxygen uptake(VO_(2) max/kg)[study group(5.22±0.95)vs control group(4.50±0.85)ml·min^(-1)·kg^(-1)],VO_(2)/peak heart rate(VO_(2)/HR_(peak))[study group(14.78±2.20)vs control group(12.42±2.00)ml],and peak heart rate(HR_(peak))[study group(161.02±14.02)vs control group(152.03)±13.82)/min)]increased in the two groups,and the study group was higher than the control group(P<0.05).After the intervention,the arterial oxygen saturation(SaO_(2))and partial pressure of oxygen(PaO_(2))in the two groups were increased,the partial pressure of carbon dioxide(PaCO_(2)),Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores were decreased.The SaO_(2) and PaO_(2) of the study group were higher than those of the control group,and the PaCO_(2),SAS and SDS were lower than those of the control group,and the difference was statistically significant(P<0.05).After the intervention,the respiratory symptoms,living ability,and the impact of illness on life scores in the revised version of the Ariways Questionnaire 20-rised(AQ20-R)in the two groups were reduced,and the study group was lower than the control group(P<0.05).Conclusion Implementing aerobic exercise combined with health belief intervention in elderly COPD patients for improving cardiopulmonary reserve function,blood oxygen content,psychological state and quality of life,and it has clinical value.