美声唱法对稳定期慢性阻塞性肺疾病患者呼吸康复的影响

Effect of bel canto in the respiratory rehabilitation of patients with chronic obstructive pulmonary disease in stable stage

目的探讨美声唱法呼吸训练对稳定期慢性阻塞性肺疾病患者呼吸康复的效果。方法采用类试验研究方法,选取2018年9—12月兰州大学第一医院收治的稳定期慢性阻塞性肺疾病患者40例为研究对象。一病区为试验组,二病区为对照组,各20例,2个病区的医生诊疗水平、护士护理能力相当,病区环境相同。试验组给予美声唱法呼吸训练,对照组给予常规呼吸训练。建立微信群,出院后在微信群内发放训练视频,督促患者进行训练,干预3个月后采用圣乔治呼吸量表(SGRQ)、医院焦虑抑郁量表(HADS)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)评价2组患者的生命质量、焦虑、抑郁和肺功能改善情况。结果干预前试验组SGRQ、HADS得分和FEV1/FVC分别为(41.35±9.94)分、(16.55±4.29)分、(47.13±8.85)%,出院时分别为(28.95±5.66)分、(11.20±2.75)分、(59.51±10.49)%,干预3个月分别为(21.75±6.31)分、(7.15±3.51)分、(66.69±7.87)%;干预前对照组SGRQ、HADS得分和FEV1/FVC分别为(42.10±10.50)分、(16.60±4.73)分、(46.23±10.14)%,出院时分别为(34.90±10.16)分、(13.35±2.37)分、(52.91±7.86)%,干预3个月分别为(35.80±7.27)分、(14.20±5.05)分、(52.65±8.60)%。随着干预时间的增加SGRQ、HADS得分均有所下降(F=29.65、17.44,均P<0.05),FEV1/FVC有所增加(F=27.38,P<0.05)。组内比较显示试验组SGRQ、HADS得分和FEV1/FVC在出院时、干预3个月与干预前,及干预3个月与出院时得分比较差异有统计学意义(t值为-7.73~7.38,均P<0.05);对照组SGRQ、HADS得分和FEV1/FVC只有在出院时与干预前比较差异有统计学意义(t=-4.63、-2.79、5.28,均P<0.05)。2组SGRQ、HADS得分和FEV1/FVC干预前比较差异无统计学意义,出院时和干预3个月比较差异有统计学意义(t值为-6.53~5.39,均P<0.05)。结论美声唱法呼吸训练可以提高稳定期慢性阻塞性肺疾病患者的生命质量、减轻焦虑、抑郁和提高FEV1/FVC。

Objective To investigate the effect of bel canto breathing training method on the respiratory rehabilitation of patients with chronic obstructive pulmonary disease in stable stage.Methods Using a quasi-experimental research method,40 patients with chronic obstructive pulmonary disease in stable stage from September to December 2018 in two wards(the first ward and the second ward)with the same level of diagnosis and treatment of respiratory physicians,nurses'nursing ability and the ward environment of the First Hospital of Lanzhou University were selected.The first ward was used as the experimental group,and the second ward was used as the control group,there were 20 cases in each group.The patients in the experimental group were given bel canto breathing training and conventional breathing training,while the patients in the control group were given conventional breathing training.A WeChat group was established,and training videos were distributed in the WeChat group after discharge to urge patients to perform training.After 3 months of intervention,the quality of life,anxiety,depression,and pulmonary function were evaluated by St George′s Respiratory Questionnaire(SGRQ),Hospital Anxiety and Depression Scale(HADS),proportion of forced expiratory volume in forced vital capacity in the first second(FEV1/FVC).Results The SGRQ score,HADS score and FEV1/FVC value in the experimental group before intervention respectively were(41.35±9.94),(16.55±4.29)points and(47.13±8.85)%,at discharge respectively were(28.95±5.66),(11.20±2.75)points and(59.51±10.49)%and after three months of intervention respectively were(21.75±6.31),(7.15±3.51)points and(66.69±7.87)%,while the SGRQ score,HADS score and FEV1/FVC value in the control group before the intervention respectively were(42.10±10.50),(16.60±4.73)points and(46.23±10.14)%,at discharge respectively were(34.90±10.16),(13.35±2.37)points and(52.91±7.86)%,and after three months of intervention(35.80±7.27),(14.20±5.05)points and(52.65±8.60)%.With the increase of the intervention time of bel canto breathing training,the SGRQ score and HADS score decreased(F=29.65,17.44,both P<0.05),and the FEV1/FVC value increased(F=27.38,P<0.05).Within-group comparisons the SGRQ score,HADS score,and FEV1/FVC value in the experimental group at discharge,three months after the intervention versus pre-intervention,and three months after the intervention versus discharge showed statistically significant differences(t values were-7.73-7.38,all P<0.05).SGRQ score,HADS score,and FEV1/FVC value in the control group were only statistically significant at discharge versus pre-intervention(t=-4.63,-2.79,5.28,all P<0.05).The SGRQ,HADS score and FEV1/FVC value between the 2 groups were not statistically significant before the intervention,but statistically significant at discharge and three months after the intervention(t values were-6.53-5.39,all P<0.05).Conclusions Bel canto breathing training can improve the quality of life,reduce anxiety,depression and increase FEV1/FVC in patients with chronic obstructive pulmonary disease in stable stage.