主动循环呼吸技术对进展性纤维化性间质性肺病患者的治疗效果

Effect of active cycle of breathing technologies on patients with progressive fibrotic interstitial lung disease

目的:观察主动循环呼吸技术(ACBT)对进展性纤维化性间质性肺病(PF-ILD)患者不同阶段的治疗效果。方法:收集2018年12月至2020年12月天津医科大学第二医院康复医学科就诊的48例PF-ILD患者,采用随机数字表法分为对照组和试验组,各24例。所有患者均接受为期18周康复治疗,分为院内指导和家庭锻炼阶段。对照组接受常规运动康复,试验组在对照组的基础上增加ACBT训练。在各阶段开始、结束时分别进行用力肺活量占预计值的百分比(FVC%pred)、一氧化碳弥散占预计值的百分比(DLCO%pred)、涎液化糖链抗原-6(KL-6)、6 min步行试验(6MWT)及圣乔治呼吸问卷(SGRQ)测试,所得数据使用t检验或U检验。结果:在院内指导阶段结束时,试验组FVC%pred、DLCO%pred、6MWT、SGRQ评分优于对照组(t/z=4.154、3.280、2.540、-7.757,均P<0.05),KL-6与对照组相比,差异无统计学意义(P>0.05)。在家庭锻炼阶段结束时,试验组FVC%pred、DLCO%pred、SGRQ评分优于对照组(t/z=4.170、2.449、-6.246,均P<0.05),6MWT、KL-6为与对照组无差异(均P>0.05)。结论:在院内指导阶段和家庭锻炼阶段,ACBT对PF-ILD患者治疗效果较好,值得推广。

Objective:To observe the therapeutic effect of active cycle of breathing technologies(ACBT)on patients with progressive fibrotic interstitial lung disease(PF-ILD).Methods:A total of 48 patients with PF-ILD from December 2018 to December 2020 in the Department of Rehabilitation,The Second Hospital of Tianjin Medical University were collected and randomly divided into control group and experimental group,with 24 cases in each group.All patients received rehabilitation treatment for 18 weeks,which was divided into hospital guidance and family exercise.The control group received routine exercise rehabilitation,and the experimental group increased ACBT training on the basis of the control group.At the beginning and end of each stage,the percentage of forced vital capacity in the predicted value(FVC%pred),the percentage of carbon monoxide dispersion in the predicted value(DLCO%pred),salivary liquefied sugar chain antigen-6(KL-6),six-minute walk test(6MWT)and St.George′s Respiratory Questionnaire(SGRQ)were tested respectively.The data were tested by t-test or U-test.Results:At the end of the in-hospital guidance stage,FVC%pred,DLCO%pred,6MWT and SGRQ in the experimental group were significantly better than those in the control group(t/z=4.154,3.280,2.540,-7.757,all P<0.05),and there was no difference in KL-6 between the experimental group and the control group(t=-0.479,P>0.05).At the end of family exercise,FVC%pred,DLCO%pred and SGRQ in the experimental group were significantly better than those in the control group(t/z=4.170,2.449,-6.246,all P<0.05),and there was no difference in 6MWT and KL-6 between the experimental group and the control group(t/z=-1.495,-0.004,all P>0.05).Conclusion:In the hospital guidance stage and family exercise stage,ACBT has a good therapeutic effect on PF-ILD patients,which is worthy of popularization and use.