早期中医肺康复训练对慢性阻塞性肺疾病急性加重期患者生存质量的影响

Effect of early lung rehabilitation training of Traditional Chinese medicine on quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨早期中医肺康复训练对慢性阻塞性肺病(COPD)急性加重期患者生活质量的影响。方法选择广州中医药大学第二附属医院ICU 2019年4月至2020年4月收治的57例COPD急性加重期患者为研究对象,随机数表法分为对照组28例和试验组29例,对照组接受常规治疗,试验组在对照组方案基础上接受早期中医肺康复训练,即在入组后进行六字诀呼吸训练、上下肢训练、步行训练。比较两组干预前、第1、6、12周的呼吸困难量表评分、6 min步行距离和COPD评估测试等。结果干预12周后试验组患者的呼吸困难改善优于对照组(P<0.05),干预时间越长效果越好(第1、6、12周的OR值分别为0.721,0.434,0.102);试验组的运动耐力增加幅度优于对照组(F_(分组)=8.658,P<0.05);试验组的生存质量提高较对照组更为明显(F_(分组)=4.209,P<0.05)。结论早期中医肺康复训练应用于COPD急性加重期患者能缓解呼吸困难症状,提高运动耐力以及改善生存质量,且应用时间越长,疗效越好。

Objective To investigate the effect of early lung rehabilitation training of Traditional Chinese medicine on quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 57 patients with AECOPD admitted to Guangdong Provincial Hospital of Chinese Medicine from April 2019 to April 2020 were selected,28 cases were randomly assigned to control group and 29 cases to experimental group.The control group received conventional treatments,and the experimental group received lung rehabilitation training of Traditional Chinese medicine,including six-word formula breathing training,upper and lower limbs training and walking training,combined with conventional treatments.The 6-minute walking distance,COPD assessment Test(CAT)score and dyspnea Scale(mMRC)scores were compared between the two groups before and at 1st week,6th week and 12th week after intervention.Results The difference between control group and experimental group was statistically significant(P<0.05).After 12 weeks of intervention,dyspnea in the experimental group was significantly improved compared with control group(P<0.05).The longer the intervention time was,the better the effect was(OR values of the 1st,6th and 12th weeks were 0.721,0.434 and 0.102,respectively).The increase of exercise endurance in experimental group was better than control group(F=8.658,P<0.05).The quality of life in experimental group was significantly improved compared with control group(F=4.209,P<0.05).Conclusion Early application of pulmonary rehabilitation training of Traditional Chinese medicine in patients with AECOPD acute exacerbation stage was safe and feasible,which could relieve the dyspnea symptom,improve exercise endurance and quality of life.