反馈式呼吸电刺激训练对中重度稳定期慢性阻塞性肺疾病患者康复的影响

Effect of feedback respiratory electrical stimulation training on rehabilitation of patients with moderate to severe stable chronic obstructive pulmonary disease

目的探讨反馈式呼吸电刺激训练(RESTB)对中重度稳定期慢性阻塞性肺疾病(COPD)患者呼吸康复的影响。方法选取120例中重度稳定期COPD患者作为研究对象,随机分为对照组和观察组,每组60例。对照组采用吸氧、支气管扩张剂等常规治疗,观察组在常规治疗基础上行RESTB,持续12周。干预前后,观察并比较2组患者的肺功能指标[第1秒用力呼气容积(FEV)、用力肺活量(FVC)、FEV/FVC]、呼吸肌功能指标[最大吸气压(MIP)、最大呼气压(MEP)]、平静呼吸膈肌活动度(QDM)、用力呼吸膈肌活动度(FDM)、膈肌厚度分数(DTF)、呼吸困难量表(MRC)评分、生活质量[圣乔治呼吸问卷(SGRQ)评分]、运动耐力[6 min步行距离(6MWD)]、睡眠质量[匹兹堡睡眠质量指数量表(PSQI)评分]和心理状况[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分]。结果干预前后,2组患者FVC、FEV、FEV/FVC比较,差异均无统计学意义(P>0.05);干预后,观察组MIP、MEP、QDM、FDM、DTF均高于干预前,且高于对照组,差异有统计学意义(P<0.05);干预后,观察组MRC评分、SGRQ评分低于干预前,且低于对照组,差异有统计学意义(P<0.05);干预后,观察组6MWD长于干预前,且长于对照组,差异有统计学意义(P<0.05);干预后,2组PSQI评分、HAMA评分、HAMD评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论将RESTB应用于中重度稳定期COPD患者的呼吸康复训练中,可改善呼吸肌功能,提高运动耐力和睡眠质量,改善心理状况和生活质量。

Objective To explore the effect of feedback respiratory electrical stimulation training(RESTB) on respiratory rehabilitation of patients with moderate and severe chronic obstructive pulmonary disease (COPD).Methods A total of 120 patients with moderate and severe stable COPD were selected as study objects,and were divided into control group (n=60) and observation group(n=60).The control group received conventional treatment such as oxygen inhalation and bronchodilator,and the observation group received RESTB on the basis of conventional treatment,the treatment of both groups was lasted for 12 weeks.The pulmonary function indexes[forced expiratory volume in the first second (FEV),forced vital capacity (FVC),FEV/FVC],respiratory muscle function indexes[maximum inspiratory pressure (MIP),maximum expiratory pressure (MEP)],tranquildiaphragmatic activity(QDM),diaphragmatic activity in forced breathing (FDM),diaphragm thickness score (DTF),Dyspnea Scale (MRC) score,quality of life[St.George’s Respiratory Questionnaire (SGRQ) score],exercise endurance[6 min walking distance (6MWD)],sleep quality[Pittsburgh Sleep Quality Index Scale (PSQI) score]and psychological status[Hamilton Anxiety Scale (HAMA) score,Hamilton Depression Scale (HAMD) score]were compared before and after intervention.Results Before and after intervention,there were no significant differences in FVC,FEVand FEV/FVC between two groups (P>0.05).After intervention,MIP,MEP,QDM,FDM and DTF in the observation group were higher than before intervention,and were higher than those of the control group (P<0.05).After intervention,MRC score and SGRQ score of the observation group were lower than before intervention,and were lower than those of the control group (P<0.05).After intervention,6MWD in the observation group was longer than that before intervention and the control group (P<0.05).After intervention,PSQI score,HAMA score and HAMD score of the two groups were lower than before treatment,and were lower in the observation group than those in the control group (P<0.05).Conclusion RESTB can improve respiratory muscle function,exercise endurance and sleep quality,improve psychological condition and quality of life of patients with moderate and severe COPD.