电针联合药物及有氧运动治疗稳定期慢性阻塞性肺病的疗效观察及对运动心肺功能的影响

Observation of the therapeutic effect of electroacupuncture combined with medication and aerobic exercise in the treatment of stable chronic obstructive pulmonary disease and its influence on cardiopulmonary exercise function

目的观察电针联合药物及有氧运动治疗稳定期慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)的临床疗效及对运动心肺功能、运动耐量及生活质量的影响。方法选取124例稳定期COPD患者,采用随机数字表法分为对照组和观察组,每组62例。两组均采用规范药物联合有氧运动治疗,观察组在以上基础上给予电针治疗,对照组则给予安慰针治疗。比较两组治疗前后1秒用力呼气容积占预计值百分比[forced expiratory volume in one second(FEV_(1))as percentage of predicted value,FEV_(1)%pred]、用力肺活量占预计值百分比[forced vital capacity(FVC)as percentage of predicted value,FVC%pred]、FEV_(1)/FVC、最大功率(maximum power output,Wmax)、最大摄氧量(maximum oxygen uptake,VO2max)、最大心率(maximum heart rate,HRmax)、6 min步行距离(6 minutes walk distance,6MWD)、慢性阻塞性肺病评估测试(COPD assessment test,CAT)评分及圣乔治呼吸问卷(St George's respiratory questionnaire,SGRQ)评分变化,并比较两组临床疗效。结果治疗后,两组FEV_(1)%pred、FVC%pred和FEV_(1)/FVC与治疗前比较及组间比较差异无统计学意义(P>0.05);观察组Wmax、VO2max较治疗前增加(P<0.05),且明显高于对照组(P<0.05);两组HRmax与治疗前比较及组间比较差异无统计学意义(P>0.05);观察组6MWD较治疗前增加(P<0.05),且明显高于对照组(P<0.05);两组CAT评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);观察组SGRQ量表的临床症状、活动能力、疾病影响评分及总分均较治疗前降低(P<0.05),且明显低于对照组(P<0.05)。两组总有效率比较差异无统计学意义(P>0.05)。结论电针联合药物及有氧运动能明显改善稳定期COPD患者运动心肺功能,提高其运动耐量,有助于改善患者生活质量水平。

Objective To observe the clinical efficacy of electroacupuncture combined with medication and aerobic exercise in the treatment of stable chronic obstructive pulmonary disease(COPD)and its influence on cardiopulmonary exercise function,exercise tolerance and quality of life.Method A total of 124 patients with stable COPD were randomly divided into a control group and an observation group,with 62 cases in each group.Both groups were treated with standard medication combined with aerobic exercise,the observation group was treated with electroacupuncture in addition to the above,and the control group was treated with sham acupuncture.The changes of forced expiratory volume in one second(FEV_(1))as percentage of predicted value(FEV_(1)%pred),forced vital capacity(FVC)as percentage of predicted value(FVC%pred),FEV_(1)/FVC,maximum power output(Wmax),maximum oxygen uptake(VO2max),maximum heart rate(HRmax),6 minutes walk distance(6MWD),COPD assessment test(CAT)score and St George’s respiratory questionnaire(SGRQ)score before and after treatment were compared between the two groups,and the clinical efficacy was also compared between the two groups.Result After treatment,there were no significant differences in FEV_(1)%pred,FVC%pred and FEV_(1)/FVC in the two groups compared with those before treatment and no significant differences in FEV_(1)%pred,FVC%pred and FEV_(1)/FVC between the two groups(P>0.05).After treatment,the Wmax and VO2max in the observation group were higher than those before treatment(P<0.05),and were significantly higher than those in the control group(P<0.05).After treatment,there was no significant difference in HRmax in the two groups compared with that before treatment and no significant differences in HRmax between the two groups(P>0.05).After treatment,the 6MWD in the observation group was higher than that before treatment(P<0.05),and was significantly higher than that in the control group(P<0.05).After treatment,the CAT score in the two groups was lower than that before treatment(P<0.05),and it was lower in the observation group than in the control group(P<0.05).After treatment,the clinical symptoms,activity ability,disease impact scores and total score of SGRQ scale in the observation group were lower than those before treatment(P<0.05),and were significantly lower than those in the control group(P<0.05).There was no significant difference in the total effective rate between the two groups(P>0.05).Conclusion Electroacupuncture combined with medication and aerobic exercise can significantly improve the cardiopulmonary function of patients with stable COPD,improve their exercise tolerance,and help to improve the life quality of patients.