基于行为改变理论的远程营养干预用于慢性阻塞性肺疾病患者对营养状态及康复效果的影响

Influence of remote nutritional intervention based on behavioral change theory on nutritional status and rehabilitation effect in patients with chronic obstructive pulmonary disease

目的探讨基于行为改变理论的远程营养干预用于慢性阻塞性肺疾病(COPD)患者对营养状态及康复效果的影响。方法选取2019年5月至2022年5月期间南京医科大学附属无锡人民医院住院治疗后出院的86例COPD患者,按照随机信封法分为两组,对照组43例,采用常规出院后延续干预,观察组43例,采用常规出院后延续干预+基于行为改变理论的远程营养干预。比较两组干预前、干预30 d后COPD患者肺功能、生活质量、营养状态、免疫功能。结果干预前两组第一秒用力呼气容积占预计值的百分比(FEV1%)、肺活量(VC)比较差异无统计学意义(P>0.05),干预30 d后观察组FEV1%、肺活量(VC)高于对照组(P<0.05);干预前两组COPD生存质量评分比较差异无统计学意义(P>0.05),干预30 d后观察组COPD生存质量评分低于对照组(P<0.05);干预前两组白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(Tf)与体质量指数(BMI)水平比较差异无统计学意义(P>0.05),干预30 d后观察组ALB、PA、Tf与BMI水平高于对照组(P<0.05);干预前两组免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、T淋巴细胞亚群中CD3+、CD4+水平比较差异无统计学意义(P>0.05),干预30 d后观察组IgA、IgG、T淋巴细胞亚群中CD3+、CD4+水平高于对照组(P<0.05)。结论基于行为改变理论的远程营养干预可改善COPD患者肺功能、生活质量,加强机体营养,进而增强机体免疫功能。

Objective To explore the influence of behavioral change theory-based remote nutritional intervention on nutritional status and rehabilitation effect in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 86 patients with COPD who were hospitalized and discharged from the hospital from May 2019 to May 2022 were selected as the study objects.According to the random envelope method,they were divided into two groups with 43 cases each.The control group received continuous intervention after discharge.The observation group received routine post-discharge continuation intervention combined with remote nutrition intervention based on behavior change theory.The pulmonary function,quality of life,nutritional status and immune function of COPD patients were compared between the two groups before intervention and 30 days after intervention.Results There was no significant difference in the percentage of forced expiratory volume in the first second(FEV1%)and vital capacity(VC)between the two groups before intervention(P>0.05).After 30 days of intervention,FEV1%and VC of observation group were higher than those of control group(P<0.05).Before intervention,there were no differences in the scores of COPD quality of life between the two groups(P>0.05).The COPD quality of life scores of observation group after 30 days of intervention were lower than those of control group(P<0.05).There was no significant difference in the levels of albumin(ALB),prealbumin(PA),transferrin(Tf)and body mass index(BMI)between the two groups before intervention(P>0.05).After 30 days of intervention,the levels of ALB,PA,Tf and BMI in observation group were higher than those in control group(P<0.05).There were no significant differences in the levels of immunoglobulin A(IgA),immunoglobulin G(IgG),CD3+and CD4+in T lymphocyte subsets between the two groups before intervention(P>0.05).After 30 days of intervention,the levels of CD3+and CD4+in IgA,IgG and T lymphocyte subsets in observation group were higher than those in control group(P<0.05).Conclusions Remote nutritional intervention based on behavioral change theory can improve the pulmonary function and quality of life and strengthen the body's nutrition of patients with COPD,thus enhancing the body's immune function.