呼吸康复阀在慢阻肺气道黏液高分泌表型中的疗效观察

Efficacy of a Respiratory Rehabilitation Valve in Chronic Obstructive Pulmonary Diseasewith Airway Mucus Hypersecretion Phenotype

目的比较呼吸康复阀与胸部物理训练在稳定期慢阻肺患者肺康复排痰治疗中的临床效果。方法将58例稳定期慢阻肺患者随机分组,试验组(32例)给予呼吸康复阀训练,对照组(26例)行主动咳嗽训练,各自共进行为期3个月的排痰干预训练,对比两组患者干预前后的肺功能指标、咳嗽和咳痰症状以及生活质量等变化。结果与对照组相比,试验组肺功能指标FEV1、FVC及FEV1/FVC%较训练前显著改善(P<0.05)。干预训练前、后比较,两组在咳嗽咳痰症状、mMRC等级、CAT评分、CCQ评分、SGRQ评分、Borg评分及6MWD等方面均有变化,且试验组mMRC等级、CAT评分及6MWD改善程度均显著高于对照组(P<0.05)。结论慢阻肺的基本治疗,辅以肺康复排痰训练能够改善稳定期慢阻肺患者的咳嗽咳痰症状,呼吸康复阀训练能够改善稳定期慢阻肺患者的部分肺功能指标、生活质量及运动耐力,值得进一步研究及推广。

Objective To compare the clinical effects of a respiratory rehabilitation valve and chest physical training on pulmonary rehabilitation and expectoration in patients with stable chronic obstructive pulmonary disease(COPD).Methods Fifty-eight patients with stable COPD were randomly divided into two groups.The experimental group(n=32)received respiratory rehabilitation valve training,while the control group(n=26)underwent active cough training.Both groups received expectoration intervention training for three months.The changes in lung function indices,cough and expectoration symptoms,and quality of life were compared between the two groups before and after the intervention.Results The experimental group showed significant improvements in lung function indices(FEV1,FVC,and FEV1/FVC%)compared to the control group post-training(P<0.05).Improvements were also observed in symptoms of cough and expectoration,mMRC,COPD Assessment Test(CAT),Clinical COPD Questionnaire(CCQ),St George′s Respiratory Questionnaire(SGRQ),Borg Dyspnea Score(Borg),and 6-minute walking distance(6MWD).The improvements in mMRC grade,CAT score,and 6MWD were significantly higher in the experimental group than in the control group(P<0.05).Conclusion Basic treatment of COPD,supplemented by lung rehabilitation and expectoration training,can improve the symptoms of cough and expectoration in patients with stable COPD.Respiratory rehabilitation valve training can enhance some pulmonary function indices,quality of life,and exercise endurance in patients with stable COPD,warranting further study and promotion.