不同阈值负荷下吸气肌训练对COPD患者肺功能、膈肌功能及生活质量的影响

Effects of Inspiratory Muscle Training under Different Threshold Loads on Lung Function,Diaphragm Function and Quality of Life in COPD Patients

目的:观察低强度[20%最大吸气压(MIP)]、中等强度(40%MIP)阈值负荷下吸气肌训练对慢性阻塞性肺疾病(COPD)患者膈肌功能、肺功能及生活质量的影响。方法:按照随机数字表法将2020年4月至2023年5月期间山东省立医院菏泽医院收治的120例COPD患者分为对照组、低强度组和中等强度组,各为40例。对照组给予常规治疗;在对照组基础上,低强度组以20%MIP作为吸气肌训练的起始负荷;中等强度组以40%MIP作为吸气肌训练的起始负荷。对比三组患者的肺功能[用力肺活量(FVC)、MIP、第一秒用力呼气容积(FEV_(1))、峰值呼气流速(PEF)、每分钟最大通气量(MVV)]、膈肌功能[膈肌位移(DE)、深吸气末膈肌厚度(DTei)及平静呼气末膈肌厚度(DTee)、膈肌厚度分数(DTF)]及生活质量[COPD患者生活质量量表(COPD-QOL)、St·George's呼吸疾病问卷(SGRQ)]。结果:治疗后,对照组、低强度组、中等强度组MIP、FVC、FEV_(1)、MVV、PEF依次升高(P<0.05)。治疗后,对照组、低强度组、中等强度组DE、DTei、DTF依次升高(P<0.05)。治疗后,对照组、低强度组、中等强度组DTee依次下降(P<0.05)。治疗后,对照组、低强度组、中等强度组COPD-QOL、SGRQ评分依次下降(P<0.05)。结论:吸气肌训练可有效改善COPD患者肺功能、膈肌功能及生活质量,以中等强度阈值负荷效果最佳。

Objective:To observe the effects of inspiratory muscle training under low intensity[20%maximum inspiratory pressure(MIP)]and medium intensity(40%MIP)threshold load on diaphragm function,lung function and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods:120 COPD patients who were admitted to Heze Hospital of Shandong Provincial Hospital from April 2020 to May 2023 were divided into control group,low intensity group and medium intensity group according to the random number table method,with 40 cases in each group.Control group was given routine treatment;On the basis of control group,the low intensity group used 20%MIP as the initial load of inspiratory muscle training;Medium intensity group used 40%MIP as the initial load of inspiratory muscle training.The lung function[forced vital capacity(FVC),MIP,forced expiratory volume in the first second(FEV_(1)),peak expiratory flow(PEF),maximum ventilation volume per minute(MVV)],diaphragm function[diaphragmatic displacement(DE),deep inspiratory diaphragm thickness(DTei)and quiet end-expiratory diaphragm thickness(DTee),diaphragmatic thickness fraction(DTF)]and quality of life[COPD quality of life scale(COPD-QOL),St?George's respiratory disease questionnaire(SGRQ)]were compared among three groups.Results:After treatment,MIP,FVC,FEV_(1),MVV and PEF in control group,low intensity group and medium intensity group increased in turn(P<0.05).After treatment,DE,DTei and DTF in control group,low intensity group and medium intensity group increased in turn(P<0.05).After treatment,DTee in control group,low intensity group and medium intensity group decreased in turn(P<0.05).After treatment,the scores of COPD-QOL and SGRQ in control group,low intensity group and medium intensity group decreased in turn(P<0.05).Conclusion:Inspiratory muscle training can effectively improve lung function,diaphragm function and quality of life in COPD patients,and the effect of moderate intensity threshold load is the best.