呼吸训练器辅助康复训练在慢阻肺稳定期患者中的应用价值

Application value of respiratory trainer-assisted rehabilitation training in patients with stable COPD

目的:探讨呼吸训练器辅助康复训练对稳定期慢性阻塞性肺疾病(COPD)全球倡议组织(GOLD)3级患者的临床价值。方法:选择本院收治的COPD稳定期GOLD 3级患者97例,随机分为对照组48例和研究组49例。对照组接受常规康复训练,研究组进行呼吸训练器辅助常规康复训练。采用肺功能测试仪,6分钟步行距离(6MWD),圣乔治呼吸问卷(SGRQ),改良英国医学研究会呼吸困难指数(mMRC)和慢性阻塞性肺疾病评估测试量表(CAT)分别于干预前和干预3个月后评估2组的疗效,比较2组患者干预前后的肺功能指标,包括第一秒用力呼气容积(FEV1)占预计值百分比(FEV1%)、用力肺活量(FVC)、FEV1与FVC的比值(FEV1/FVC);比较2组患者干预前后的运动耐力、生活质量、呼吸困难情况及干预3个月内COPD急性加重次数。结果:干预3个月后,2组的FEV1%高于干预前(P<0.01,0.05),研究组的FEV1%、FVC、FEV1/FVC水平和6MWD均大于干预前和对照组(P<0.01,0.05),对照组的FVC、FEV1/FVC水平和6MWD与干预前比较差异无统计学意义;2组SGRQ、mMRC、CAT评分均低于干预前(P<0.01),且研究组低于对照组(P<0.01);干预3个月后研究组急性加重次数少于对照组(P<0.01)。结论:呼吸训练器辅助康复训练对改善COPD稳定期GOLD 3级患者的肺功能、运动耐力及生活质量有积极作用。

Objective:To analyze the clinical value of respiratory trainer-assisted rehabilitation training in GOLD3 patients with chronic obstructive pulmonary disease(COPD)at stable stage.Methods:In total,97patients with GOLD 3in stable COPD admitted to our hospital were selected and randomly divided into 2groups,48cases in the control group and 49cases in the study group.The control group received conventional rehabilitation training,and the study group underwent respiratory trainer-assisted conventional rehabilitation training.The efficacy of the 2 groups was assessed using apulmonary function tester,6-minute walking distance(6MWD),St George’s respiratory questionnaire(SGRQ),modified British Medical Research Council dyspnoea index(mMRC)and chronic obstructive pulmonary disease assessment test(CAT)scale before and after 3months of intervention,respectively,and the pulmonary function indexes before and after intervention were compared between the 2groups,including the percentage of the first-second forceful expiratory volume(FEV1)to the predicted value as a percentage of predicted value(FEV1%),forceful lung capacity(FVC),and the ratio of FEV1to FVC(FEV1/FVC).The exercise endurance,quality of life,dyspnoea and the number of acute exacerbations of COPD in the 2groups were compared before and after the intervention and 3months after the intervention.Results:After 3months of intervention,the FEV1%in the 2groups was higher than that before intervention(P<0.01,0.05),and the FEV1%,FVC,FEV1/FVC levels,and 6MWD in the study group were greater than those of the pre-intervention and control group(P<0.01,0.05),and the difference in the FVC,FEV1/FVC levels,and 6MWD of the control group before and after the intervention was not statistically significant.SGRQ,mMRC,and CAT scores after intervention in both groups were lower than before intervention(P<0.01),and those in the study group were lower than in the control group(P<0.01).The number of acute exacerbations in the study group was less than that in the control group after 3months of intervention(P<0.01).Conclusion:Respiratory trainer-assisted rehabilitation training has a positive effect on improving lung function,exercise endurance and quality of life in GOLD 3patients with stable COPD.