阈值负荷吸气肌训练对稳定期慢性阻塞性肺疾病的疗效

Clinical effects of threshold loading inspiratory muscle training on chronic obstructive pulmonary disease at stable phase

目的探究阈值负荷吸气肌训练对稳定期慢性阻塞性肺疾病的疗效。方法选取淮安市第一人民医院呼吸科2019年2月-2023年2月收治的100例稳定期慢性阻塞性肺疾病患者作为研究对象,采取随机数字表法分为研究组和对照组各50例,对照组予常规呼吸训练,研究组予阈值负荷吸气肌训练。比较2组干预前后吸气肌功能、肺功能、血气分析指标及运动耐力。结果干预前,2组吸气肌[最大吸气压(MIP)和最大呼气压(MEP)]、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积与用力肺活量的比值(FEV_(1)/FVC)和呼吸流量峰值(PEF)]、血气分析指标[动脉血氧分压(PaO_(2))和动脉血二氧化碳分压(PaCO_(2))]、运动耐力[改良版呼吸困难量表(mMRC)、6 min步行试验距离(6 MWT)]比较差异无统计学意义(P>0.05);干预后,2组MIP、MEP、FVC、FEV_(1)、FEV_(1)/FVC、PEF和PaO_(2)高于干预前(P<0.05),且研究组高于对照组(P<0.05);2组mMRC评分和PaCO_(2)低于干预前(P<0.05),且研究组低于对照组(P<0.05);2组6MWT长于干预前(P<0.05),且研究组长于对照组(P<0.05)。结论应用阈值负荷吸气肌训练,可提高稳定期慢性阻塞性肺疾病患者呼吸肌功能和肺功能,改善临床症状,提高运动耐力,值得临床推广。

Objective To explore the clinical effect of threshold loading inspiratory muscle training in patients with stable chronic obstructive pulmonary disease.Methods One hundred patients with stable chronic obstructive pulmonary disease who were admitted to Huai an First People’s Hospital from February 2019 to February 2023 were selected as research objects.They were divided into study group and control group according to random number table method,with 50 patients in each group.Conventional breathing training was applied in the control group,and threshold loading inspiratory muscle training was given to the study group.The inspiratory muscle function,lung function,arterial blood gas indexes and exercise endurance were recorded and compared between the two groups before and after intervention.Results There were no significant differences in the inspiratory muscle function(maximal inspiratory pressure[MIP]and maximal expiratory pressure[MEP]),pulmonary function(forced vital capacity[FVC],forced expiratory volume in first second[FEV_(1)],FEV_(1)/FVC,and peak expiratory flow[PEF]),arterial blood gas indexes(arterial partial pressure of oxygen[PaO_(2)]and arterial partial pressure of carbon dioxide[PaCO_(2)]),or exercise endurance(modified Medical Research Council Dyspnea scale[mMRC]score and six⁃minute walking test[6MWT]distance)between the two groups before intervention(P>0.05).The MIP,MEP,FVC,FEV_(1),FEV_(1)/FVC,PEF,PaO_(2)and 6MWT distance were significantly increased after intervention in both groups(P<0.05),and these indexes in the study group were significantly higher than those in the control group(P<0.05).The mMRC score and PaCO_(2)were significantly decreased after intervention in both groups(P<0.05),and the two indexes in the study group were significantly lower than those in the control group(P<0.05).The 6MWT was significantly longer after intervention,and the study group had a longer 6MWT than the control group(P<0.05).Conclusion Threshold loading inspiratory muscle training can significantly improve the function of respiratory muscle and lungs,relieve clinical symptoms,and enhance exercise endurance in patients with stable chronic obstructive pulmonary disease.It is worthy of clinical application.