Research Status of TCM Rehabilitation in Chronic Obstructive Pulmonary Disease (COPD)

This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further development of COPD rehabilitation program.

Current status and progress of prevention andtreatment of chronic obstructive pulmonarydisease in China

Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease, leading toa great number of death and a huge disease burden to China. Recently, as the promulgation of a series of national healthpolicies, the diagnosis and treatment of COPD has gradually gained attention. The prevention and treatment capacity ofCOPD in China has been greatly improved, but there are still problems of insufficient diagnosis and irregular treatment. Theproblem is mainly related to the lack of universal pulmonary function test, insufficient number and level of doctors, and thenonstandard use of drugs. The prevention and treatment of COPD in primary medical institutions is particularly lacking. Inorder to promote the prevention and treatment of COPD, China has innovatively adopted a number of measures, including"Happy Breathing" project, standardized diagnosis and treatment system and capacity building for respiratory diseases inprimary medical institutions, el at. Effective progress has been made through these methods, and great improvement of theprevention, diagnosis and treatment of COPD has been achieved.

A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease(COPD)

Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology

Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.

腹部肥胖对COPD急性加重的影响

目的探讨腹部肥胖相关指标对慢性阻塞性肺疾病(COPD)患者急性加重的影响。方法对“新疆多民族自然人群队列建设及健康随访研究”招募的和田墨玉县常住居民经肺功能检测诊断为COPD的患者,进行问卷及常规检查测量腰围,体成分检测内脏脂肪等级,计算腰高比、体重调整腰围指数(WWI),随访患者至少1年急性加重住院情况。以急性加重住院为结局分析腹部肥胖相关指标对COPD急性加重的影响,并比较不同腹部肥胖指标对COPD急性加重的预测价值。结果631名COPD患者经过随访,报告了186例COPD急性加重住院病例。整个随访期间,COPD急性加重和无急性加重患者在年龄、肺结核疾病史、吸烟、二手烟、烹饪和取暖燃料、慢阻肺患者评价评分(CAT评分)等方面的比较差异有统计学意义(均P<0.05)。单因素及模型1和2显示,腰围、腰高比、WWI、内脏脂肪等级均对COPD急性加重有影响,指标每增加一个单位急性加重均有增加;腰高比及内脏脂肪等级对COPD急性加重影响的结果较稳定,多重调整后腰高比OR=1.304(1.010~1.683),内脏脂肪等级OR=1.912(1.122~3.257)。腹部肥胖相关指标对COPD急性加重均有预测价值,其中WWI的曲线下面积最大,为0.614。结论腹部肥胖指标腰高比、WWI、内脏脂肪等级是COPD急性加重的危险因素,COPD的防控应考虑减少腹部肥胖的干预策略。

Predictive role of interleukin-6 and CAT score in mechanical ventilation in patients with chronic obstructive pulmonary disease at the acute exacerbation stage in the emergency department

BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.

Comparative Study on the Efficacy of Tiotropium Bromide Inhalation and Oral Doxofylline Treatment of Moderate to Severe Stable Chronic Obstructive Pulmonary Disease

This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder （18 μg/day） or oral doxofylline tablets （0.2 g/time, 2 times a day） for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV1, FEV1/FVC% and 6-min walk distance were sig-nificantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases （9.9%） and 12 cases （12.9%）, respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day （two times a day） are effective and safe for the treatment of COPD.

Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease （COPD）. The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states （POMS） evaluation were performed. In the forest group,

The risk factors for chronic obstructive pulmonary disease in Li and Han ethnic groups in Hainan, China

Objective: To investigate the risk factors of chronic obstructive pulmonary disease(COPD) in Li and Han ethnic group in Hainan, China. Methods: All subjects were randomly selected from various regions in Hainan. General characteristics were compared between COPD cases and healthy control cases in both Li and Han ethnic groups. The odds ratio(OR), the corresponding 95% confidence interval(CI) of COPD were calculated by logistic regression.Results: A total of 277 Li COPD cases, 307 Li healthy control subjects, 290 Han COPD cases and 301 Han healthy control were included in this study. In both the Li and Han groups, the average age exceeded 65 years, and the cigarette number smoked per day and the smoking duration were correlated with risk of COPD. In the Li COPD subjects, low weight, smoking, and recurrent infection of respiratory tract were mainly risk factors; while the mainly risk factor of Han COPD subjects was family history of respiratory disease. Conclusions: The risk factors are different in COPD subjects of Han and Li nationalities in Hainan of China. The age and smoking are strongly correlated with COPD risk.

Regulatory Effect of Shenge Yifei Capsule on TGF-β1/Smad Signaling Pathway in Rats with Chronic Obstructive Pulmonary Disease

[Objectives]This study aimed to study the effects of Shenge Yifei capsule on the TGF-β1/Smad signaling pathway in rats with chronic obstructive pulmonary disease(COPD).[Methods]Ten rats were randomly selected as the control group,and the other 40 rats were selected for modeling by fumigation combined with Klebsiella pneumoniae infection.A total of 38 rats were successfully modeled.They were randomly divided into model group(8 rats),low-dose Shenge Yifei capsule group(10 rats),high-dose Shenge Yifei capsule group(10 rats)and theophylline group(10 rats)in accordance with the principle of half male and half female.The rats in the model and control groups were given with distilled water by gavage,and the rats in the drug administration groups were given with corresponding drugs.The TGF-β1 level in the serum,and the expression levels of TGF-β1,Smad2,Smad3 and Smad7 and TGF-β1,Smad3 and Smad7 in airway tissues were detected.[Results]After 12 weeks,the serum TGF-β1 levels of the theophylline group and high-dose Shenge Yifei capsule group were lower than that of the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the theophylline group and high-dose Shenge Yifei capsule group were lower than that in the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the high-dose Shenge Yifei capsule group were lower than those in the low-dose Shenge Yifei capsule group and theophylline group(P<0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups(P<0.05).The expression levels of Smad7 in the theophylline group and high-dose Shenge Yifei capsule group were higher than that in the low-dose Shenge Yifei capsule group(P<0.05).After 18 weeks,no significant difference was found in serum TGF-β1 level among the theophylline group and low and high-dose Shenge Yifei capsule groups(P>0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups.The expression level of Smad7 in the high-dose Shenge Yifei capsule group was lower than that in the theophylline group(P<0.05).[Conclusions]Shenge Yifei capsule can regulate the TGF-β1/Smads signaling pathway.They can down-regulate the expression of TGF-β1,Smad2 and Smad3 and up-regulate the expression of Smad7,reducing the degree of airway modeling,delaying the development of COPD disease.Conventional high-dose Shenge Yifei capsule is more effective in inhibiting the expression of Smad2.

吴茱萸热罨包联合穴位贴敷治疗COPD无创通气患者腹胀的效果

目的观察吴茱萸热罨包联合穴位贴敷治疗慢性阻塞性肺疾病(COPD)无创通气患者并发腹胀的效果。方法选取南昌大学第二附属医院呼吸与危重症医学科收治的60例COPD无创通气腹胀患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组30例。对照组予常规治疗及护理,观察组在对照组基础上加用吴茱萸热罨包联合穴位贴敷,2组均连续治疗3 d。比较2组患者治疗前后的肠鸣音次数、腹围及临床疗效。结果治疗后观察组每分钟肠鸣音次数多于对照组(P<0.05),腹围小于对照组(P<0.05),治疗总有效率高于对照组(P<0.05)。结论吴茱萸热罨包联合穴位贴敷治疗COPD无创通气患者并发腹胀,可促进患者肠道蠕动,改善腹胀状况。

血清淀粉样蛋白A与老年COPD患者肺弥散功能及运动受限的关联性分析

目的分析血清淀粉样蛋白A(SAA)与老年慢性阻塞性肺疾病(COPD)患者肺弥散功能及运动受限的相关性。方法招募2020年1月至2021年7月重庆大学附属涪陵医院收治的188例老年稳定期COPD患者,均接受肺功能测试(PFT)和心肺运动试验(CPET)评估。将肺一氧化碳弥散因子(T_(L)CO)<肺正常下限(LLN)的患者纳入弥散功能异常组(102例),T_(L)CO≥LLN的患者纳入弥散功能正常组(86例)。采用酶联免疫吸附试验(ELISA)测定患者SAA水平。采用Pearson相关分析探讨SAA水平与峰值摄氧量(VO_(2peak))的相关性。采用多因素logistic回归分析老年COPD患者肺弥散功能的影响因素。采用多元线性回归模型分析老年COPD患者的SAA水平与第1秒用力呼气容量的Z评分(FEV_(1Z-score))、FEV_(1)与预测值的百分比(ppFEV_(1))的关联性。采用受试者工作特征(ROC)曲线分析SAA水平对老年COPD患者肺弥散功能异常的预测效能。结果多因素logistic回归分析结果显示,较低的ppFEV_(1)、用力肺活量的Z评分(FVC_(Z-score))、(FEV_(1)/FVC)_(Z-score)是促进老年COPD患者肺弥散功能异常的独立危险因素(P<0.05),较高的ppFVC、FEV_(1)/FVC、肺泡通气量的Z评分(VA_(Z-score))是抑制老年COPD患者肺弥散功能异常的独立保护因素(P<0.05)。弥散功能异常组SAA水平显著高于弥散功能正常组[(135.09±58.05)ng/mL vs(78.10±32.81)ng/mL,t=8.079,P<0.001]。ROC曲线分析结果显示,SAA水平具有预测老年COPD患者肺弥散功能异常的应用价值[AUC(95%CI)=0.797(0.735~0.860),P<0.001],最佳截断值为85.07 ng/mL,其对应的灵敏度和特异度分别为77.50%和69.80%。多元线性回归分析结果显示,FEV_(1Z-score)与ppFEV_(1)每降低一个单位,弥散功能异常组患者的SAA水平分别升高0.009(95%CI:-0.013~-0.005)ng/mL、0.149(95%CI:-0.210~-0.088)ng/mL。Pearson相关分析结果显示,老年COPD患者的SAA水平与VO_(2peak)呈负相关(r=-0.512,P<0.001)。结论在老年COPD患者中,SAA水平与FEV_(1Z-score)有关,检测SAA水平有助于鉴别老年COPD肺弥散功能异常患者。此外,SAA水平与VO_(2peak)呈负相关,说明导致FEV_(1)降低的机制可能有助于解释老年COPD肺弥散功能异常患者运动受限的原因。

COPD病人睡眠障碍发生率及其影响因素的Meta分析

目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the Cochrane Library数据库中关于COPD病人睡眠障碍影响因素的相关文献,检索时限为建库至2023年5月4日。结果:共纳入13篇文献,睡眠障碍发生率为52%,其中呼吸困难指数(mMRC)≥2分[OR=2.01,95%CI(1.14,3.53),P<0.05]、COPD病人自我评估测试(CAT)≥10分[OR=1.24,95%CI(1.01,1.53),P<0.05]、肺功能评估(GOLD)分级Ⅲ~Ⅳ级[OR=2.76,95%CI(1.64,4.65),P<0.05]、合并阻塞性睡眠呼吸暂停后通气综合征(OSA)[OR=2.12,95%CI(1.64,2.74),P<0.05]、疲乏[OR=4.56,95%CI(2.47,8.43),P<0.05]、焦虑[OR=1.13,95%CI(1.07,1.18),P<0.05]、抑郁[OR=1.25,95%CI(1.09,1.45),P<0.05]、长期卧床[OR=2.18,95%CI(1.43,3.32),P<0.05]是COPD病人睡眠障碍的主要影响因素。结论:现有证据表明,COPD病人睡眠障碍发生率较高,mMRC≥2分、CAT≥10分、GOLD分级Ⅲ~Ⅳ级、合并OSA、疲乏、焦虑、抑郁、长期卧床是COPD病人睡眠障碍的主要影响因素。

Chronic Obstructive Pulmonary Disease and Semantic Language Abilities

Objective: The main aim of the present study is to evaluate the semantic language abilities of patients with Chronic Obstructive Pulmonary Disease (COPD) compared to normal group. Secondly to examine the role of hypoxemia, hypercapnia and pulmonary parameters on language scores. Method: We assessed 100 COPD patients with the use of a comprehensive battery of neurocognitive tests standardized for the Greek population, examining semantic language abilities, namely the Boston Naming Test (BNT), the Picture Peabody Vocabulary Test (PPVT) and the Controlled Oral Word Fluency Test (COWAT). Results: The results revealed that although the overall performance of our group of patients was within normal range, it was statistically significant lower compared to normal distribution on all semantic language tests. Moreover, we found that the percentile of COPD patients that performed in the deficient range was significantly higher compared to normal distribution. Further analysis of pulmonary parameters showed that Forced Expiratory Volume in 1 sec (FEV1, FEV1%), Forced Vital Capacity (FVC, FVC%) and FEV1/FVC were not correlated with patients’ performance on the language tests. Low Partial Pressure of Oxygen in blood oxygen levels (PaO2) was found to be able to predict the performance of patients on BNT, PPVT and semantic verbal fluency test. Abnormally elevated Partial Pressure of Carbon Dioxide (PCaO2) in blood were not found to be related to language dysfunctions. Conclusions: Our findings indicate that our group of COPD patients is more prone to present semantic language impairments compared to normal group while low blood oxygen levels were associated with reduced performance on BNT, PPVT and semantic verbal fluency tests.

Study on the Correlation between Temperature and Chronic Obstructive Pulmonary Disease in Shijiazhuang, China—Retrospective Cohort

Using the chronic obstructive pulmonary disease (COPD) medical records from January 1st to December 31st of 2013 and the Meteorological observation data, the air pollution data in the same time periods, generalized additive models were used to quantitatively analyze the relationship between COPD hospitalizations and temperature with controlling the confounding effects of time trend, meteorological factors and air pollution index (AQI). Results showed: variable temperature in 24 h (BT), 3d lagged minimum temperature (Tm3) and 5d lagged diurnal maximum temperature and minimum temperature range (Tc5) have different effects on COPD hospitalizations. When BT is between -4.4°C and -0.7°C, the relative risk (RR) increases to 1.0207 (95% CI: 1.0074 - 1.0342)with every 1°C increase in BT;when Tm3 is between -3.6°C and 3.2°C, the relative risk (RR) increases to 1.0118 (95% CI: 1.0015 - 1.0222)with every 1°C increase in Tm3, and when Tm3 is greater than 20.5°C, the relative risk (RR) increases to 1.0069 (95% CI: 1.0005 - 1.0133) with every 1°C increase in Tm3;when Tc5 is between 0.9°C and 8.6°C, if the Tc5 increases 1°C, the relative risk (RR) increases to 1.0125 (95% CI: 1.0066 - 1.0185. There are different effects for weather in different seasons on COPD hospitalizations: in autumn and winter, it is mainly of little BT and heavy air pollution weather;in spring, the large Tc5 weather is a main feature, and in summer, it’s mainly of high temperature and low pressure weather. The results help to provide some guidance on COPD forecasting services.

乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者炎性反应、肺功能的影响

目的探究乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者炎性反应、肺功能的影响。方法选取2021年7月至2022年12月收治的COPD患者80例,随机数字表法将其分为盐酸氨溴索组和联合组,每组40例,盐酸氨溴索组患者使用盐酸氨溴索注射液治疗,联合组患者使用乙酰半胱胺酸颗粒联合盐酸氨溴索注射液治疗。检测2组患者肺功能[第1秒用力呼气容积(FEV_(1))/FEV_(1)预计值(FEV_(1)/preFEV_(1))、FEV_(1)/占用力肺活量比值(FEV_(1)/FVC)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(paCO_(2))]水平,对2组免疫功能、炎性反应[C-反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]、氧化应激[超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)]反应指标进行检测,对比2组治疗效果、不良反应发生情况。结果治疗后,联合组患者FEV1/preFEV1、FEV1/FVC水平高于盐酸氨溴索组(P<0.05)。治疗后,联合组患者PaO_(2)水平高于盐酸氨溴索组,PaCO_(2)水平低于盐酸氨溴索组(P<0.05)。治疗后,联合组患者CD4^(+)、CD4^(+)/CD8^(+)水平高于盐酸氨溴索组,CD8^(+)低于盐酸氨溴索组(P<0.05)。治疗后,联合组患者CRP、TNF-α水平低于盐酸氨溴索组(P<0.05)。治疗后,联合组SOD水平高于盐酸氨溴索组,TAOC水平低于盐酸氨溴索组(P<0.05)。联合组患者治疗有效率高于盐酸氨溴索组(P<0.05)。联合组患者不良反应发生率略高于盐酸氨溴索组,但差异无统计学意义(P>0.05)。结论使用乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者进行治疗,能够改善患者肺功能、血气指标水平,改善患者免疫功能,减轻患者炎性反应、氧化应激反应严重程度,治疗效果显著。

不同频次康复锻炼对COPD患者运动耐力、肺功能及生存质量的影响

目的探讨不同频次康复锻炼对慢性阻塞性肺疾病(COPD)患者运动耐力、肺功能和生存质量的影响。方法选择2021年9月至2022年8月收治的COPD患者98例,按治疗方案不同分为对照组和观察组,每组49例,对照组给予常规治疗,观察组采用不同频次康复锻炼。比较治疗前后运动耐力[6 min步行试验(6MWT)、Borg劳累度评估量表]、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC]及血气分析[动脉血氧分压(PO_(2))、氧合指数、动脉血二氧化碳分压(PCO_(2))]变化情况;随访3个月,比较2组生存质量情况。结果治疗后,2组6MWT变长,Borg劳累度评估量表评分降低,且观察组更明显(P<0.05);治疗后,2组肺功能明显改善,且观察组更明显(P<0.05);治疗后,2组血气指标改善,观察组更为明显(P<0.05)。治疗后,观察组生活质量高于对照组(P<0.05)。结论老年COPD患者采取不同频次康复锻炼,可提高运动耐力,利于肺功恢复,提高生存质量。

COPD病人症状负担对生活质量的影响

目的:调查慢性阻塞性肺疾病(COPD)病人症状负担,分析症状负担对生活质量的影响,并进一步探讨相关机制。方法:采用便利抽样方法选取宁波市某三级甲等医院232例COPD病人为研究对象,采用一般资料调查表、记忆症状评估量表、医学应对方式问卷和慢性阻塞性肺疾病评估测试量表进行调查。结果:COPD病人生理症状负担、心理症状负担、总负担指数、症状负担、屈服均与生活质量呈正相关(P<0.05),面对与生活质量呈负相关(P<0.05);屈服在症状负担各维度与生活质量间均存在部分中介作用,且屈服参与调节中介。结论:面对应对方式在COPD病人症状负担对生活质量影响中存在部分中介作用,且屈服参与调节中介。提示医护人员应当动态评估病人在疾病治疗过程中症状负担及应对方式,实施个性化干预来优化疾病管理模式。

Ambulatory Oxygen in Chronic Obstructive Pulmonary Disease

Ambulatory oxygen has been shown to improve pulmonary hemodynamics and reduce dynamic hyperinflation in patients with Chronic Obstructive Pulmonary Disease. Therefore, it is hypothesized to be of benefit in patients with either exertional desaturation or dyspnoea. There is evidence of short-term improvements in exercise distance, exercise time, breathlessness, oxygen saturation and minute ventilation. However, longer term studies only identified improvements in oxygenation and minute ventilation. The benefits were even more limited in patients with no resting hypoxemia. The role in improving exercise training in pulmonary rehabilitation by increasing exercise time and reducing dyspnoea was marginal and no improvements were detected in walking distance or quality of life. Practical considerations make compliance with ambulatory oxygen therapy a major issue with the weight of oxygen and social unacceptability the most often quoted problems. The evidence for any benefit of ambulatory oxygen is therefore limited despite the theoretical benefits.

基于行为改变轮理论的出院准备干预方案在COPD病人中的应用

目的:探讨基于行为改变轮(BCW)理论的干预方案对慢性阻塞性肺疾病(COPD)病人出院准备度的影响。方法:采用方便抽样法选取山西省某三级甲等医院呼吸内科的COPD住院病人为研究对象,将2022年8月住院的35例病人作为对照组,2022年9月住院的34例病人作为干预组。对照组实施常规护理,干预组实施基于BCW理论的干预方案。比较两组病人出院准备度、出院指导质量、自我效能、生活质量及非计划再入院率。结果:干预组病人出院准备度得分、出院指导质量得分及出院时和出院后自我效能得分均高于对照组,出院时和出院后生活质量得分均低于对照组。结论:基于BCW理论的干预方案可提高病人出院准备度、出院指导质量、自我效能及生活质量。