水中肺康复对慢性阻塞性肺疾病稳定期患者肺功能的效果

doi:10.3969/j.issn.1006-9771.2021.11.014

摘要/Abstract

摘要：

目的观察水中肺康复在慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法 2020年2月至2021年2月,本院COPD稳定期患者50例根据训练方法分为对照组(n = 25)和试验组(n = 25),分别接受陆上和水中肺康复8周。治疗前后,采用肺功能仪测量患者第1秒用力呼气容积(FEV₁)、第1秒用力呼气容积占预计值的百分比(FEV_l%)、第1秒用力呼气容积占用力肺活量的百分比(FEV₁/FVC),采用表面肌电图测量膈肌和右腹横肌肌电均方根(RMS),采用改良版英国医学研究委员会呼吸困难量表(mMRC)、6分钟步行试验(6MWT)、成人COPD生活质量量表(COPD-QOL)进行评定。结果治疗后,两组FEV₁、FEV_l%、FEV₁/FVC、膈肌和腹横肌RMS、6MWT距离和COPD-QOL评分均提高(t > 2.08, P < 0.05),试验组均较对照组提高更多(t > 2.27, P < 0.05);两组mMRC评分均减少(t > 2.09, P < 0.05),试验组较对照组减少(t = 2.13, P < 0.05)。结论在水中进行肺康复训练,可显著改善COPD患者的肺功能,增强呼吸肌肌力,改善呼吸困难,提高运动耐量,改善生活质量。

关键词: 慢性阻塞性肺疾病, 肺康复, 水中运动, 肺功能, 呼吸肌

Abstract:

Objective To observe the effect of water-based pulmonary rehabilitation on stable chronic obstructive pulmonary disease (COPD).Methods From February, 2020 to February, 2021, 50 patients with stable COPD in our hospital were divided into control group (n = 25) and experimental group (n = 25), who accepted pulmonary rehabilitation training on land and in water, for eight weeks. They were measured forced expiratory volume in first second (FEV₁), percents of forced expiratory volume in first second for prediction (FEV_l%) and ratio of forced expiratory volume in first second in forced vital capacity (FEV₁/FVC) with pulmonary function instrument; measured root mean square (RMS) of electromyogram of diaphragm and right transversus abdominis with surface electromyography; and assessed with modified breathlessness measurement of British Medical Research Council (mMRC), 6-minute walk test (6MWT) and quality of life scale for COPD adults (COPD-QOL) before and after treatment.Results FEV₁, FEV_l%, FEV₁/FVC, RMS of diaphragm and transversus abdominis, and 6MWT distance and COPD-QOL score increased in both group (t > 2.08, P < 0.05), and increased more in the experimental group than in the control group (t > 2.27, P < 0.05); while mMRC score decreased (t > 2.09, P < 0.05), and decreased more in the experimental group than in the control group (t = 2.13, P < 0.05).Conclusion Water-based pulmonary rehabilitation training can further improve lung function, strength of respiratory muscles, dyspnea, tolerance and quality of life for patients with COPD.

Key words: chronic obstructive pulmonary disease, pulmonary rehabilitation, exercise in water, lung function, respiratory muscle

王洁萍,彭娟,樊必双,滕悦,胥方元. 水中肺康复对慢性阻塞性肺疾病稳定期患者肺功能的效果[J]. 《中国康复理论与实践》, 2021, 27(11): 1329-1333.

WANG Jie-ping,PENG Juan,FAN Bi-shuang,TENG Yue,XU Fang-yuan. Effect of Water-based Pulmonary Rehabilitation on Stable Chronic Obstructive Pulmonary Disease[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1329-1333.

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组别	n	性别(男/女, n)	年龄(岁)	病程(年)	疾病分级
对照组	25	20/5	63.06±1.53	12.45±2.14	3.24±1.55
试验组	25	18/7	60.27±2.95	11.76±1.53	3.08±1.06
χ²/t值		38.72	-1.87	-1.92	-1.98
P值		0.043	0.072	0.068	0.063

组别	n	治疗前	治疗后	t值	P值
对照组	25	1.56±0.19	1.72±0.25	2.091	0.047
试验组	25	1.47±0.28	2.68±0.33	2.253	0.039
t值		-1.865	2.273
P值		0.071	0.036

组别	n	治疗前	治疗后	t值	P值
对照组	25	56.89±14.25	61.93±16.08	2.333	0.037
试验组	25	58.26±13.11	70.67±15.13	2.362	0.033
t值		1.984	2.416
P值		0.063	0.029

组别	n	治疗前	治疗后	t值	P值
对照组	25	57.88±8.02	59.17±7.76	2.104	0.048
试验组	25	56.19±6.34	65.71±7.29	2.271	0.036
t值		-2.019	2.362
P值		0.059	0.032

组别	n	治疗前	治疗后	t值	P值
对照组	25	6.758±2.072	7.124±1.964	2.112	0.047
试验组	25	7.013±1.834	9.356±2.191	2.401	0.028
t值		-1.872	2.316
P值		0.065	0.035