改良肺康复训练计划在中度以上慢性阻塞性肺疾病患者中的应用效果
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摘要
目的探讨改良肺康复训练计划在中度以上慢性阻塞性肺疾病(COPD)患者中的应用效果。方法将2016年7月～2018年7月遵义医学院第五附属(珠海)医院收治的80例中度以上COPD患者按就诊顺序分为研究组(41例)和参照组(39例)。参照组给予常规治疗护理措施+呼吸训练,研究组在参照组基础上给予改良肺康复训练计划,两组均干预12周。比较两组干预前后的6 min步行试验(6MWT)距离、改良版英国医学研究委员会呼吸问卷(mMRC)评分、圣乔治呼吸问卷(SGRQ)评分、血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果干预前,两组的6MWT距离、mMRC评分、SGRQ评分、IL-6和TNF-α水平比较,差异均无统计学意义(P>0.05)。干预后,研究组的6MWT距离明显大于参照组,m MRC和SGRQ评分明显低于参照组(P<0.05);研究组的IL-6、TNF-α水平明显低于参照组(均P<0.05)。结论改良肺康复训练计划应用于中度以上COPD患者,可以有效提高其运动耐力,缓解其呼吸困难症状,改善其生活质量和炎症反应。
Objective To explore the effect of improved pulmonary rehabilitation training program in patients with above moderate chronic obstructive pulmonary disease(COPD). Methods All of 80 patients with above moderate COPD admitted to the Fifth Affiliated(Zhuhai) Hospital of Zunyi Medical College from July 2016 to July 2018 were divided into the study group(41 cases) and reference group(39 cases) according to the order of treatment. The reference group was given routine treatment and nursing measures + breathing training, and the study group was given a modified pulmonary rehabilitation training program based on the reference group. Both groups were treated for 12 weeks. The distance of 6-minute walk test(6 MWT), improved British Medical Research Council Respiratory Questionnaire(mMRC)score, St.George′s Respiratory Questionnaire(SGRQ) score, serum interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) levels were compared between the two groups before and after intervention. Results There were no significant differences in the distance of 6 MWT, mMRC score, SGRQ score,IL-6 and TNF-α levels between the two groups before intervention(P>0.05). After intervention, the distance of 6 MWT of the study group was significantly larger than the reference group, and the mMRC and SGRQ scores were significantly lower than the reference group(P<0.05). The levels of IL-6 and TNF-α in the study group were significantly lower than those in the reference group(P<0.05). Conclusion Applying the improved pulmonary rehabilitation training program in patients with moderate or above COPD can effectively improve their exercise tolerance, relieve symptoms of dyspnea, improve quality of life and inflammatory response of patients.
Objective To explore the effect of improved pulmonary rehabilitation training program in patients with above moderate chronic obstructive pulmonary disease(COPD). Methods All of 80 patients with above moderate COPD admitted to the Fifth Affiliated(Zhuhai) Hospital of Zunyi Medical College from July 2016 to July 2018 were divided into the study group(41 cases) and reference group(39 cases) according to the order of treatment. The reference group was given routine treatment and nursing measures + breathing training, and the study group was given a modified pulmonary rehabilitation training program based on the reference group. Both groups were treated for 12 weeks. The distance of 6-minute walk test(6 MWT), improved British Medical Research Council Respiratory Questionnaire(mMRC)score, St.George′s Respiratory Questionnaire(SGRQ) score, serum interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) levels were compared between the two groups before and after intervention. Results There were no significant differences in the distance of 6 MWT, mMRC score, SGRQ score,IL-6 and TNF-α levels between the two groups before intervention(P>0.05). After intervention, the distance of 6 MWT of the study group was significantly larger than the reference group, and the mMRC and SGRQ scores were significantly lower than the reference group(P<0.05). The levels of IL-6 and TNF-α in the study group were significantly lower than those in the reference group(P<0.05). Conclusion Applying the improved pulmonary rehabilitation training program in patients with moderate or above COPD can effectively improve their exercise tolerance, relieve symptoms of dyspnea, improve quality of life and inflammatory response of patients.
引文
[1]陈溢玲,晏益华,李颖彬,等.肺康复护理对COPD稳定期患者肺功能及生活质量的影响[J].中国实用医药,2017,12(14):147-149.
[2]卓致远,武焱旻,张琦,等.噻托溴胺联合呼吸操训练治疗稳定期慢性阻塞性肺病患者的临床研究[J].临床肺科杂志,2016,21(12):2287-2290.
[3]韩蕊,杨伟,张丽,等.慢性阻塞性肺疾病稳定期患者肺康复治疗的临床研究[J].实用临床医药杂志,2017,21(17):120-122.
[4]吴海燕,钱钧,李树雯,等.心肺康复运动训练对COPD稳定期患者肺功能的影响[J].中国康复医学杂志,2016,31(3):351-353.
[5]伏冉,郑玉龙,王贻,等.全面肺康复治疗对中、重度慢性阻塞性肺疾病患者稳定期肺功能和血气指标的影响[J].中华物理医学与康复杂志,2016,38(8):594-597.
[6]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[7]刘欣欣,王浩彦,张曼林,等.改良版英国医学研究会呼吸困难量表评分及肺功能测定对慢性阻塞性肺疾病患者运动能力的预测价值研究[J].临床内科杂志,2016,33(6):404-406.
[8]柳涛,蔡伯蔷.慢性阻塞性肺疾病患者生活质量评估方法及其意义[J].中国呼吸与危重监护杂志,2003,2(4):196-197.
[9]李洁,王艳红.综合运动康复训练对慢性阻塞性肺疾病稳定期病人肺功能及运动耐力的影响[J].护理研究,2016,30(6):2271-2272.
[10]刘萍,王永斌,高天霖,等.综合性肺康复治疗对稳定期慢性阻塞性肺疾病患者运动能力与生存质量影响[J].中国康复医学杂志,2016,31(8):884-887.
[11]王恒,庄卫生.心肺康复运动训练对COPD稳定期患者肺功能的影响分析[J].实用中西医结合临床,2018,18(6):12-13.
[12]卜丽娜,宋爱玲,贾卫红,等.肺康复对稳定期慢性阻塞性肺疾病的疗效分析[J].临床肺科杂志,2016,21(5):799-801.
[13]李红建,王波,张安珍.COPD稳定期患者血清IL-6、TNF-α、MMP-9水平与BODE指数的相关性研究[J].国际呼吸杂志,2016,36(16):1221-1224.
[14]胡柳,伦雪萍.肺康复手段促进改善COPD病人肺功能的研究[J].中西医结合心血管病杂志,2018,6(24):41-42.
[15]孙丽,黄惠雪,白雪.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].中国康复医学杂志,2016,31(4):434-437.
[2]卓致远,武焱旻,张琦,等.噻托溴胺联合呼吸操训练治疗稳定期慢性阻塞性肺病患者的临床研究[J].临床肺科杂志,2016,21(12):2287-2290.
[3]韩蕊,杨伟,张丽,等.慢性阻塞性肺疾病稳定期患者肺康复治疗的临床研究[J].实用临床医药杂志,2017,21(17):120-122.
[4]吴海燕,钱钧,李树雯,等.心肺康复运动训练对COPD稳定期患者肺功能的影响[J].中国康复医学杂志,2016,31(3):351-353.
[5]伏冉,郑玉龙,王贻,等.全面肺康复治疗对中、重度慢性阻塞性肺疾病患者稳定期肺功能和血气指标的影响[J].中华物理医学与康复杂志,2016,38(8):594-597.
[6]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[7]刘欣欣,王浩彦,张曼林,等.改良版英国医学研究会呼吸困难量表评分及肺功能测定对慢性阻塞性肺疾病患者运动能力的预测价值研究[J].临床内科杂志,2016,33(6):404-406.
[8]柳涛,蔡伯蔷.慢性阻塞性肺疾病患者生活质量评估方法及其意义[J].中国呼吸与危重监护杂志,2003,2(4):196-197.
[9]李洁,王艳红.综合运动康复训练对慢性阻塞性肺疾病稳定期病人肺功能及运动耐力的影响[J].护理研究,2016,30(6):2271-2272.
[10]刘萍,王永斌,高天霖,等.综合性肺康复治疗对稳定期慢性阻塞性肺疾病患者运动能力与生存质量影响[J].中国康复医学杂志,2016,31(8):884-887.
[11]王恒,庄卫生.心肺康复运动训练对COPD稳定期患者肺功能的影响分析[J].实用中西医结合临床,2018,18(6):12-13.
[12]卜丽娜,宋爱玲,贾卫红,等.肺康复对稳定期慢性阻塞性肺疾病的疗效分析[J].临床肺科杂志,2016,21(5):799-801.
[13]李红建,王波,张安珍.COPD稳定期患者血清IL-6、TNF-α、MMP-9水平与BODE指数的相关性研究[J].国际呼吸杂志,2016,36(16):1221-1224.
[14]胡柳,伦雪萍.肺康复手段促进改善COPD病人肺功能的研究[J].中西医结合心血管病杂志,2018,6(24):41-42.
[15]孙丽,黄惠雪,白雪.肺康复对老年慢性阻塞性肺疾病稳定期患者血清炎症因子的影响[J].中国康复医学杂志,2016,31(4):434-437.