穴位按摩联合六字诀呼吸操在慢性阻塞性肺疾病稳定期患者中的应用
|
摘要
目的探讨穴位按摩联合六字诀呼吸操治疗慢性阻塞性肺疾病稳定期患者的临床疗效。方法将75例慢性阻塞性肺疾病稳定期患者随机分为治疗组(38例)与对照组(37例)。对照组采取常规治疗及护理,同时配合缩唇呼吸及腹式呼吸康复锻炼3个月。治疗组在常规治疗及护理基础上行穴位按摩干预14d,同时配合六字诀呼吸操干预3个月。观察两组治疗前后中医证候积分、改良英国医学研究委员会呼吸困难量表(mMRC)评分、焦虑抑郁评分、慢性阻塞性肺疾病评估测试(CAT)评分以及第一秒钟用力呼气容积与用力肺活量的比值(FEV1/FVC)变化。结果干预3个月后,治疗组中医证候积分、mMRC评分、CAT评分、焦虑抑郁评分显著优于对照组(均P<0.01),两组FEV1/FVC比较,差异无统计学意义(P>0.05)。结论穴位按摩联合六字诀呼吸操能改善慢性阻塞性肺疾病稳定期患者症状,减轻焦虑抑郁情绪。
Objective To observe the effectiveness of acupoint massage in combination with Liu-Zi-Jue respiratory exercise in stable COPD patients.Methods Seventy-four stable COPD patients were randomly assigned to one of two groups.Subjects in the control group(n=37)were given conventional treatment and care,and were asked to perform mouth breathing exercise and abdominal breathing exercise for 3 months.Participants in the treatment group(n=38)received acupoint massage intervention for 14 days in addition to conventional treatment and care,and were asked to conduct Liu-Zi-Jue respiratory exercise for 3 months.The TCM syndrome score,modified Medical Research Council Dyspnea scale(mMRC scale)score,COPD assessment test(CAT)score,Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores,as well as the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)were compared between the two groups.Results After 3 months of intervention,the scores of the former 5 indicators were significantly lower in the treatment group compared with the control group(P<0.01 for all).There was no significant difference in FEV1/FVC between the two groups(P>0.05).Conclusion Acupoint massage combined with Liu-Zi-Jue respiratory exercise can mitigate syndromes of stable COPD patients,and alleviate their anxiety and depression.
Objective To observe the effectiveness of acupoint massage in combination with Liu-Zi-Jue respiratory exercise in stable COPD patients.Methods Seventy-four stable COPD patients were randomly assigned to one of two groups.Subjects in the control group(n=37)were given conventional treatment and care,and were asked to perform mouth breathing exercise and abdominal breathing exercise for 3 months.Participants in the treatment group(n=38)received acupoint massage intervention for 14 days in addition to conventional treatment and care,and were asked to conduct Liu-Zi-Jue respiratory exercise for 3 months.The TCM syndrome score,modified Medical Research Council Dyspnea scale(mMRC scale)score,COPD assessment test(CAT)score,Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores,as well as the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)were compared between the two groups.Results After 3 months of intervention,the scores of the former 5 indicators were significantly lower in the treatment group compared with the control group(P<0.01 for all).There was no significant difference in FEV1/FVC between the two groups(P>0.05).Conclusion Acupoint massage combined with Liu-Zi-Jue respiratory exercise can mitigate syndromes of stable COPD patients,and alleviate their anxiety and depression.
引文
[1]Global initiative for chronic obstructive lung disease(GOLD).Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease 2017report[EB/OL].(2016-11-16)[2017-07-09].http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-preventioncopd/.
[2]Lou P,Zhu Y,Chen P,et al.Prevalence and correlations with depression,anxiety,and other features in outpatients with chronic obstructive pulmonary disease in China:a cross-sectional case control study[J].BMC Pulm Med,2012,12(1):53-69.
[3]Zhong N,Wang C,Yao W,et al.Prevalence of chronic obstructive pulmonary disease.a large,population-based survey[J].Am J Respir Crit Care Med,2007,176(8):753-760.
[4]van Boven J F,Roman-Rodriguez M,Palmer J F,et al.Comorbidome,pattern and impact of asthma-COPD overlap syndrome in real life[J].Chest,2016,149(4):1011-1020.
[5]于美玲,张中和.慢性阻塞性肺疾病研究进展[J].中国临床研究,2013,26(1):82-85.
[6]国家中医药管理局医政司.24个专业105个病种中医诊疗方案(试行)[M].北京:中国中医药出版社,2011:87-92.
[7]Williams J E A,Johnson-Warrington V,Singh S J,et al.S72The utility of the modified BODE index(incorporating the incremental shuttle walking test)in assessing survival in patients with COPD screened for Pulmonary Rehabilitation(PR)[J].Thorax,2010,65(Suppl 4):A34.
[8]中国行为医学科学编辑委员会.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:214-225.
[9]刘洪,张弛,李惠华,等.穿琥宁注射液对慢性阻塞性肺疾病气道炎症与细胞因子水平的影响[J].中国中医急症,2003,12(5):433-434.
[10]林懿才,刘晖,肖波,等.慢支咳喘灵对慢性阻塞性肺疾病稳定期患者免疫功能的影响[J].中国中医急症,2008,17(6):729-730.
[11]陈群,刘石梅.慢性阻塞性肺病患者血液流变学变化及益气活血中药干预作用[J].湖南中医杂志,2005,21(3):3-5.
[12]林英杰.足三里注射胸腺肽对小儿免疫功能影响的研究[J].右江民族医学院学报,2003,25(2):151-153.
[13]缪小红.穴位按摩对预防长期卧床老年患者肺部感染的效果观察[J].护理实践与研究,2013,10(21):128-129.
[14]姚亮,沈圆圆,杨佩兰.“伏九贴”治疗支气管哮喘慢性持续期临床研究[J].上海中医药杂志,2016,50(3):44-45.
[15]宁雪,谢坚.重复叩击肝俞、膈俞穴促进排痰在临床中的应用[J].按摩与康复医学,2012,3(5):25.
[16]雷斌,石爱桥,吕吉勇.健身气功·六字诀锻炼对心率的影响研究[J].哈尔滨体育学院学报,2008,26(6):183-185.
[17]陈秋帆,洪文扬.抑郁症的治疗需调肺[J].辽宁中医药大学学报,2008,10(9):12-13.
[2]Lou P,Zhu Y,Chen P,et al.Prevalence and correlations with depression,anxiety,and other features in outpatients with chronic obstructive pulmonary disease in China:a cross-sectional case control study[J].BMC Pulm Med,2012,12(1):53-69.
[3]Zhong N,Wang C,Yao W,et al.Prevalence of chronic obstructive pulmonary disease.a large,population-based survey[J].Am J Respir Crit Care Med,2007,176(8):753-760.
[4]van Boven J F,Roman-Rodriguez M,Palmer J F,et al.Comorbidome,pattern and impact of asthma-COPD overlap syndrome in real life[J].Chest,2016,149(4):1011-1020.
[5]于美玲,张中和.慢性阻塞性肺疾病研究进展[J].中国临床研究,2013,26(1):82-85.
[6]国家中医药管理局医政司.24个专业105个病种中医诊疗方案(试行)[M].北京:中国中医药出版社,2011:87-92.
[7]Williams J E A,Johnson-Warrington V,Singh S J,et al.S72The utility of the modified BODE index(incorporating the incremental shuttle walking test)in assessing survival in patients with COPD screened for Pulmonary Rehabilitation(PR)[J].Thorax,2010,65(Suppl 4):A34.
[8]中国行为医学科学编辑委员会.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:214-225.
[9]刘洪,张弛,李惠华,等.穿琥宁注射液对慢性阻塞性肺疾病气道炎症与细胞因子水平的影响[J].中国中医急症,2003,12(5):433-434.
[10]林懿才,刘晖,肖波,等.慢支咳喘灵对慢性阻塞性肺疾病稳定期患者免疫功能的影响[J].中国中医急症,2008,17(6):729-730.
[11]陈群,刘石梅.慢性阻塞性肺病患者血液流变学变化及益气活血中药干预作用[J].湖南中医杂志,2005,21(3):3-5.
[12]林英杰.足三里注射胸腺肽对小儿免疫功能影响的研究[J].右江民族医学院学报,2003,25(2):151-153.
[13]缪小红.穴位按摩对预防长期卧床老年患者肺部感染的效果观察[J].护理实践与研究,2013,10(21):128-129.
[14]姚亮,沈圆圆,杨佩兰.“伏九贴”治疗支气管哮喘慢性持续期临床研究[J].上海中医药杂志,2016,50(3):44-45.
[15]宁雪,谢坚.重复叩击肝俞、膈俞穴促进排痰在临床中的应用[J].按摩与康复医学,2012,3(5):25.
[16]雷斌,石爱桥,吕吉勇.健身气功·六字诀锻炼对心率的影响研究[J].哈尔滨体育学院学报,2008,26(6):183-185.
[17]陈秋帆,洪文扬.抑郁症的治疗需调肺[J].辽宁中医药大学学报,2008,10(9):12-13.