稳定期慢性阻塞性肺病患者的康复治疗

目的：探讨运动康复对稳定期慢性阻塞性肺病（chronicobstructivepulmonarydisease，COPD）患者的生活质量以及其COPD急性发作次数的影响。方法：将101例COPD患者分为常规药物治疗组（Y组，n=53）和运动康复组（K组，n=48）。对Y组患者进行常规药物治疗，符合家庭氧疗的患者同时进行家庭氧疗。K组患者在常规药物治疗的基础上进行运动训练，具体方法如下：（1）颈部和上肢肌肉训练，3次／d，5min／次；（2）步行，3次／d，时间和距离不限，感到不适时停止；有家庭氧疗条件的患者在运动锻炼的同时进行吸氧锻炼。对所有患者每月进行电话随访，出现病情反复者及时就近治疗。记录每例患者1年中COPD急性发作的次数，同时记录患者入组时以及1年后的第1秒用力呼气量（forcedexpiratoryvolumeinonesecond，FEVl）、1S用力呼气容积占用力肺活量的比值（forcedexpiratoryvolumeinonesecond／forcedvitalcapacity，FEVl／FVC）和6min步行距离（six-minutewalkingdistance，6MWD）。结果：入组时2组患者的平均年龄、肺功能和6MWD均无显著差异（P〉0．05）。康复运动／年后K组患者的6MWD显著长于Y组（P=0．004）。K组患者1年中急性加重的次数显著少于Y组（P=0．025）。结论：除药物治疗外，运动康复训练和心理支持对提高COPD患者的生活质量也非常重要。

Rehabilitation of Patients with Stable Chronic Obstructive Pulmonary Disease

Objective：To investigate the importance of physical rehabilitation in patients with stable chronic obstructive pulmonary disease（COPD）. Methods.. A total of 101 patients with stable COPD were divided into medication group （n = 53） and rehabilitation group （n = 48）. Patients in the medication group were treated with common drugs, and family oxygen therapy was a- dopted if necessary. Patients in the rehabilitation group did exercise besides drug treatment. Patients received telephone survey every month. Once acute attack occur, they went to the nearest hospital for treatment. The numbers of acute attack in one year was recorded. The forced expiratory volume in one second （FEV1）, the ratio of forced expiratory volume in one second to forced vital capacity（FEV1/FVC）, and the six-minute walking distance（6MWD）at the beginning of the study and after one year were compared between the two groups. Results： There were no significant difference in age, pulmonary function and 6MWD between the two groups at the beginning of the study（P〉0.05）. One year later, 6MWD in the rehabilitation group was significantly longer than that in the medication group（P = 0. 004）. During the one year of study, the cases of acute attack in the rehabilitation group was significantly less than that in the medication group （P = 0. 025）. Conclusions： Physical exercise and psychological support play important roles in the rehabilitation of patients with stable COPD.