慢性阻塞性肺疾病稳定期患者综合康复治疗疗效观察

目的观察慢性阻塞性肺疾病（COPD）患者康复治疗前、后症状评分、6分钟步行试验（6MWT）及肺功能的变化。方法采用前瞻性随机对照研究，将60例COPD稳定期患者分为治疗组和对照组各30例；其中治疗组进行综合康复治疗（包括心理康复治疗、呼吸肌康复治疗、长期家庭氧疗），康复治疗前和48周后分别测定第1秒用力肺活量（FEV1）、第1秒用力肺活量／用力肺活量（FEV1／FVC）和FEV，占正常预计值的百分比（FEV1％）及6MWT运动距离；并通过问卷调查的形式进行症状评价。结果治疗组咳嗽、咯痰及呼吸困难等症状明显改善，6MWT运动距离明显提高，与对照组比较有显著差异（P〈0．05），但肺功能指标的改变无统计学意义（P〉0．05）。结论对COPD稳定期患者进行长期、综合程序康复治疗可以显著提高运动耐力，减轻临床症状。

Effects of periodical exercise training of outpatients with chronic obstructive pulmonary disease

Objective To determine the effectiveness of pulmonary rehabilitation program of patients with chronic obstructive pulmonary disease（COPD）. Methods A prospective and randomized study was carried out 60 COPD patients were recruited and randomized into either a treat group （30 cases） or a control group（30 cases）. Following completion of 2 weeks pulmonary rehabilitation program in hospital, and treat group followed for 48 weeks. Measurements were taken at baseline and 48 weeks later. Measurements include Pulmonary function test and 6 minute walk test（6MWT）. The symptoms and the physically active ability were also evaluated. Results （ 1 ）6MWT in the treat group were significantly increased after exercise training [ （357.5 ± 16.6）mvs （326.2 ±19.3 ）m] （P 〈 0.05 ） ;but 6MWT in the control group were no statistic difference was found（P 〉 O. 05 ） ;（2） FEV1 ,FEV1/FVC ~ FEV1% were improved after exercise training in the treat group, but no statistic difference was found （ P 〉 0.05 ） ; （ 3 ） The symptoms were ameliorated and the physically active ability was significantly improved after 48 weeks pulmonary rehabilitation program（ P 〉 0.05 ）. Conclusions The symptoms and the exercise endurance are improved after 48 weeks pulmonary rehabilitation program in COPD patients, but the pulmonary function is not sig- nificantly improved.