改良家庭肺康复训练对中度以上慢性阻塞性肺疾病患者的效果评价

目的探讨改良家庭肺康复训练对中度以上慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的呼吸困难症状、肺功能、运动耐力、生活质量的影响。方法便利抽样法选择2014年9月至2015年12月在常州市第一人民医院呼吸内科出院的中度以上COPD患者125例为研究对象,根据随机数字表法,将其分为对照组和观察组,其中对照组62例,观察组63例。对照组给予常规治疗护理措施加呼吸训练,观察组给予常规治疗护理措施加改良肺康复训练计划,干预时间均为12周。观察干预前后两组患者的呼吸困难评分(modified Medical Research Council dyspnea scale,mMRC)、肺功能指标、圣乔治呼吸问卷(St·Gorge’s respiratory questionnaire,SGRQ)和6min步行试验(6minute walking test,6MWT)的变化。结果观察组患者干预后SGRQ的呼吸症状(54.93±11.90)分、活动受限(52.64±14.33)分、疾病影响(55.40±9.91)分及总分(54.66±10.68)分均显著降低,与对照组比较差异有统计学意义(P0.05)与对照组比较,观察组患者干预后6MWT(372.09±67.15)m显著提高,mMRC(秩和值1726.00)显著降低,差异均有统计学意义(均P0.05)。观察组和对照组患者干预后肺功能指标比较差异均无统计学意义(均P0.05)。结论中度以上COPD患者实施改良家庭肺康复计划,有助于改善其呼吸困难症状、提高机体活动能力、改善生活质量,可作为其缓解期康复治疗的有效手段。

Effects Evaluation of Modified Home-based Pulmonary Rehabilitation in Patients with Moderate or Above Chronic Obstructive Pulmonary Disease

Objective To evaluate the effects of modified home-based pulmonary rehabilitation in patients with moderate or above chronic obstructive pulmonary disease (COPD),including symptoms of dyspnea,lung function,exercise capacity,and quality of life.Methods By convenience sampling,125 patients with moderate to severe chronic obstructive pulmonary disease in the department of respiration of Changzhou First People's Hospital were selected and randomly divided into control group (n =62) and observation group (n-63).The control group received routine nursing plus breathing training,while observation group received routine nursing plus modified home-based pulmonary rehabilitation training plan,the trainings lasted for 12 weeks.The modified medical research council dyspnea scale (mMRC),lung function,StGorge's respiratory questionnaire (SGRQ),and 6 minute walking test (6MWT) were evaluated.Result There was a significant reduction of SGRQ symptoms (54.93± 11.90),activity limitation (52.64±14.33),disease impacts (55.40±9.91) and total score (54.66±10.68) in the observation group,and there was statistically significant compard with control group(P＜0.05).There was a significant improvement of 6MWT (372.09±67.15) in the observation group,and there was a significant reduction of mMRC(sum of ranks 1726.00) in the observation group(all P＜0.05).There was no statistical significant found of lung function in both groups(allP ＞ 0.05).Conclusions Modified home-based pulmonary rehabilitation can reduce the symptoms of dyspnea,improve the exercise capacity and improve the quality of life in patients with moderate to severe chronic obstructive pulmonary disease.