呼吸训练对缓解期老年重度COPD患者生存质量及日常生活活动的影响

目的：探讨呼吸训练对缓解期老年重度慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者的生存质量及日常生活活动的影响.方法：选择缓解期老年重度COPD患者30例,随机分为对照组10例,呼吸训练组20例.对照组常规内科治疗,呼吸训练组除常规内科治疗外采用缩唇呼吸和腹式呼吸训练3个月.呼吸训练前后分别评价生存质量（QOL）和日常生活活动（ADL）,同时测定肺功能和呼吸次数/分钟,与非训练组及训练前进行比较.结果：尽管呼吸训练组呼吸训练后与对照组及与训练前比较肺功能和ADL均无明显差异,但呼吸训练组呼吸频率与训练前比较明显降低（P＜0.05）,与对照组比较呼吸频率明显降低（P＜0.01）,呼吸短促症状明显减轻（P＜0.05）,QOL部分提高.结论：①生存质量指标中呼吸短促症状评价,结合呼吸次数/分钟评估呼吸康复效果较好;②即使是老年严重的COPD患者,也能通过呼吸训练使他们在生存质量上得到改善,呼吸康复适用于所有COPD患者.

Effects of breathing training on quality of life and activities of daily living in elderly patients with stable severe chronic obstructive pulmonary disease

Objective: To investigate the impact of breathing training on quality of life (QOL) and activities of daily living (ADL) in elderly patients with stable severe chronic obstructive pulmonary disease (COPD).Method: Thirty cases of elder patients with stable severe COPD were randomly divided into two groups. The breathing training group which consisted of 20 cases and the control group which consisted of 10 cases. Both groups received medicine theropy. Meanwhile,the breathing training group was chosen to pursed-lip breathing and diaphragmatic breathing training. We prospectively compared the degrees of improvement of lung function, respiratory rate, QOL and ADL after 3 months breathing training program. Assessment was made before and after the program.Result:Although lung function and ADL had not significant change after breathing training, the respiratory rate and the dyspnea improved significantly in breathing training group.Conclusion:These findings indicated that the dyspnea and the respiratory rate may be more sensitive to assess the rehabilitation effect of breathing training in elderly patients with stable severe COPD, suggesting that the QOL of elder patients with stable severe COPD improved by the breathing training. Pulmonary rehabilitation should be recommended for all patients with COPD.