呼吸操对慢阻肺患者肺功能影响的探讨

目的观察呼吸操对慢性阻塞性肺病（COPD）患者恢复期血气以及对肺功能和缺氧耐受性的影响。方法对符合慢性肺心病及缓解期诊断标准的患者50例，随机分成锻炼组25例和对照组25例，锻炼组进行呼吸操锻炼，对照组口服安慰剂。两组于开始前和1个月后分别进行血气，肺功能、行走距离和生存质量测定。结果锻炼组结束后各项指标的改善与锻炼前比较差异有显著性。而对照组各项指标服安慰剂前后无明显变化。结论呼吸操对缓解期慢性阻塞性肺病（COPD）患者动脉血气、肺功能、运动能力及生存质量等均有重要影响。     

慢性阻塞性肺疾病缓解期的规范化管理

目的观察对慢性阻塞性肺疾病缓解期的规范化管理、评价康复训练对COPD患者生活质量及改善肺功能。方法将38例COPD患者自身训练前后,通过护理干预如：营养指导、合理使用抗生素、心理卫生、呼吸操训练、运动训练、咳嗽咳痰、家庭氧疗指导。结果COPD患者肺功能明显改善。结论规范化的护理管理能提高COPD患者缓解期生活质量和肺功能改善。     

综合性肺康复治疗对稳定期COPD患者肺功能及血气指标的影响

将同期收治的60例慢性阻塞性肺疾病（COPD）稳定期患者随机分为观察组和对照组各30例，两组均予COPD基础治疗，观察组在此基础上给予呼吸功能锻炼、呼吸体操、有氧训练、氧疗、营养支持、心理与行为干预和教育等综合性肺康复治疗，观察两组肺功能及血气指标变化。结果观察组治疗前、后肺功能及血气指标均明显改善，效果优于对照组（P〈0．05）。认为综合性肺康复治疗有利于提高稳定期COPD患者的生存质量。     

家庭氧疗配合呼吸训练对缓解期COPD的疗效

目的观察家庭氧疗配合呼吸训练对缓解期COPD患者的疗效及护理。方法选择30例缓解期COPD患者随机分为两组,笫1组单纯家庭氧疗(每天15小时以上);笫2组在家庭氧疗的基础上配合呼吸训练,观察两组治疗前后肺功能的变化情况。结果笫2组肺功能各项指标均有显著的提高,P<0.01。结论家庭氧疗配合呼吸训练能有效改善COPD患者肺功能。     

家庭氧疗对COPD缓解期的作用分析

目的 探讨COPD缓解期患者在家中进行氧疗对疾病缓解的作用.方法 选择缓解期COPD患者50例出院时教会他们使用氧气瓶或制氧机及氧疗方法.出院后常规使用抗生素,配合氧疗呼吸操训练.结果 经一年干预50例患者急性发作次数明显减少,肺功能、血气指标明显提高.结论 长期家庭氧疗每天＞15 h,配合呼吸操训练可明显改变COPD患者生活质量及预后、提高心肺功能、减少住院次数.     

有氧运动及呼吸训练对慢性阻塞性肺疾病肺功能的影响

目的分析有氧运动及呼吸训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)肺功能的影响。 方法选择2020年4月至2020年12月我院收治的95例稳定期COPD患者随机分为观察组50例、对照组45例。对照组患者接受健康宣教及规范COPD治疗,观察组在此基础上接受有氧运动联合呼吸训练治疗。两组连续治疗3个月,比较治疗前后肺功能指标变化。 结果治疗后,两组PEF、FEV₁、FEV₁/FVC、BODE(COPD患者生存状况评估)指标及指数均较治疗前显著改善(P<0.05),观察组改善程度显著(P<0.05);观察组hs-CRP、IL-6、TNF-α水平及圣乔治呼吸调查问卷(St.George′s Respiratory Questionnaire, SGRQ)评分较治疗前下降,与对照组相比存在统计学差异(P<0.05);观察组治疗依从性及治疗满意度高于对照组(P<0.05)。 结论有氧运动联合呼吸训练可提升稳定期COPD肺功能,改善BODE指标及指数,降低机体炎症水平,提高治疗满意度和生活质量,治疗依从性高。     

胃肠外营养支持疗法对慢性阻塞性肺疾病急性发作期患者康复干预效果评价

目的探讨胃肠外营养支持疗法对慢性阻塞性肺疾病(COPD)急性发作期患者康复进程及生存质量的影响。方法选择我院84例COPD急性发作期患者为研究对象,观察组和对照组各42例。两组患者均给予积极控制感染和对症治疗,观察组患者在一般治疗的基础上给予静脉营养支持,10d为1个疗程。疗程结束后比较两组患者各项营养指标和呼吸功能指标的差异。结果疗程结束后对照组2例患者死于肺心病、心力衰竭;观察组无死亡患者。观察组患者的各项营养指标和呼吸功能指标与对照组比较,差异有统计学意义(P<0.05)。结论 COPD急性发作期患者早期使用胃肠外营养支持能明显加速患者康复进程,提高生存质量,减低死亡率,减少并发症。     

延续性护理改善慢性阻塞性肺疾病患者肺功能及生存质量分析

目的探讨延续性护理对慢性阻塞性肺疾病患者肺功能及生存质量的影响。方法选取慢性阻塞性肺疾病(COPD)患者148例,随机分为观察组和对照组,每组74例。观察组患者采用延续性护理,对照组采用常规护理,随访3个月。出院3个月后检测两组患者的肺功能相关指标并进行圣乔治呼吸(SGRQ)问卷调查。结果观察组患者呼吸症状、疾病影响得分低于对照组,Pa O2值显著高于对照组(P0.05);观察组患者1秒钟用力呼气容积(FEV)、最大呼气中段平均流速(MMEF)和用力肺活量(FVC)改善程度优于对照组(P0.05)。结论延续性护理能够改善COPD患者的肺功能,显著提高COPD患者的生存质量。     

运动及渐进性肌肉放松训练对缓解期COPD患者运动耐力、日常生活能力及情绪的影响

目的观察运动(呼吸和步行)及渐进性肌肉放松训练对缓解期慢性阻塞性肺疾病(COPD)患者运动耐力、日常生活能力及情绪的影响。方法 55例缓解期中、重度COPD患者随机分为对照组31例、训练组24例。对照组给予药物治疗,康复训练组除予以药物治疗外,配合进行运动和渐进性肌肉放松训练,持续观察6个月。观察期前后分别评价运动耐力(6MWD)、呼吸困难程度(Borg评分)和日常生活能力(ADL评分),同时进行焦虑抑郁程度和肺功能评定。结果 COPD患者训练后6MWD明显高于训练前和对照组(均P0.05),ADL评分明显增加(P0.05),而Borg评分明显减轻(P0.05),焦虑、抑郁评定亦显著降低(P0.05),但训练前后患者肺功能无明显差异(P0.05)。结论运动及渐进性肌肉放松训练尽管对缓解期COPD患者肺功能无显著影响,但可增加其运动耐力和ADL能力,减轻呼吸困难和焦虑抑郁程度。     

呼吸康复锻炼对慢性阻塞性肺疾病缓解期患者肺功能及生活质量的影响

目的探讨呼吸康复锻炼对慢性阻塞性肺疾病(COPD)缓解期患者肺功能及生活质量的影响。方法选取2018年4月至2019年3月在我院呼吸内科住院治疗的COPD缓解期患者62例,将拒绝呼吸康复锻炼的患者设为对照组,共31例,给予常规治疗护理;将接受呼吸康复锻炼的患者设为观察组,共31例,给予常规治疗护理,同时进行呼吸康复。两组患者均干预12周。比较干预前后两组患者的用力肺活量(FVC)、用力呼气一秒量(FEV1)、一秒率(FEV1/FVC)以及圣乔治呼吸问卷(SGRQ)评分。结果干预前,两组患者的FVC、FEV1、FEV1/FVC以及SGRQ评分比较,差异均无统计学意义(P0.05)。干预12周后,两组患者的FVC、FEV1、FEV1/FVC均显著提高,SGRQ评分显著降低;观察组患者的FVC、FEV1、FEV1/FVC明显高于对照组,SGRQ评分显著低于对照组,差异有统计学意义(P0.05)。结论呼吸康复锻炼能有效改善COPD缓解期患者的肺功能,提高患者的生活质量。     

呼吸训练对稳定期慢性阻塞性肺疾病患者的影响

目的探讨呼吸功能锻炼对慢性阻塞性肺疾病（COPD）康复期患者肺功能、呼吸困难程度和生存质量的影响。方法采用自身前后对照的方法,72例COPD稳定期的患者进行缩唇呼吸、腹式呼吸、呼吸操等呼吸肌功能锻炼方法,锻炼6个月。测定患者肺功能、6 min行走距离（6MWT）、Borg评分和生存质量。结果呼吸肌锻炼后肺功能指标均有明显改善（P〈0.05）,6 min行走距离（6MWT）测定;改良的Borg评分表;生存质量与锻炼前比较,差异有统计学意义（P〈0.05）。结论呼吸功能锻炼能改善肺功能、增加6min行走距离、减轻呼吸困难程度和提高生存质量。     

呼吸操在重度慢性阻塞性肺疾病患者呼吸肌力量训练中的作用研究

目的观察中医养生呼吸训练操结合氧疗方法对重度慢性阻塞性肺疾病（COPD）稳定期患者康复治疗的作用。方法重度COPD男性病人39例中20例为对照组,采用单纯鼻导管吸氧,另19例为实验组,鼻导管吸氧结合呼吸操训练,治疗前以及六个月治疗后分别检测运动能力、血气分析、肺功能和呼吸肌力指标。结果六个月治疗后,鼻导管吸氧结合呼吸操训练组的各项指标均优于对照组（P〈0．05）。结论鼻导管结合呼吸操训练可有效提高慢性阻塞性肺疾病患者的呼吸肌的强度和耐力,增加肺活量,促进有效气体交换。     

Nutrition and chronic respiratory failure

Protein calorie malnutrition is frequently observed in patients with chronic obstructive pulmonary disease (COPD). The main mechanism is hypermetabolism essentially resulting from increased oxygen consumption of the respiratory muscles. Malnutrition is associated with poor prognosis, irrespective of age and respiratory function impairment. Malnutrition has several harmful consequences on the respiratory system: atrophy and decreased strength of the respiratory muscles, decreased exercise performance, decreased quality of life, and likely increased risk of community-acquired and nosocomial pneumonia. A long-duration oral supplementation may improve the nutritional status and exercise tolerance in ambulatory COPD patients. The interest of anabolic drugs, especially recombinant growth hormone, has not been demonstrated in malnourished COPD patients.     

肺呼吸康复治疗在慢性阻塞性肺疾病稳定期患者中的应用研究

目的分析探讨肺呼吸康复治疗在慢性阻塞性肺疾病稳定期患者中的应用效果。方法选择2018年1月至2020年3月间收治的80例慢阻肺稳定期患者,随机分为常规治疗组和肺呼吸康复治疗组。常规治疗组予以常规治疗,肺呼吸康复治疗组在常规治疗基础上,采用呼吸训练器进行吸气和呼气训练。观察比较两组患者出院随访4周后的肺功能、生活质量及运动能力。结果经4周治疗训练后,两组患者肺功能各项指标较治疗前均有显著改善(P<0.05)。肺呼吸康复治疗组患者治疗后FVC为2.43±0.61L,FEV₁为1.39±0.34L,FEV 1/FVC为57.18%±5.83%,各项指标均显著优于常规治疗组(P<0.05)。肺呼吸康复治疗组治疗后6min步行试验距离为382.52±39.06m,CAT评分为12.12±5.07分,患者治疗后运动能力及生活质量优于常规治疗组(P<0.05)。治疗后,肺呼吸康复治疗组BODE评分为3.21±0.57,优于常规治疗组,差异有统计学意义(P=0.009)。结论呼吸训练器联合常规治疗应用于肺呼吸康复治疗,可明显改善COPD稳定期患者的肺功能,改善生活质量。     

Effect of respiratory muscle endurance training in patients with COPD undergoing pulmonary rehabilitation

BACKGROUND: Respiratory muscle endurance training (hyperpnea training) has been shown to have beneficial effects in patients with COPD. STUDY OBJECTIVES: The purpose of this study was to determine whether hyperpnea training, when added to an endurance exercise training program, would lead to additional benefits compared with endurance training alone in patients with COPD. SETTING AND PARTICIPANTS: Patients with COPD entering an 8-week outpatient pulmonary rehabilitation program. Fifteen patients (mean [+/- SE] FEV1, 45 +/- 6% predicted) were randomized to combined therapy, and 14 patients (mean FEV1, 44 +/- 4% predicted) were randomized to endurance training. METHODS: Peak exercise capacity, exercise endurance time during constant workload cycle exercise, 6-min walk distance, quality of life as measured by the chronic respiratory questionnaire, respiratory muscle strength and endurance, and quadriceps fatigability were measured before and after endurance or combined training. RESULTS: After rehabilitation, peak exercise capacity, exercise endurance time, 6-min walk distance, and quality of life all increased in both groups, but there was no significant difference in the extent of improvement between groups. Mean respiratory muscle endurance increased to a significantly greater extent in the combined therapy group (17.5 +/- 2.7 vs 8.5 +/- 2.5 min, respectively; p = 0.02). Respiratory muscle strength was significantly increased, and quadriceps fatigability was significantly reduced after rehabilitation in the combined therapy group but not in the endurance training group, but the difference between groups did not reach statistical significance. CONCLUSION: The endurance of the respiratory muscles can be improved by specific training beyond that achieved by endurance training alone in patients with COPD. However, this improvement did not translate into additional improvement in quality of life or exercise performance.     

噻托溴胺联合呼吸操训练治疗稳定期慢性阻塞性肺病患者的临床研究

目的探讨噻托溴胺联合呼吸操训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,慢阻肺)稳定期患者的肺通气功能、生活质量以及运动耐力的影响。方法选择2014年10月至12月稳定期慢阻肺患者共73例,随机分为常规药物治疗组(A组,n=37)和呼吸操训练组(B组,n=36)。对A组患者常规吸入噻托溴胺,有氧疗指征者给予长期家庭氧疗。B组患者除应用噻托溴胺和(或)氧疗外,指导呼吸操训练,方法包括腹式呼吸、缩唇呼气及全身性呼吸体操。记录每例患者入组时及12周后的FEV1占预计值的百分比(FEV1%Pred)、圣乔治呼吸疾病问卷(SGRQ)评分及6 min步行距离(6MWD)。结果入组时两组患者的性别、平均年龄、肺功能分级、FEV1%Pred、SGRQ评分及6MWD均无显著差异(P0.05)。干预12周后两组患者FEV1%Pred、SGRQ评分及6MWD均较治疗前有显著变化。其中B组患者的SGRQ评分显著低于A组,B组患者的6MWD显著长于A组(P0.05)。结论在常规吸入长效抗胆碱能药物治疗外,配合呼吸操训练可更好的改善稳定期慢阻肺患者的生活质量及运动耐力。     

Exercise training increases respiratory muscle strength and exercise capacity in patients with chronic obstructive pulmonary disease and respiratory muscle weakness

BackgroundHow respiratory muscle strength influences the effectiveness of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) is unclear.ObjectiveTo investigate the benefits of PR in subjects with COPD according to respiratory muscle strength.MethodsNinety-seven subjects with COPD were evaluated using maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), pulmonary function tests, the cardiopulmonary exercise test (CPET), and the St. George's Respiratory Questionnaire (SGRQ). Subjects were divided into four groups: 1 (normal MIP and MEP); 2 (low MIP); 3 (low MEP); and 4 (low MIP and MEP). Subjects underwent PR for 3 months; MIP, MEP, SGRQ, and CPET were evaluated post-PR.ResultsSubjects with both poor MIP and MEP had the highest dyspnea score, lowest exercise capacity, and poorest health-related quality of life (HRQoL). PR improved exercise capacity and HRQoL in all groups, with more improvement in MIP, MEP, tidal volume (on exercise), and dyspnea (at rest) in subjects with both low MIP and MEP.ConclusionsPatients with respiratory muscle weakness had worse dyspnea, lower exercise capacity, and poorer HRQoL at baseline. Exercise training improved respiratory muscle strength with concurrent improvement of exercise capacity, HRQoL, and dyspnea score. Subjects with both poor baseline MIP and MEP showed greater benefits of PR.     

Peripheral muscle strength in stable COPD patients: correlation with respiratory function variables and quality of life

The aim of this study was to assess peripheral muscle strength in patients with chronic obstructive pulmonary disease (COPD) using a simple test and to look for correlation with function variables, physiological strength variables and quality of life parameters. Twenty-three COPD patients with moderate to severe air-flow limitation (FEV1 = 39 +/- 12%) in stable phase but displaying inability to carry out daily tasks were enrolled. Peripheral muscle strength was assessed in all patients by measuring the maximum load in a single repetition of five simple upper and lower extremity exercises performed at a multi-gymnastics station. Results were compared to respiratory function variables (FVC, FEV1, FEV1/FVC and gasometry), to results of an exercise test on a cycle ergometer with monitoring of respiratory gases (VEmax, VO2max and Wmax), to endurance (minutes) to dyspnea (Mahler's scale) and to quality of life (Chronic Respiratory Disease Questionnaire-CRDQ). No relation between functional parameters and endurance in minutes was found. Minute ventilation (VE) proved to be significantly related to oxygen intake (VO) and maximum work in the stress test. Dyspnea on Mahler's scale was unrelated, but fatigue variables and emotional function variables on the CRDQ were related. We conclude that peripheral muscle strength is unrelated to level of flow limitation or exercise tolerance in COPD patients. Peripheral muscle strength is related, however, to maximum work load and some aspects of quality of life.     

Efficacy of inhaled steroids in undiagnosed subjects at high risk for COPD: results of the detection, intervention, and monitoring of COPD and asthma program

BACKGROUND AND AIM: COPD leads to a progressive decline of pulmonary function. Family physicians treat a substantial number of patients with COPD and are encouraged to start treatment at as early a stage as is possible. This study analyzed the effectiveness of early inhaled corticosteroid treatment on the decline of pulmonary function in COPD patients. PATIENTS AND SETTING: Subjects with a rapid decline in lung function (ie, FEV(1) decline, > 80 mL/yr) who had never before received a diagnosis of asthma or COPD. METHODS: Two-year, randomized, controlled, double-blind clinical trial of fluticasone propionate (250 microg bid; 24 patients) or placebo (25 patients), followed by a 7-month open-label study in which all subjects received fluticasone propionate. The primary outcome was the post-bronchodilator therapy FEV(1,) and secondary outcomes were respiratory symptoms, exacerbations, health state, quality of life, and health-care utilization. RESULTS: After 31 months, there were no statistical differences in post-bronchodilator therapy FEV(1) between the intervention group and the control group. No statistical differences were observed for symptoms, exacerbations, or quality of life, although tendencies were consistently in favor of treatment. There was no significant impact on the direct or indirect costs. CONCLUSIONS: There are no indications that early treatment with inhaled corticosteroids modifies a rapid decline in lung function or respiratory symptoms and quality of life.     

慢性阻塞性肺疾病2种肺康复策略的疗效比较

目的:比较2种不同的肺康复干预策略对慢性阻塞性肺疾病(COPD)患者BODE指数评分、焦虑抑郁及日常生活活动能力的改善及脱落率。方法:采用随机、对照的方法将155例稳定期COPD患者分为3组,肺康复干预Ⅰ组给予康复宣教、有氧呼吸操及体能训练;肺康复干预Ⅱ组仅给予康复宣教及有氧呼吸操,对照组不给予肺康复干预,为期20周。比较康复前后3组患者BODE指数、焦虑抑郁及日常生活活动能力评分及脱落的差异。结果:经过20周的肺康复干预,肺康复干预Ⅰ、Ⅱ组较对照组在焦虑抑郁评分、6 min步行距离、呼吸困难程度评分均明显改善(P<0.01),但脱落率明显高于其他2组(P