三球式呼吸训练器在慢性阻塞性肺疾病患者肺康复中的应用研究

目的：探讨三球式呼吸训练器在慢性阻塞性肺疾病（COPD）肺康复中的应用价值。方法对COPD稳定期患者进行前瞻性病例对照研究，分为3组：治疗A组60例，利用三球式呼吸训练器进行训练；治疗B组58例，行缩唇‐鼓腮‐腹式呼吸训练；对照组58例行常规内科治疗。结果治疗A组训练前后比较：FEV1实／预计值（％）、MVV实／预计值（％）增加，生活质量评分（QOL）减少（P＜0．01），FEV1／FVC（％）差异无统计学意义（P＞0．05）；治疗B组训练前后比较：QOL减少（P＜0．01），FEV1实／预计值（％）、MVV实／预计值（％）、FEV1／FVC（％）差异无统计学意义（P＞0．05）；治疗A组与对照组治疗后比较：FEV1实／预计值（％）、MVV实／预计值（％）增加，QOL减少（P＜0．01）；治疗B组与对照组治疗后比较：QOL减少（P＜0．01），FEV1实／预计值（％）、MVV实／预计值（％）差异无统计学意义（P＞0．05）；治疗 A组与治疗B组治疗后比较：FEV1实／预计值（％）、MVV实／预计值（％）差异有统计学意义（P＜0．01），QOL比较差异无统计学意义（P＞0．05）。结论 COPD稳定期患者使用三球式呼吸训练器进行肺康复训练能有效地改善肺功能及生活质量，基于此设备具有便捷的优点，在基层及肺康复大型设备不足的医院有很好的推广应用价值。

The application of respiratory exerciser tri-ball in pulmonary rehabilitation patients with chronic obstructive pulmonary disease

Objective To discuss the function of respiratory exerciser tri‐ball in pulmonary rehabilitation (PR) patients with chronic obstructive pulmonary disease(COPD) .Methods Prospectie case‐control study was used in COPD patients ,the patients were randomly divided into three groups ,60 COPD patients (group A) using respiratory exerciser TRI‐BALL ,58 COPD patients (group B) using traditional pursed lips ventral breathing training ,and 58 COPD patients(group C) using general internal medicine treatment .Results Group A :compared with before breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant after breath training (P<0 .01) ,but not for FEV1/FVC(% )(P>0 .05) .Group B :compared with before breath training ,the decrease of QOL was statistically significant (P<0 .01) ,but not for FEV1/FEV1 predicted (% ) ,MVV/MVV predicted (% ) and FEV1/FVC (% )(P>0 .05) .Compared with control group after breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant in group A (P<0 .01) .Compared with control group after breath training , the decrease of quality of life score (QOL) were statistically significant in group B (P<0 .01) ,but not for FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) (P>0 .05) .Compared the changes of pulmonary function test(PFT) index and QOL between group A and B ,the increments of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) were statistically significant in group A(P<0 .01) ,but not for QOL(P>0 .05) .Conclusion It is useful to improve the pulmonary function and quality of life in patients with COPD using respiratory exerciser tri‐ball .It is more effective than traditional pursed lips ventral breathing training ,due to the equipment is very small ,cheap ,easy to quantify training and convenient for household use ,it is worth to be popularized in primary hospital .