呼吸肌功能训练对慢性阻塞性肺疾病患者的影响

目的研究呼吸肌功能训练对慢性阻塞性肺疾病高分辨CT(HRCT)不同表型患者的肺功能和生活质量的影响。方法选择2008年12月至2011年12月武汉市中医医院呼吸内科收治的120例慢性阻塞性肺疾病患者作为研究对象,根据HRCT检查结果分为支气管壁增厚组、肺气肿组、混合型组,在给予呼吸肌功能训练后检测肺功能相关指标和生活质量相关指标。结果支气管壁增厚组和肺气肿组的用力肺活量、第一秒末呼气容积、一秒率、气流阻塞程度、改良呼吸困难指数评分、6 min步行距离、卡氏行为状态评分、躯体功能、心理功能、社会功能、认知功能和总体生活质量评分结果,都明显高于混合型组(P<0.05);支气管壁增厚组和肺气肿组的步行后心率及呼吸频率均显著低于混合型组(P<0.05)。结论呼吸肌功能训练能够有效地改善肺功能、提高生活质量,并且对气管壁增厚型和肺气肿型慢性阻塞性肺疾病患者具有更为积极的治疗价值。

Effect of Respiratory Muscle Training on Pulmonary Function and Quality of Life in COPD Patients

Objective To study the effect of respiratory muscle training on pulmonary function and quality of life in COPD patients with different HRCT phenotypes. Methods A total of 120 patients with COPD from Wuhan Central Hospital during Dec. 2008 and Dec. 2011 were collected and divided into three groups of bronchial wall thiekening group, emphysema group, mixed group aeeording to HRCT. Then indicators of pulmonary function and quality of life were observed after respiratory muscle function training. Results FVC, FEV1 , FEV1/FCV, FEV1% pred, MMRC,6MWD, KPS score, physical function, psychological function, social function, cognitive function and overall quality of life of bronchial wall thickening group and emphysema group were significantly higher than mixed type group; heart rate and respiration rate after walking were obviously lower than the mixed type group. Conclusion Respiratory muscle training can effectively improve lung function and quality of life, and has more therapeutic value for tracheal wall thickening and emphysema COPD patients.