呼吸训练对慢性阻塞性肺疾病稳定期患者的康复效果

目的探讨缩唇呼吸训练和缩唇腹式呼吸训练在慢性阻塞性肺疾病稳定期患者康复治疗中的作用。方法将2007年8月至2008年4月呼吸内科出院的89例慢性阻塞性肺疾病临床缓解患者随机分为3组：A组为空白对照组，B组采用单纯缩唇呼吸训练，C组采用缩唇-版式呼吸圳练。分别检测3组患者出院时、出院4周后的呼吸频率、动脉血气分析（SaO2，PaO2，PaCO2）、肺功能（FEV1、6min步行距离、呼吸困难评分）等指标。结果A组患者出院后各项指标无明显变化；B、C组患者进行4周呼吸训练后与出院时及A组患者出院4周后比较，呼吸频率、动脉血气分析、6min步行距离、呼吸困难评分等差异均有统计学意义；B、C两组患者上述指标在训练后差异也有统计学意义。结论慢性阻塞性肺疾病稳定期患者进行呼吸训练能有效改善患者的呼吸困难及生活质量，缩唇-腹式呼吸训练较单纯缩唇呼吸训练效果更为显著。

Rehabilitationai Effects of Breathing Training in Patients with Stable Chronic Obstructive Pulmonary Disease

Objective To study the effects of pursed-lip breathing and purse-lip＆diaphragmatic breathing in the patients with stable chronic obstructive pulmonary disease（COPD）. Methods Eighty-nine patients with stable COPD discharged respiratory department form Aug. 2007 to Apr. 2008 were randomly divided into the control group（group A,n=29） given placebo, the pursed-lip breathing group（group B,n= 30） and the purse-lip＆diaphragmatic breathing group （group C, n = 30）. The respiratory rate, arterial blood gas analysis（SaO2 ,PaO2 ,PaCO2 ）,pulmonary function（FEV1 ,six-minute walk test and dyspnea scale） of the 3 groups were examined independently on discharge and at 4 weeks after discharge. Results No significant changes of all the indicators were observed in group A. Significant differences were observed on the respiratory rate,arterial blood gas analysis,six-minute walk test,dyspnea scale with in the group B and C as well as between the group B and C with four weeks of breathing training and the control group（group A） four weeks after discharge. There were significant differences on the above indicators of group B and group C after the breathing training. Conclusion The breathing training can improve the dyspnea condition and quality of life for the patients with stable COPD. Pursed-lip＆diaphragmatic breathing is preferable to pursed-lip breathing.