机构地区:[1]广州医学院第一附属医院呼吸疾病国家重点实验室广州呼吸疾病研究所,510120 [2]广州市荔湾区第二人民医院呼吸内科 [3]广东省人民医院呼吸内科
出 处:《中华医学杂志》2012年第14期952-955,共4页National Medical Journal of China
基 金:广东省第二批产业技术研究与开发基金(2007A032000004)
摘 要:目的观察简易太极拳锻炼对稳定期慢性阻塞性肺疾病(COPD)患者运动耐力和生活质量的影响。方法2010年5月至2011年3月,分批招募广州市荔湾、越秀及海珠3个行政区的70例稳定期COPD患者按性别和年龄(相差±2岁)配对入组,太极拳组35例患者在社区进行3个月的简化24式太极拳锻炼,对照组35例患者给予常规的院外管理。采集患者一般资料、病史、吸烟状况及用药情况,实验前后分别进行肺通气功能、COPD临床问卷(CCQ)评分、6min步行距离和呼吸困难Borg评分等指标的测定。结果共63例完成3个月的试验,其中太极拳组33例(95.3%),对照组30例(86.7%)。太极拳组和对照组在年龄、男性比例、体质指数、常规用药比例、病程、吸烟者比例、6min步行距离、CCQ总分及症状、活动部分评分等基线资料差异均无统计学意义(均P〉0.05)。试验后太极拳组6min步行距离较试验前提高了(51±55)m,而对照组减小了(19±58)m,两组差异有统计学意义(P〈0.01)。试验后太极拳组和对照组CCQ总分分别下降(-5.81±9.41)和(0.90±8.87),症状部分评分分别下降下降(-3.79±6.17)和(1.07±5.48),活动部分评分分别下降(-2.09±3.98)和(-0.13±3.85),差异均有统计学意义(均P〈0.05)。试验后太极拳组患者的用力肺活量(FVC)、第1秒用力呼气量(FEV1)及其占预计值的百分比(FEV,%预计值)均有一定改善,步行前后的Borg评分有下降,呼吸困难症状得到改善,但组间差异均无统计学意义(均P〉0.05)。结论简易太极拳锻炼能够提高患者的运动耐力,改善患者生活质量,适合作为社区稳定期COPD患者康复治疗方法之一。Objective To evaluate the effects of shadow boxing training on the exercise endurance and quality of life of Chinese patients with COPD ( chronic obstructive pulmonary disease). Methods From May 2010 to March 2011, a total of 70 COPD patients in stable phases were recruited from Liwan, Yuexiu and Haizhu districts of Guangzhou. There were 35 patients in the shadow boxing exercise group and 35 patients in the control group. And they were matched by gender and age. The patients in the shadow boxing group exercised for 3 months while those in the control group received the conventional out-hospital management only. Their demographic, medical history, smoking status, medicinal use, spirometric data, clinical COPI) questionnaire (CCQ) scores, 6-minute walking distance and Borg scores were collected before and after trial. Results A total of 63 COPD patients (33 in shadow boxing group vs. 30 in control group) completed the study. There was an average dropout rate of 5.7% (2/35) in shadow boxing group and 14. 3% (5/35) in control group. No differences existed between two groups in age (67 ±8 vs 69 ±9 yr), male proportion (84. 8 % vs 86. 7% ), body mass index (22.8 ±2. 6 vs 22.7 ± 3.0), usage proportion of medicine (42. 4% vs 33.3% ), duration of disease (4. 0 ± 7.5 vs 5.5 ±7.3 ), percentage of smokers (78. 8% vs 80.0% ), 6-minute walking distance (447 +94 vs 414 ± 100), CCQ total.score ( 15.0 ±9.4 vs 14. 1 ±8.8), CCQ symptom score (9. 2 ±5.6 vs 8.3±5.0) and activity score (5.8±4. 5 vs 5.8±4.4) at baseline ( all P 〉 0.05 ). At the end of study, the 6-minute walking distance of patients bad statistical differences between two groups (P 〈0. 01 ). The shadow boxing group increased by (51± 55 ) m while the control dropped by (19 ± 58) m. The total score, symptom score and activity score of clinical COPD questionnaire had statistical differences between two groups. They decreased significantly in the shadow boxing group as compar
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