综合康复干预对农村稳定期慢性阻塞性肺疾病患者的影响  

Effects of comprehensive rehabilitation on stable chronic obstructive pulmonary disease patients in rural communities

作　　者：邹德奇 张学顺[1] 徐艳丽[1] 孙卫华[1] 汪瑜[1] 高海[1] 赵建伟[1] 

机构地区：[1]山东省海阳市第三人民医院呼吸科,265100

出　　处：《中华全科医师杂志》2013年第4期259-262,共4页Chinese Journal of General Practitioners

基　　金：基金项目：中华医学会临床医学慢性呼吸道疾病科研专项资金资助（07010010009）

摘　　要：目的研究综合康复干预对农村稳定期慢性阻塞性肺疾病（COPD）患者的影响。方法对2010年6月至2012年6月212例稳定期COPD患者采用随机数字表分为干预组107例和对照组105例。依托新型农村合作医疗卫生服务站，干预组患者在常规治疗的同时进行心理与行为干预、呼吸肌锻炼、家庭氧疗、营养支持等康复治疗措施，对照组患者仅予常规治疗，在干预前、干预6个月后应用简明健康调查量表SF-36（中文版）评估两组患者生存质量。记录患者生存质量评分、肺功能变化情况及病情变化情况（包括急性发作次数、住院次数）。结果与对照组相比，干预组患者躯体健康和精神健康总分的变化值均有明显改善，干预组和对照组分值分别为11．4±8．2比1．6±1．2、5．5±3．5比2．2±0．9，均P〈0．01。躯体健康中生理功能、生理职能、躯体疼痛、总体健康评分变化值的差异有统计学意义，干预组和对照组分别为6．7±4．3比1．2±0．8、10．9±6．3比1．9±1．5、6．4±4．7比3．6±2．7、3．2±2．7比1．6±1．1，均P〈0．01。精神健康中活力、情感职能、社会功能、心理健康评分变化值亦有统计学意义，干预组和对照组分别为4．9±3．2比1．9±1．4、2．7±2．1比1．6±1．1、11．6±9．2比3．6±2．3、6．7±4．3比1．4±0．9，均P〈0．01。干预组患者急性发作次数、住院次数显著减少，而对照组这些指标改善不明显，两组患者肺功能指标改善并不明显。结论利用新型农村合作医疗体系进行综合康复干预能有效改善农村COPD患者生存质量，减少急性加重和住院次数。Objective To explore the effects of comprehensive rehabilitation on patients with stable chronic obstructive pulmonary disease （COPD） in rural communities. Methods Between June 2010 and June 2012, 212 stable COPD patients were randomly divided into management group （n = 107） and control group （n = 105 ）. All patients received conventional treatment. In addition, 107 stable COPD patients relying on new rural cooperative medical service station in management group underwent community comprehensive rehabilitation including training in respiratory function, exercise training, nutrition intervention and psychological care. Effect of lung function, symptoms （times of acute attack ＆ hospitalization） and quality-of-life （QOL） rated by SF-36 questionnaire between two groups were recorded at Month 6. Results The score changes of QOL had significant inter-group differences between 2 groups for PCS （scores for physical component summary） and MCS （scores for mental component summary） （11.4 ± 8. 2 vs. 1.6 ± 1.2, 5. 5 ± 3.5 vs. 2. 2 ±0. 9, all P 〈 0. 01 ）. In the scores for physical component summary, the score change of physical function, physiological function, body pain and general health were significantly different between two groups （6. 7 ± 4. 3 vs. 1.2 ± 0. 8, 10. 9 ± 6. 3 vs. 1.9 ± 1.5, 6. 4 ± 4. 7 vs. 3.6 ± 2. 7, 3.2 ±2. 7 vs. 1.6 ± 1.1, P 〈 0. 01 ）. In the scores for mental component summary, the score change of vitality, emotional function, social function and mental health were significantly different between two groups （4.9±3.2vs. 1.9±1.4,2.7±2.1vs. 1.6±1.1, 11.6±9.2vs. 3.6±2.3,6.7±4.3vs. 1.4±0.9, P〈 0. 01 ）. The times of acute attack and hospitalization were obviously lower than those of the control group. No significant inter-group difference existed in lung function. Conclusion Comprehensive rehabilitation may improve the QOL in stable COPD patients in rural communities and reduce their times of acute attack.

关 键 词：肺疾病 慢性阻塞性 干预性研究 治疗结果 

分 类 号：R563.9[医药卫生—呼吸系统]