肺康复训练对COPD急性加重期患者的远期疗效及心理状态的影响  

Long term effect of pulmonary rehabilitation training on patients with acute exacerbation of COPD and its influence on the psychological state of the patients

作　　者：刘杰[1] 张茜 李永霞 史超[1,2] 罗建江 马欢 LIU Jie;ZHANG Qian;LI Yongxia;SHI Chao;LUO Jianjiang;MA Huan(Physiatry Department,the Sixth Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830002 Chin)

机构地区：[1]新疆医科大学第六附属医院康复科,乌鲁木齐830002 [2]新疆维吾尔自治区中医医院呼吸科,830000

出　　处：《疑难病杂志》2018年第5期450-454,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金(2014211C012)

摘　　要：目的观察肺康复训练对COPD急性加重期患者的远期疗效及对患者心理状态的影响。方法选取2016年1月—12月新疆医科大学第六附属医院康复科和新疆维吾尔自治区中医医院呼吸科收治的COPD急性加重期患者92例,按照随机数字表法分为观察组和对照组,各46例,对照组给予常规治疗,观察组在对照组基础上给予肺康复训练;比较2组患者治疗前后的握力、6 min步行试验(6MWD)、慢性阻塞性肺病评估测试(CAT)量表、改良英国医学研究理事会呼吸困难评分(m MRC)、肺功能指标;采用贝克抑郁自评量表(BDI)、焦虑—状态特质焦虑量表(STAI)评估2组患者治疗前后的心理状态变化。结果治疗后,2组患者握力、6MWD评测值均明显高于治疗前(观察组t=5.973、20.661,对照组t=3.882、11.565,P均<0.05),且观察组患者握力、6MWD评测值明显高于对照组(t=5.395、14.836,P=0.010、0.003);治疗后,2组患者m MRC评分、CAT评分、BDI评分、STAI评分明显低于治疗前(观察组t=5.772、4.767、3.273、5.597,对照组:t=3.436、3.856、2.864、3.215,P均<0.05),且观察组患者明显低于对照组(t=3.815、2.869、1.742、3.844,P<0.05);治疗后,2组患者的FEV_1、FEV_1/FVC水平较治疗前均明显提高(观察组t=5.264、4.864,对照组t=5.076、4.742,P均<0.01),但2组间比较差异无统计学意义(P>0.05)。结论 COPD急性加重期进行肺康复训练可提高患者运动能力,缓解临床症状,改善心理状态,值得临床推广。Objective To observe the long term effect of pulmonary rehabilitation training on patients with acute exacerbation of COPD and its influence on the psychological status of the patients. Methods 92 patients with acute exacerbation of COPD treated in Physiatry department of The Sixth Affiliated Hospital of Xinjiang Medical University and Respiration department of The Xinjiang Uygur Autonomous Region traditional Chinese medicine hospital from January to December in 2016 were selected,and averagely divided into experimental group and control group according to the random number table method,46 cases in each group. The control group was given conventional anti infection,relieving cough and asthma,reducing phlegm and other treatment,and the experimental group was given pulmonary rehabilitation training on the basis treatment of the control group. After 4 courses of treatment,the grip strength,6 minute walk test （6MWD）,COPD assessment test （COPD assessment test,CAT）,the Modified Medical Research Council Dyspnea （mMRC） dyspnea score and pulmonary function index were compared between the two groups before and after treatment; Beck depression Inventory （BDI） and State-trait anxiety iInventory （STAI） were used to assess the changes of psychological status of the two groups before and after treatment. Results After treatment,the grip strength and 6MWD evaluation in the two groups were higher than before treatment （experimental groupcontrol group; t =5.973,20.661,3.882,11.565, P 〈0.05）,and the experimental group were significantly higher than those in the control group（ t =5.395, 14.836 , P =0.010,0.003）; After treatment,The mMRC score,CAT score,BDI score and STAI score of the two groups were lower than before treatment（experimental group： t =5.772,4.767,3.273,5.597, P 〈0.05;control group： t =3.436,3.856,2.864,3.215, P 〈0.05）; and the experimental group were significantly lower than those in the control group （ t =3.815,2.869,1.742,3.844, P =0.008,0.007,0.011,0.006）; After treatme

关 键 词：慢性阻塞性肺疾病 急性加重期 肺康复训练 临床疗效 心理状态 

分 类 号：R563.9[医药卫生—呼吸系统]