不同时期施行肺康复对COPD患者抑郁及焦虑的改善效果比较  

Comparison of effects of pulmonary rehabilitation on depression and anxiety at different stages in patients with chronic obstructive pulmonary disease

作　　者：李毅[1] 李月川[1] LI Yi;LI Yuechuan(Department of Respiratory Intensive Care Unit, Tianjin Chest Hospital, Tianjin 300222, China)

机构地区：[1]天津市胸科医院呼吸与危重症科,300222

出　　处：《天津医药》2016年第8期1010-1014,共5页Tianjin Medical Journal

基　　金：天津市科技计划项目(13ZCZDSY02000)

摘　　要：目的比较不同时期施行肺康复方案对慢性阻塞性肺疾病(COPD)患者抑郁及焦虑的影响。方法天津市胸科医院呼吸与危重症科因COPD急性加重住院患者97例,随机分为稳定期康复组(稳定期组,39例)及加重期康复组(加重期组,58例);2组患者均在急性期症状好转及急性期感染控制后(T1)进行基线评估,加重期组立即行12周(T2)肺康复训练;稳定期组患者在此期间仅接受常规药物治疗及肺康复宣教,至症状缓解并维持稳定12周(T2)进行第2次基线评估,随后开始进行12周(T3)肺康复训练。观察2组患者在不同时期的抑郁评分及焦虑评分的变化。结果 2组患者在T1时期的社会人口学基线资料比较差异无统计学意义(均P>0.05)。组内比较,稳定期组患者贝克抑郁自评量表(BDI)评分在T3时低于T1及T2(均P<0.05),但T1与T2比较,BDI差异无统计学意义(P>0.05);加重期组患者BDI评分在T2时低于T1(P<0.05)。组间比较,2组患者T1时期的BDI评分差异无统计学意义(P>0.05);加重期组患者在T2时的BDI评分低于稳定期组T2及T3时期的BDI评分(P<0.05),差异均有统计学意义(P<0.05)。组内比较,稳定期组患者焦虑-状态特质量表(STAI)评分在T3时低于T1及T2(均P<0.05),但T1与T2比较,STAI评分差异无统计学意义(P>0.05);加重期组患者STAI评分在T2时低于T1(P<0.05)。组间比较,2组患者T1时期的STAI评分差异无统计学意义(P>0.05);加重期组患者在T2时的STAI评分低于稳定期组T2时的STAI评分(P<0.05),而与稳定期组T3时的STAI评分比较差异无统计学意义(P>0.05)。结论与稳定期肺康复相比,急性加重期COPD患者进行早期的肺康复训练可以更早更好地改善抑郁及焦虑状态。Objective To observe the effects of pulmonary rehabilitation (PR) on depression and anxiety at different stages of chronic obstructive pulmonary disease (COPD) patients. Methods Ninety-seven COPD patients hospitalized in Department of Respiratory Intensive Care Unit, Tianjin Chest Hospital, were randomly divided into two groups: control group (n=39) and acute exacerbation COPD (AECOPD) group (n=58). Patients in both groups were assessed for baseline date when symptoms were improved from acute phase (T1). Then patients in control group were received pharmaco- therapy and rehabilitation publicity without PR. When symptoms was relieved and stable (T2), patients were given 12-week PR (T3). The Beck depression inventory (BDI) scores and State- Trait Anxiety Inventory (STAI) scores were observed in both groups respectively. Results There were no statistics differences in baseline data in both groups (P>0.05). In control group, the BDI score was significantly lower at T3 than that of T1 and T2 (F=5.309, P<0.05). But there was no significant difference in BDI between T1 and T2 (P>0.05). Similarly in AECOPD group, the BDI score was significantly lower at T2 than that of T1(t=3.612, P<0.05). At T1, there was no significant difference in BDI score between both groups (P>0.05). At T2 the BDI score was significantly lower in AECOPD group than that of control group, and also which was lower than that of T3 of control group (P<0.05). In control group, the STAI score was significantly lower at T3 than that of T1 and T2 (F=9.852, P<0.05),but there was no significant difference in STAI between T1 and T2 (P>0.05). The STAI score was significantly lower in T2 than that of T1 in AECOPD group (t=5.091, P<0.05). There was no significant difference in STAI score at T1 between two groups (P>0.05). There was significantly lower STAI score at T2 in AECOPD group than that of control group (P<0.05),while there was no significant difference in STAI score at T3 between two groups (P>0.05). Conclusion Pulmonary rehabilitation at early stage may

关 键 词：肺疾病 慢性阻塞性 抑郁 焦虑 急性加重期 肺康复 

分 类 号：R563[医药卫生—呼吸系统]