肺功能锻炼对慢性阻塞性肺疾病患者肌肉功能及肺通气功能的影响分析  

Effect of pulmonary functional exercise on muscle function and pulmonary function in patients with chronic obstructive pulmonary disease

作　　者：李军华[1] 刘春燕[1] 喻小菊 牟敏[1] 杨丹[1] 张仕国[1] 蔡懿[1] 陈志勇[1] LI Jun-hua;LIU Chun-yan;YU Xiao-ju;MU Min;YANG Dan;ZHANG Shi-guo;CAI Yi;CHEN Zhi-yong(Department of Respiratory Medicine, Bazhong Central Hospital, Sichuan, Bazhong 636600, China)

机构地区：[1]巴中市中心医院呼吸内科,四川巴中636600

出　　处：《中国医学前沿杂志（电子版）》2017年第6期68-73,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：四川省卫生厅科研课题(130235)

摘　　要：目的分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者出院后自行肺功能锻炼对肌肉功能和肺通气功能的影响。方法选择2016年1月至2016年11月于本院呼吸内科就诊的68例COPD患者为研究对象。按照随机数表法将入选患者分为锻炼组和常规组,每组各34例,两组患者出院后均采用常规药物治疗,锻炼组患者自行肺功能锻炼。治疗3个月后复查并比较两组患者肺通气功能指标、动脉血气分析指标、呼吸肌肌力、60°/s和180°/s角速度时肘屈伸和膝屈伸的峰力矩及BODE指数。结果治疗3个月后,锻炼组患者BODE指数显著低于常规组(P<0.05),常规组患者BODE指数治疗前后比较无显著差异(P>0.05)。治疗后锻炼组患者第一秒用力呼气量(forced expiratory volume in first second,FEV_1)、FEV_1占用力肺活量百分比、FEV_1占预计值百分比、呼吸肌最大吸气压和最大呼气压、肘屈伸及膝屈伸峰力矩均显著高于常规组(P<0.05)。锻炼组患者动脉血氧分压、动脉血二氧化碳分压及动脉血p H较常规组改善更显著(P<0.05)。结论 COPD患者出院后自行肺功能锻炼可有效恢复呼吸肌和肌肉功能,提高肺功能和活动能力,缓解临床症状,显著提高患者生活质量。Objective To investigate the effect of pulmonary functional exercise on muscle function and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Method From January2016to November2016,68patients with COPD in our hospital were randomly divided into exercise group(n=34)and routine group(n=34)according to the random number table method.Routine group patients were treated by conventional drugs,exercise group patients were treated by pulmonary functional exercise for3months on the basis of routine group.After3months of treatment,pulmonary function,arterial blood gas analysis indexes,respiratory muscle,BODE index and peak torque of elbow flexion/extension and knee flexion/extension movement at angular velocity of60°/s and180°/s between the two groups were compared.Result After3months of treatment,the BODE index of exercise group was significantly lower than that of routine group(P<0.05).The BODE index of routine group had no significantly difference than before treatment(P>0.05).The pulmonary forced expiratory volume in first second(FEV1),FEV1/forced vital capacity,FEV1%pred,maximum inspiratory pressure,maximal expiratory pressure,peak torque of elbow and knee flexion/extension movement of exercise group were significantly higher than those of routine group(P<0.05).The arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)and arterial blood pH of exercise group were significantly better than that of routine group(P<0.05).Conclusion The application of pulmonary functional exercise in COPD patients can effectively restore respiratory muscle and skeletal muscle function,improve lung function and activity.Besides,it can improve blood gas analysis index,relieve clinical symptoms and improve the quality of life.

关 键 词：慢性阻塞性肺疾病 肺功能锻炼 肌肉功能 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]