AECOPD患者集束化管理策略下的中西医结合肺康复治疗临床研究  

Observation on Curative Effect of Lung Rehabilitation Therapy with Integrated Traditional Chinese and Western Medicine under Cluster Management Strategy for AECOPD Patients

作　　者：朱进[1] 罗群 高燕 金红 王玮 余娟[1] 梁婷 Zhu Jin;Luo Qun;Gao Yan(Chongqing Hospital of traditional Chinese medicine,Chongqing,400021,China)

机构地区：[1]重庆市中医院

出　　处：《中国中医急症》2019年第10期1775-1777,1784,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家中医药管理局重点学科（国中医药医政发[2012]2）;重庆市中医院培育课题（2016-2-7）

摘　　要：目的观察集束化管理策略下的中西医结合肺康复治疗对慢性阻塞性肺疾病急性加重(AECOPD)患者的疗效。方法将我院AECOPD患者120例随机分为3组各40例。对照组采用常规药物治疗、氧疗、雾化和健康指导,清肺化痰汤剂;西医康复组在对照组的基础上加用缩唇呼吸训练、咳嗽咯痰训练、背部叩拍、扩胸运动训练等康复指导;中西医结合康复组在西医治疗组的基础上加用中医"六字诀"康复锻炼,西医康复组和中西医结合康复组同时采用集束化管理策略对患者实施康复管理。通过呼吸困难评分(mMRC)、生活质量评分(CAT)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC),患者自理能力评分,分别于入组时、出院时、3个月时观察3组患者呼吸困难、症状改善、自理能力、肺功能指标改善情况以及1年内随访急性发作次数并进行统计学分析。结果中西医结合康复组和西医康复组mMRC,CAT出院时及3个月时均明显低于对照组(P <0.05),FEV1 3组数据出院时、3个月时较入院时有改善,但是各组之间差异不明显,无统计学意义(P> 0.05),FEV1/FVC值西医康复组和中西医结合康复组于出院时、3个月时均明显高于对照组(P <0.05),生活自理能力评分中西医结合康复组于出院时、3个月时明显高于西医康复组和对照组,急性发作次数中西医结合康复组明显少于对照组和西医康复组(P <0.05)。结论 AECOPD患者采用集束化管理策略下的中西医结合肺康复和西医肺康复治疗对于改善患者出院时、3个月时呼吸困难、症状、FEV1/FVC值效果显著,中西医结合康复组在出院时及3个月时对于改善患者自理能力、提高患者生活质量有较好效果,中西医结合肺康复能够有效减少患者急性发作次数。Objective:To observe the effect of lung rehabilitation therapy with integrated traditional Chinese and Western medicine under cluster management strategy on AECOPD patients.Methods:120 patients were ran domly divided into three groups,40 cases in each group.The control group was treated with routine drug therapy,oxygen therapy,atomization and health guidance,and Qingfei Huatan Decoction;the treatment group was treated with lip reduction breathing training,cough and sputum training,back tapping,chest enlargement exercise and other rehabilitation guidance on the basis of the control group;the treatment group was treated with six-character formula of traditional Chinese medicine on the basis of Western medicine treatment group,western medicine rehabili tation group and Western medicine rehabilitation group.In the rehabilitation group,cluster management strategy was adopted to implement rehabilitation management for patients.Through mMRC scale,CAT scale,FEV1 and FEV1/FVC value,patients′self-care ability score,dyspnea,symptoms improvement,self-care ability,improvement of pulmonary function indicators and the number of acute attacks were observed and analyzed at admission,discharge,3 months and 1 year respectively.Results:The mMRC,CAT of the lung rehabilitation group and the Western rehabilitation group were significantly lower than those of the control group at discharge and 3 months(P<0.05).The data of FEV1 group were improved at discharge and 3 months after admission,but there was no significant difference among the three groups(P>0.05).The value of FEV1/FVC of the Western medicine group and the integrated traditional Chinese and Western medicine group was significantly lower than that of the control group at discharge and 3 months.Time was significantly higher than that of control group,the difference was statistically significant(P<0.05).The scores of self-care ability of life in integrated traditional Chinese and Western medicine group were significantly higher than that of rehabilitation group and control grou

关 键 词：AECOPD 集束化管理策略 中西医结合 肺康复 

分 类 号：R563.9[医药卫生—呼吸系统]