主动呼吸循环技术联合常规肺康复运动训练对COPD康复期患者心率变异性和肺功能的影响  

Effects of active cycle of breathing techniques combined with routine pulmonary rehabilitation exercise training on heart rate variability and pulmonary function in patients with COPD during convalescence

作　　者：张灵 孙程程[1] 蒋水平 马桂花 孙敖 ZHANG Ling;SUN Chengcheng;JIANG Shuiping;MA Guihua;SUN Ao(Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《西部医学》2022年第1期74-78,共5页Medical Journal of West China

基　　金：四川大学华西医院发展专项基金项目(HXHL19036)。

摘　　要：目的探讨主动呼吸循环技术(ACBT)联合肺康复运动训练对慢性阻塞性肺疾病(COPD)康复期患者心率变异性(HRV)和肺功能的影响。方法分析2017年8月~2019年8月到我院就诊的COPD康复期患者的临床资料,从采用常规肺康复训练治疗的患者中随机选取36例为常规训练组,从采用ACBT干预的患者中随机选取36例为ACBT组,从采用常规肺康复训练联合ACBT治疗的患者中随机选取36例为常规训练+ACBT组。对比3组患者干预前、干预12周后HRV指标[24 h正常RR间期标准差(SDNN)、连续5 min正常RR间期差值的均方根值(rMSSD)、正常相邻RR间期的间隔50 ms以上的百分比(PNN50)、低频(LF)以及高频(HF)]、肺功能指标[第1 s用气呼吸容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)]、康复情况[6分钟步行距离(6MWD)、Borg呼吸困难评分(BS)]及生活质量(CRQ评分)的差异。结果干预12周后,3组患者的HRV指标、肺功能指标及CRQ评分较干预前显著提高,且常规训练+ACBT组的上述指标显著高于ACBT组和常规训练组(均P<0.05);3组患者干预12周后的6MWD评分较干预前显著提高(均P<0.05),BS评分较干预前明显降低(均P<0.05),规训练+ACBT组的6MWD评分显著高于ACBT组及常规训练组,BS评分显著低于ACBT组及常规训练组(均P<0.05)。结论ACBT联合肺康复运动训练对COPD康复期患者进行干预,可有效改善患者心率变异性,提升患者肺功能,促进康复,提升生活质量,具有较好的应用价值。Objective To explore the effects of active cycle of breathing techniques combined with pulmonary rehabilitation exercise training on heart rate variability(HRV)and pulmonary function in patients with chronic obstructive pulmonary disease(COPD)during convalescence.Methods The clinical data of patients with COPD during convalescence who were treated in the hospital between August 2017 and August 2019 were analyzed.36 cases randomly selected from patient with routine pulmonary rehabilitation training were included in routine training group,and 36 cases from patients with active cycle of breathing techniques(ACBT)intervention were randomly selected as ACBT group,and 36 cases who were randomly selected from patients receiving routine pulmonary rehabilitation training combined with ACBT were set as routine training+ACBT group.The HRV indicators[standard deviation of NN intervals(SDNN),root mean square values of the standard deviation between adjacent normal number of intervals(rMSSD),percentage between RR and the period>50ms(PNN50),low frequency(LF),high frequency(HF)],pulmonary function indicators[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF)],rehabilitation status[6min walking distance(6MWD),Borg dyspnea score(BS)]and quality of life(CRQ score)were compared among the three groups before intervention and after 12 weeks of intervention.Results After 12 weeks of intervention,the HRV indicators,pulmonary function indicators and CRQ score in the three groups were obviously higher than those before intervention,and the above indicators of routine training+ACBT group were significantly higher than those of ACBT group and routine training group(all P<0.05).The 6MWD scores of the three groups of patients after 12 weeks of intervention were significantly improved compared with those before intervention(all P<0.05)while the BS scores were obviously reduced compared to before intervention(all P<0.05),and the 6MWD score of routine training+ACBT group was significantly higher than

关 键 词：慢性阻塞性肺疾病 康复期 主动呼吸循环技术 肺康复运动训练 心率变异性 肺功能 

分 类 号：R563[医药卫生—呼吸系统]