缩唇腹式呼吸联合有氧抗阻运动训练对慢性阻塞性肺疾病肺康复患者的影响  

Effects of Pursed-lip Abdominal Breathing Combined with Aerobic Resistance Exercise Training on Patients with Chronic Obstructive Pulmonary Disease Undergoing Pulmonary Rehabilitation

作　　者：张洪 唐卉[1] 余帅江 石瑶[1] 杨晓兰[1] 曾萍 ZHANG Hong;TANG Hui;YU Shuaijiang;SHI Yao;YANG Xiaolan;ZENG Ping(The Third People’s Hospital of Chengdu,Chengdu 610031,China;West China Public Health School of Sichuan University,West China Fourth Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]成都市第三人民医院,四川成都610031 [2]四川大学华西公共卫生学院,四川大学华西第四医院,四川成都610041

出　　处：《北华大学学报（自然科学版）》2024年第3期375-380,共6页Journal of Beihua University（Natural Science）

基　　金：四川省国际科技创新合作/港澳台科技创新合作项目(2021YFH0165)。

摘　　要：目的探讨缩唇腹式呼吸联合有氧抗阻运动训练对慢性阻塞性肺疾病(COPD)肺康复患者肺功能和运动耐力的影响。方法选取接受肺康复训练的COPD患者153例,按随机数表法分为对照组76例、研究组77例,对照组采用缩唇腹式呼吸训练,研究组采用缩唇腹式呼吸联合有氧抗阻运动训练。治疗3个月后,比较两组患者肺功能指标(用力肺活量(FVC)、1 s用力呼气容积(FEV1/FVC)、每min最大通气量(MVV))、呼吸困难分级(mMRC)、血气分析指标(动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、6 min步行距离(6 MWD))以及外周血炎性因子(白介素10(IL-10)、IL-17)、血管重塑指标(血管内皮生长因子(VEGF)、高迁移率族蛋白B1(HMGB1))水平。结果治疗后,两组患者FVC、FEV1/FVC和MVV均升高(P<0.05),研究组FVC、FEV1/FVC和MVV显著高于对照组(P<0.05);治疗后,两组患者mMRC评分均降低(P<0.05),研究组显著低于对照组(P<0.05);治疗后,两组患者PaO_(2)、SaO_(2)升高(P<0.05),PaCO_(2)降低(P<0.05),且治疗后与对照组比较,研究组患者PaO_(2)、SaO_(2)升高(P<0.05),PaCO_(2)降低(P<0.05);治疗后,两组患者6MWD均升高(P<0.05),且治疗后研究组高于对照组(P<0.05);治疗后,两组患者外周血IL-10水平升高(P<0.05),IL-17、VEGF、HMGB1水平降低(P<0.05),且治疗后研究组IL-10水平高于对照组(P<0.05),IL-17、VEGF、HMGB1水平低于对照组(P<0.05)。结论缩唇腹式呼吸联合有氧抗阻运动训练能改善COPD肺康复患者肺功能和血气分析指标,提高运动耐力,减轻肺部炎症反应和血管重塑,值得临床推广。Objective To explore the effects of pursed-lip abdominal breathing combined with aerobic resistance exercise training on pulmonary function and exercise tolerance in patients with chronic obstructive pulmonary disease(COPD)undergoing pulmonary rehabilitation training.Method 153 patients with COPD who received pulmonary rehabilitation training were enrolled and divided into control group(76 cases)and study group(77 cases)by means of the random number table method.The control group was given pursed-lip abdominal breathing training while the study group adopted pursed-lip abdominal breathing combined with aerobic resistance exercise training.After 3 months of treatment,the pulmonary function indicators(forced vital capacity(FVC),forced expiratory volume in 1 s(FEV1/FVC),maximum ventilation volume per minute(MVV)),dyspnea grading(mMRC),blood gas analysis indicators(arterial partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),6-minute walking distance(6 MWD))and levels of peripheral blood inflammatory factors(interleukin 10(IL-10),IL-17)and vascular remodeling indicators(vascular endothelial growth factor(VEGF),high mobility group protein B1(HMGB1))of patients in two groups were compared.Results After treatment,FVC,FEV1/FVC and MVV in both groups increased(P<0.05),and the three indicators in study group were significantly higher than those in control group(P<0.05).The mMRC score decreased in both groups after treatment(P<0.05),and the score in study group was significantly lower than that in control group(P<0.05).After treatment,PaO_(2) and SaO_(2) in the two groups were enhanced(P<0.05)while PaCO_(2) was reduced(P<0.05).PaO_(2) and SaO_(2) in study group were higher(P<0.05)while PaCO_(2) was lower(P<0.05)compared to control group after treatment.After treatment,6MWD in both groups increased(P<0.05),and 6MWD in study group after treatment was higher than that in control group(P<0.05).After treatment,the level of IL-10 in peripheral blood was risen(P<0.05

关 键 词：慢性阻塞性肺疾病 缩唇腹式呼吸 有氧抗阻运动训练 肺康复 肺功能 运动耐力 

分 类 号：R563[医药卫生—呼吸系统] R493[医药卫生—内科学]