负氧离子吸入联合心律储备法康复运动在COPD稳定期患者肺康复中的应用  

Application of negative oxygen ion inhalation combined with heart rhythm reserve method of rehabilitation exercise in pulmonary rehabilitation of patients with stable COPD

作　　者：吴贻红 张豪 孙俊 张亚娟 田栙凡 王小红 赵宗权 WU Yi-hong;ZHANG Hao;SUN Jun(Department of General Medicine,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Jiangsu 215000,China;Department of General Medicine,Pingjiang New Town Community Health Service Center,Sujin Street,Gusu District,Suzhou Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院全科医学科,江苏苏州215000 [2]苏州市姑苏区苏锦街道平江新城社区卫生服务中心全科医疗科,江苏苏州215000

出　　处：《临床和实验医学杂志》2025年第5期477-482,共6页Journal of Clinical and Experimental Medicine

基　　金：苏州市科技局科研项目(编号:SKY2022088);苏州市科技局科研项目(编号:SKJYD2021042);苏州市姑苏卫生人才计划资助-分层培养(重点人才)[编号:2020(076)];2023年度苏州市姑苏卫生人才科研项目(编号:GSWS2023019);江苏省医院协会关于2023年度医院管理创新研究课题(编号:JSYGY-3-2023-388)。

摘　　要：目的观察负氧离子吸入联合心律储备法康复运动在慢性阻塞性肺病(COPD)稳定期患者肺康复中的应用。方法前瞻性选取2022年1月至2023年12月南京医科大学附属苏州医院收治的COPD稳定期患者112例,按照掷硬币法将其分为两组(正面为心律储备组,反面为综合组),每组各56例。两组均给予口服抗感染药、化痰药、支气管扩张剂和氧疗等治疗,心律储备组在此基础上给予心律储备法康复运动,综合组在心律储备组基础上联合负氧离子吸入治疗。比较两组治疗前与治疗后1 d的血气指标[血氧饱和度(SaO_(2))、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]、颗粒蛋白前体(PGRN)、沉默信息调节因子1(SIRT1)、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、呼吸功能[最大运动时每分钟通气量(VEmax)、最大运动时潮气量(VTmax)、最大运动时呼吸频率(RFmax)、呼吸储备(BR)]、肺功能[最大分钟通气量(MVV)、第1秒用力呼吸容积(FEV1)、用力肺活量(FVC)]及治疗后6个月内急性发作情况。结果治疗后1 d,两组SaO_(2)、PaO_(2)均较治疗前升高,PaCO_(2)均较治疗前降低,且综合组的SaO_(2)、PaO_(2)分别为(85.77±6.03)%、(75.08±7.11)mmHg,均较心律储备组[(80.49±7.16)%、(63.36±6.96)mmHg]更高,PaCO_(2)为(48.45±6.00)mmHg,较心律储备组[(57.02±5.22)mmHg]更低,差异均有统计学意义(P<0.05)。治疗后1 d,两组PGRN均较治疗前降低,SIRT1均较治疗前升高,且综合组的PGRN为(134.41±15.02)μg/L,较心律储备组[(160.05±16.23)μg/L]更低,SIRT1为(2.20±0.53)ng/mL,较心律储备组[(1.89±0.47)ng/mL]更高,差异均有统计学意义(P<0.05)。治疗后1 d,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,且综合组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(77.81±4.66)%、(41.74±5.02)%、1.86±0.25,均较心律储备组[(70.50±4.89)%、(36.56±4.53)%、1.43±0.23]更高,CD8^(+)为(22.40±2.43)%,较心律储备Objective To observe the application of negative oxygen ion inhalation combined with the heart rhythm reserve method of rehabilitation exercise in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD)in the stable stage.Methods A total of 112 patients with stable COPD admitted to Suzhou Hospital Affiliated to Nanjing Medical University from January 2022 to December 2023 were prospectively selected and divided into two groups according to the coin toss method(the positive side was the cardiac rhythm reserve group and the negative side was the comprehensive group),with 56 cases in each group.Both groups were given oral anti-infective drugs,expectorants,bronchodilators and oxygen therapy.The cardiac rhythm reserve group was given cardiac rhythm reserve rehabilitation exercise on this basis,and the comprehensive group was combined with negative oxygen ion inhalation on the basis of the cardiac rhythm reserve group.The blood gas indexes[blood oxygen saturation(SaO_(2)),partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))],progranulin(PGRN),silent information regulator 1(SIRT1),immune function(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),respiratory function[maximum exercise minute ventilation(VEmax),maximum exercise tidal volume(VTmax),maximum exercise respiratory rate(RFmax),breathing reserve(BR)],pulmonary function[maximum minute ventilation(MVV),forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)]before and 1 day after treatment and acute attack within 6 months after treatment were compared between the two groups.Results At 1 d after treatment,SaO_(2) and PaO_(2) in the two groups were higher than those before treatment,and PaCO_(2) was lower than that before treatment,SaO_(2) and PaO_(2) in the comprehensive group were(85.77±6.03)%and(75.08±7.11)mmHg,respectively,which were higher than those in the cardiac rhythm reserve group[(80.49±7.16)%and(63.36±6.96)mmHg],PaCO_(2) was(48.45±6.00)mmHg,which was lower than that in the c

关 键 词：负氧离子吸入 心律储备法 康复运动 慢性阻塞性肺病 稳定期 

分 类 号：R563.9[医药卫生—呼吸系统]