CAJ | 학술논문

目的研究综合康复干预对农村稳定期慢性阻塞性肺疾病(COPD)患者的影响.方法对2010年6月至2012年6月212例稳定期COPD患者采用随机数字表分为干预组107例和对照组105例.依托新型农村合作医疗卫生服务站,干预组患者在常规治疗的同时进行心理与行为干预、呼吸肌锻炼、家庭氧疗、营养支持等康复治疗措施,对照组患者仅予常规治疗,在干预前、干预6个月后应用简明健康调查量表SF-36(中文版)评估两组患者生存质量.记录患者生存质量评分、肺功能变化情况及病情变化情况(包括急性发作次数、住院次数).结果与对照组相比,干预组患者躯体健康和精神健康总分的变化值均有明显改善,干预组和对照组分值分别为11.4±8.2比1.6±1.2、5.5±3.5比2.2±0.9,均P＜0.01.躯体健康中生理功能、生理职能、躯体疼痛、总体健康评分变化值的差异有统计学意义,干预组和对照组分别为6.7±4.3比1.2±0.8、10.9±6.3比1.9±1.5、6.4±4.7比3.6±2.7、3.2±2.7比1.6±1.1,均P＜0.01.精神健康中活力、情感职能、社会功能、心理健康评分变化值亦有统计学意义,干预组和对照组分别为4.9±3.2比1.9±1.4、2.7±2.1比1.6±1.1、11.6±9.2比3.6±2.3、6.7±4.3比1.4±0.9,均P＜0.01.干预组患者急性发作次数、住院次数显著减少,而对照组这些指标改善不明显,两组患者肺功能指标改善并不明显.结论利用新型农村合作医疗体系进行综合康复干预能有效改善农村COPD患者生存质量,减少急性加重和住院次数.
목적 연구종합강복간예대농촌은정기만성조새성폐질병(COPD)환자적영향.방법 대2010년6월지2012년6월212례은정기COPD환자채용수궤수자표분위간예조107례화대조조105례.의탁신형농촌합작의료위생복무참,간예조환자재상규치료적동시진행심리여행위간예、호흡기단련、가정양료、영양지지등강복치료조시,대조조환자부여상규치료,재간예전、간예6개월후응용간명건강조사량표SF-36(중문판)평고량조환자생존질량.기록환자생존질량평분、폐공능변화정황급병정변화정황(포괄급성발작차수、주원차수).결과 여대조조상비,간예조환자구체건강화정신건강총분적변화치균유명현개선,간예조화대조조분치분별위11.4±8.2비1.6±1.2、5.5±3.5비2.2±0.9,균P＜0.01.구체건강중생리공능、생리직능、구체동통、총체건강평분변화치적차이유통계학의의,간예조화대조조분별위6.7±4.3비1.2±0.8、10.9±6.3비1.9±1.5、6.4±4.7비3.6±2.7、3.2±2.7비1.6±1.1,균P＜0.01.정신건강중활력、정감직능、사회공능、심리건강평분변화치역유통계학의의,간예조화대조조분별위4.9±3.2비1.9±1.4、2.7±2.1비1.6±1.1、11.6±9.2비3.6±2.3、6.7±4.3비1.4±0.9,균P＜0.01.간예조환자급성발작차수、주원차수현저감소,이대조조저사지표개선불명현,량조환자폐공능지표개선병불명현.결론 이용신형농촌합작의료체계진행종합강복간예능유효개선농촌COPD환자생존질량,감소급성가중화주원차수.
Objective To explore the effects of comprehensive rehabilitation on patients with stable chronic obstructive pulmonary disease (COPD) in rural communities.Methods Between June 2010 and June 2012,212 stable COPD patients were randomly divided into management group (n =107) and control group (n =105).All patients received conveutional treatment.In addition,107 stable COPD patients relying on new rural cooperative medical service station in management group underwent community comprehensive rehabilitation including training in respiratory function,exercise training,nutrition intervention and psychological care.Effect of lung function,symptoms (times of acute attack & hospitalization) and quality-of-life (QOL) rated by SF-36 questionnaire between two groups were recorded at Month 6.Results The score changes of QOL had significant inter-group differences between 2 groups for PCS (scores for physical component summary) and MCS (scores for mental component summary) (11.4 ±8.2 vs.1.6 ± 1.2,5.5 ±3.5 vs.2.2 ±0.9,all P ＜0.01).In the scores for physical component summary,the score change of physical function,physiological function,body pain and general health were significantly different between two groups (6.7 ±4.3 vs.1.2 ±0.8,10.9 ±6.3 vs.1.9 ± 1.5,6.4 ±4.7 vs.3.6 ±2.7,3.2 ±2.7 vs.1.6 ± 1.1,P ＜ 0.01).In the scores for mental component summary,the score change of vitality,emotional function,social function and mental health were significantly different between two groups (4.9±3.2 vs.1.9±1.4,2.7±2.1 vs.1.6±1.1,11.6 ±9.2 vs.3.6 ±2.3,6.7 ±4.3 vs.1.4±0.9,P＜0.01).The times of acute attack and hospitalization were obviously lower than those of the control group.No significant inter-group difference existed in lung function.Conclusion Comprehensive rehabilitation may improve the QOL in stable COPD patients in rural communities and reduce their times of acute attack.