CAJ | 학술논문

目的探讨慢性阻塞性肺疾病(COPD)患者在社区采用定量步行运动和呼吸锻炼进行康复治疗的可行性和疗效.方法将中、重度慢性阻塞性肺疾病患者101例按随机数字表法分为试验组51例和对照组50例,2组患者均给予相同的常规药物治疗,试验组在常规药物治疗的基础上在家中行定量步行和呼吸锻炼.2组患者均于治疗前和治疗48周后(治疗后)进行6 min步行距离测定、COPD临床问卷评分、MRC呼吸困难评分、综合医院焦虑/抑郁情绪问卷评分和肺功能检测测定,并统计急性加重次数和总住院天数.结果 101例患者中有92例(91.1％)完成试验,其中,试验组45例,对照组47例,组间差异无统计学意义(P＞0.05).治疗后,试验组6MWT平均距离为(385±113)m,与组内治疗前的(321 ±94)m和对照组治疗后的(297±98)m比较,差异均有统计学意义(P＜0.01),且2组患者肺功能指标治疗前、后组内及组间比较,差异无统计学意义(P＞0.05).治疗后,试验组的MRC评分略有下降,与组内治疗前比较,差异无统计学意义(P＞0.05),但与对照组治疗后比较,差异有统计学意义(P＜0.05).治疗后,试验组CCQ总积分、活动积分以及焦虑/抑郁评分较组内治疗前和对照组治疗后均显著下降(P＜0.05).2组治疗期间其急性加重平均次数和总住院天数,组间差异无统计学意义(P＞0.05).结论慢性阻塞性肺疾病患者在社区采用定量步行运动和呼吸肌锻炼进行肺康复治疗效果显著且简单易行.
목적 탐토만성조새성폐질병(COPD)환자재사구채용정량보행운동화호흡단련진행강복치료적가행성화료효.방법 장중、중도만성조새성폐질병환자101례안수궤수자표법분위시험조51례화대조조50례,2조환자균급여상동적상규약물치료,시험조재상규약물치료적기출상재가중행정량보행화호흡단련.2조환자균우치료전화치료48주후(치료후)진행6 min보행거리측정、COPD림상문권평분、MRC호흡곤난평분、종합의원초필/억욱정서문권평분화폐공능검측측정,병통계급성가중차수화총주원천수.결과 101례환자중유92례(91.1％)완성시험,기중,시험조45례,대조조47례,조간차이무통계학의의(P＞0.05).치료후,시험조6MWT평균거리위(385±113)m,여조내치료전적(321 ±94)m화대조조치료후적(297±98)m비교,차이균유통계학의의(P＜0.01),차2조환자폐공능지표치료전、후조내급조간비교,차이무통계학의의(P＞0.05).치료후,시험조적MRC평분략유하강,여조내치료전비교,차이무통계학의의(P＞0.05),단여대조조치료후비교,차이유통계학의의(P＜0.05).치료후,시험조CCQ총적분、활동적분이급초필/억욱평분교조내치료전화대조조치료후균현저하강(P＜0.05).2조치료기간기급성가중평균차수화총주원천수,조간차이무통계학의의(P＞0.05).결론 만성조새성폐질병환자재사구채용정량보행운동화호흡기단련진행폐강복치료효과현저차간단역행.
Objective To observe the effects and feasibility of using walking and breathing exercises to help patients with chronic obstructive pulmonary disease in the community.Methods A hundred and one communitydwelling patients with moderate to severe chronic obstructive pulmonary disease were randomized into an experimental group (51 cases) and a control group (50 cases).The control group was given conventional pharmacotherapy,while the experimental group was given quantified walking (i.e.walking for a pre-set number of steps daily) and breathing exercises (15 minutes,3 sessions daily) to do at home for 48 weeks in addition to the conventional pharmacotherapy,.Both groups were evaluated before and after the 48 weeks of treatment using the 6-minute walk test (6MWT),a clinical COPD questionnaire,Medical Research Council (MRC) dyspnea scoring,a general anxiety/depression questionnaire and a pulmonary function test.In addition,days of hospitalization and incidence of acute exacerbation were also recorded and compared between the 2 groups.Results Among the 101 cases,92 (91.1％) completed the study (45 in the experimental group,47 in the control group,a difference which was not statistically significant).After treatment,the average 6MWT distance in the experimental group was significantly increased and significantly greater than that in the control group.No statistically significant intra-group or inter-group differences were observed with regard to the pulmonary function test or the MRC dyspnea scores.Intra-group comparison and inter-group comparison of the clinical COPD questionnaire scores and anxiety/depression scores did,however,reveal statistically significant differences.There was no significant difference in the average number of acute attacks or in the length of hospital stays.Conclusions Quantified walking and breathing exercises are effective and feasible therapy for patients with chronic obstructive pulmonary disease in the community.