CAJ | 학술논문

目的：观察中医呼吸导引对肺肾两虚型慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD）稳定期Ⅱ-Ⅲ级患者生活质量的影响。方法：选择符合纳入标准的肺肾两虚型COPD稳定期Ⅱ-Ⅲ级患者60例,采用随机数字表法随机分为治疗组和对照组,每组30例。对照组给予西医基础治疗,治疗组在西医基础治疗基础上进行中医呼吸导引练习,疗程均为3个月。观察治疗前后两组患者肺通气功能、主要临床症状、改良的英国医学研究委员会呼吸困难量表(modified Medical Research Council scale, mMRC)评分、6 min步行试验(6-minute walk test,6-MWT)距离、COPD评估测试(COPD assessment test, CAT)以及COPD疗效满意度问卷(efficacy satisfaction questionnaire for COPD, ESQ-COPD)的变化。结果：治疗后,治疗组总有效率为80.0%,对照组为66.7%,治疗组疗效优于对照组(P＜0.05)。治疗组患者的咳嗽、咯痰、喘息、气短症状的改善情况优于对照组(P＜0.05)。治疗组患者肺功能的第一秒用力呼气容积占预计值比值（forced expiratory volume in 1 second percentage of predicted value, FEV1%)、呼吸峰流速(peak expiratory flow rate, PEF%)改善率较对照组均有升高(P＜0.05), mMRC评分低于对照组(P＜0.05)；治疗组患者的6-MWT距离较对照组明显延长(P＜0.01)；治疗组患者CAT的评分低于对照组(P＜0.01)。治疗组患者的ESQ-COPD评分明显高于对照组(P＜0.05)。结论：中医呼吸导引练习联合常规西医治疗对肺肾两虚型COPD稳定期Ⅱ-Ⅲ级的患者具有较好的临床疗效,并能改善患者的生活质量。
목적：관찰중의호흡도인대폐신량허형만성조새성폐질병(chronic obstructive pulmonary disease, COPD）은정기Ⅱ-Ⅲ급환자생활질량적영향。방법：선택부합납입표준적폐신량허형COPD은정기Ⅱ-Ⅲ급환자60례,채용수궤수자표법수궤분위치료조화대조조,매조30례。대조조급여서의기출치료,치료조재서의기출치료기출상진행중의호흡도인연습,료정균위3개월。관찰치료전후량조환자폐통기공능、주요림상증상、개량적영국의학연구위원회호흡곤난량표(modified Medical Research Council scale, mMRC)평분、6 min보행시험(6-minute walk test,6-MWT)거리、COPD평고측시(COPD assessment test, CAT)이급COPD료효만의도문권(efficacy satisfaction questionnaire for COPD, ESQ-COPD)적변화。결과：치료후,치료조총유효솔위80.0%,대조조위66.7%,치료조료효우우대조조(P＜0.05)。치료조환자적해수、각담、천식、기단증상적개선정황우우대조조(P＜0.05)。치료조환자폐공능적제일초용력호기용적점예계치비치（forced expiratory volume in 1 second percentage of predicted value, FEV1%)、호흡봉류속(peak expiratory flow rate, PEF%)개선솔교대조조균유승고(P＜0.05), mMRC평분저우대조조(P＜0.05)；치료조환자적6-MWT거리교대조조명현연장(P＜0.01)；치료조환자CAT적평분저우대조조(P＜0.01)。치료조환자적ESQ-COPD평분명현고우대조조(P＜0.05)。결론：중의호흡도인연습연합상규서의치료대폐신량허형COPD은정기Ⅱ-Ⅲ급적환자구유교호적림상료효,병능개선환자적생활질량。
Objective:To observe the effect of breathing andDaoyin exercises on the quality of life in patients with stable chronic obstructive pulmonary disease (COPD) due to deficiency of the lung and kidney (grade II-III). <br> Methods:A total of 60 eligible cases were randomly allocated into a treatment group (n=30) and a control group (n=30) by random number table. Cases in the control group received routine Western medical treatment, whereas cases in the treatment group conducted breathing andDaoyin exercises in addition to routine Western medical treatment. Patients in both groups were treated for a total of 3 months. Then the observation was made on changes in pulmonary ventilation function, major clinical symptoms, modified Medical Research Council scale (mMRC), distance in 6-minute walk test (6-MWT), COPD assessment test (CAT) and efficacy satisfaction questionnaire for COPD (ESQ-COPD) before and after treatment. <br> Results:After treatment, the total effective rate was 80.0% in the treatment group, versus 66.7% in the control group, showing a statistical difference (P<0.05). Patients in the treatment group obtained more significant improvement in coughing, sputum production, dyspnea and shortness of breath than those in the control group (P<0.05). Patients in the treatment group obtained more significant elevation in the forced expiratory volume in 1 second percentage of predicted value (FEV1%) and peak expiratory flow rate (PEF%) than those in the control group (P<0.05). Patients in the treatment group obtained lower mMRC score than those in the control group (P<0.05). Patients in the treatment group obtained longer 6-MWT distance than those in the control group (P<0.05). Patients in the treatment group obtained lower CAT score (P<0.01) and higher ESQ-COPD score (P<0.05) than those in the control group. <br> Conclusion:Breathing andDaoyin exercises combined with routine Western medical treatment are effective for stable COPD (grade II-III) due to deficiency of the lung and kidney and can improve the patients’ quality of life.