华西医学

华西医学

有氧联合阻抗运动对重度和极重度慢性阻塞性肺疾病患者运动能力及生活质量的影响

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目的 探讨有氧联合阻抗运动为核心的肺康复对重度和极重度慢性阻塞性肺疾病(简称慢阻肺)患者运动能力及生活质量的影响。 方法 招募 2011 年 1 月—2013 年 1 月重度和极重度慢阻肺男性患者 30 例,采用区组随机方法分为对照组和康复组,各 15 例,对照组给予健康教育及常规药物治疗,康复组在对照组基础上进行肌肉放松和 6 周有氧联合阻抗运动训练。两组干预前后均行肺功能、6 min 步行试验(6-minute walk test,6MWT)、30 s 起坐试验(30-second sit-to-stand,30-STS)、30 s 前臂屈曲试验(30-second arm curl test,30-ACT)、医学研究委员会呼吸困难量表(Medical Research Council Dyspnea Scale,MRC)、慢性阻塞性肺疾病量表评估(Chronic Obstructive Pulmonary Disease Assessment Test,CAT)、贝克焦虑和抑郁量表测试。 结果 与对照组比较,干预后康复组 6MWT、30-STS 及 30-ACT 均显著增加[(518.44±84.62)vs.(412.93±82.53) m,(24.53±3.98) vs.(16.87±3.91)次,(26.07±3.41) vs.(17.93±3.39)次,P<0.05],而 CAT 评分、贝克焦虑和抑郁评分均显著降低[(4.87±3.68)vs.(26.10±10.18)分,(2.47±1.81)vs.(11.50±4.89)分,(2.27±2.49)vs.(12.20±6.35)分,P<0.05],MRC 评分显著降低[1.0(1.0,2.0)vs. 2.0(2.0,4.0)分,P<0.05];干预前后两组肺功能指标差异无统计学意义(P>0.05)。 结论 有氧联合阻抗运动为核心的肺康复可以减轻重度和极重度慢阻肺患者气促程度及负性情绪,提高运动能力及日常生活质量。

Objective To investigate the effect of aerobic combined with resistance training on exercise capacity and quality of life in patients with severe or very severe chronic obstructive pulmonary disease (COPD). Methods Thirty patients with severe or very severe COPD were randomly divided into the control group (n=15) and the exercise group (n=15) from January 2011 to January 2013. The control group was given health education and routine drug treatment. The exercise group was given muscle relaxation and 6-week aerobic combined resistance exercise training on the basis of the control group. Pulmonary function, 6-minute walk test (6MWT), 30-second sit-to-stand (30-STS), 30-second arm curl test (30-ACT), Medical Research Council Dyspnea Scale (MRC), COPD Assessment Test (CAT), Beck Anxiety and Depression Scale were performed before and after intervention in both groups. Results After intervention, compared with those in the control group, the 6MWT, 30-STS and 30-ACT in the exercise group increased significantly [(518.44±84.62) vs. (412.93±82.53) m, (24.53±3.98) vs. (16.87±3.91) times, (26.07±3.41) vs. (17.93±3.39) times, P<0.05], while the CAT score, Beck anxiety and depression scores decreased significantly (4.87±3.68vs. 26.10±10.18, 2.47±1.81 vs. 11.50±4.89, 2.27±2.49 vs. 12.20±6.35, P<0.05), and MRC score also decreased significantly [1.0 (1.0, 2.0)vs. 2.0 (2.0, 4.0), P<0.05]. There was no statistical difference in pulmonary function between the two groups before or after intervention (P>0.05). Conclusion Exercise-based pulmonary rehabilitation can significantly improve the treatment outcomes in Chinese patients with severe or very severe COPD.

关键词: 慢性阻塞性肺疾病; 肺康复; 运动能力; 生活质量

Key words: Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Exercise capacity; Quality of life

引用本文: 刘飒, 刘元, 张文亮, 谢康玲, 刘遂心. 有氧联合阻抗运动对重度和极重度慢性阻塞性肺疾病患者运动能力及生活质量的影响. 华西医学, 2018, 33(10): 1252-1256. doi: 10.7507/1002-0179.201805002 复制

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