缩唇腹式呼吸结合立式呼吸体操对中重度慢性阻塞性肺疾病患者的影响
发布时间：2019-06-08 17:15
【摘要】：研究目的探讨缩唇腹式呼吸结合立式呼吸体操对中重度慢性阻塞性肺疾病患者呼吸困难症状、肺功能、运动耐力、生活质量的影响。研究方法一、在苏州大学附属第三医院(常州市第一人民医院)呼吸内科病房收集住院的中重度慢性阻塞性肺疾病(COPD)患者90例为研究对象,按入院先后顺序和随机数字表法,随机分为实验组和对照组,其中实验组45例,对照组45例。二、住院期间实验组和对照组均接受低流量吸氧、遵医嘱用药、健康教育等治疗护理措施,均教授缩唇腹式呼吸锻炼方法,对照组患者自行锻炼,实验组患者在医护人员的指导下行缩唇腹式呼吸与立式呼吸体操相结合的呼吸锻炼,并以民族音乐为背景配合训练,每天2次,分别于上午、下午进行,每次15min。出院后嘱患者持续呼吸锻炼。研究人员每周电话随访一次,了解患者病情变化,呼吸锻炼情况及感受,接受与呼吸锻炼有关的指导和督促。持续3个月。对照组电话随访常规了解患者病情及用药情况,不涉及与呼吸锻炼有关的指导。三、干预前后分别评估两组患者的呼吸困难症状、肺功能、运动耐力、生活质量。研究结果一、两组患者年龄、性别、文化程度、病情严重程度、病程、吸烟史、吸烟情况、用药情况等基线资料均无显著差异。干预期间实验组失访1例,对照组失访3例,最后完成实验者86例,即实验组44例,对照组42例。二、呼吸困难症状(m MRC呼吸困难评分)干预后,实验组呼吸困难症状较前明显减轻,m MRC呼吸困难评分显著降低(P0.01);对照组m MRC呼吸困难评分无显著改变(P0.05)。干预后,实验组m MRC呼吸困难评分较对照组明显降低(P0.05)。三、肺功能干预后,实验组肺功能指标无统计学差异(P0.05);对照组干预后FEV1/FVC明显降低(P0.05),其余指标(FVC、FEV1、FEV1%、PEF)无统计学差异(P0.05)。干预后,组间比较无统计学差异(P0.05)。四、运动耐力干预后,实验组运动耐力显著提高,六分钟步行距离较锻炼前显著增加[(315.00±62.53)m vs(371.34±67.74)m,P0.01];对照组六分钟步行距离较干预前显著降低[(315.05±60.89)m vs(301.57±61.67)m,P0.01]。干预后,两组间比较差异有统计学意义[(-56.34±7.90)m vs(13.48±5.91)m,P0.01]。五、生活质量[圣·乔治COPD生活质量调查问卷(SGRQ)评分]干预后,实验组患者SGRQ各部分(呼吸症状、活动受限、疾病影响)评分及总分均显著降低(P0.01);对照组患者SGRQ各部分(呼吸症状、活动受限、疾病影响)评分及总分均无显著改变(P0.05)。干预后,实验组患者SGRQ各部分(呼吸症状、活动受限、疾病影响)评分及总分较对照组显著降低[(呼吸症状评分5.20±2.80 vs 0.48±2.58,P0.05);(活动受限评分,5.80±3.15 vs-0.98±4.50,P0.05);(疾病影响评分5.18±2.31 vs-0.02±2.90,P0.05);(总分5.32±1.41 vs-0.04±1.70,P0.05)]。研究结论缩唇腹式呼吸结合立式呼吸体操可以改善中重度COPD患者的呼吸困难症状,提高运动耐力和生活质量。缩唇腹式呼吸结合立式呼吸体操是一种安全、有效的COPD患者康复治疗方法。
[Abstract]:Objective To study the effects of the combined vertical breathing exercise on the symptoms of dyspnea, pulmonary function, exercise endurance and quality of life in patients with moderate to severe chronic obstructive pulmonary disease. Method 1.90 of the patients with moderate to severe chronic obstructive pulmonary disease (COPD) were collected in the hospital of the Third Hospital of Suzhou University (the first people's hospital in Changzhou City), and 90 cases of the patients with moderate to severe chronic obstructive pulmonary disease (COPD) were randomly divided into the experimental group and the control group according to the order of admission and the random number table method. 45 of the experimental group and 45 in the control group. 2. The experimental group and the control group received low-flow oxygen inhalation during the hospitalization, and the treatment and nursing measures such as the doctor's order medication, the health education, etc., all professors of the patient's lip-and-abdominal breathing exercise method, the control group's self-exercise, In the experimental group, the breathing exercise combined with the vertical breathing exercise is guided by the medical staff, and the training is carried out with the national music as the background,2 times a day, respectively in the morning and afternoon, and each time is 15 minutes. The patient was instructed to continue breathing exercise after discharge. The researchers followed up a weekly telephone to understand the changes in the patient's condition, the situation and feel of breathing exercises, and to receive guidance and supervision related to breathing exercises. Lasting for 3 months. The control group's telephone follow-up routine knowledge of the patient's condition and the condition of the medication, does not involve the guidance related to the breathing exercise. 3. Before and after the intervention, the symptoms of dyspnea, lung function, exercise endurance and quality of life of the two groups were evaluated. The results showed that there was no significant difference between the age, sex, the degree of culture, the severity of the disease, the course of the disease, the history of smoking, the smoking and the condition of the medication. In the experimental group,1 case was lost to follow-up,3 cases were lost to the control group, and 86 cases of the experimental group were completed, namely,44 cases in the experimental group and 42 in the control group. 2. After the intervention of the dyspnea symptom (m MRC dyspnea score), the dyspnea symptom of the experimental group was significantly reduced, and the score of the m MRC dyspnea was significantly lower (P0.01); and the score of the m MRC dyspnea in the control group was not significantly changed (P0.05). After the intervention, the scores of m-MRC-dyspnea in the experimental group were significantly lower than that in the control group (P0.05). After the intervention of pulmonary function, there was no statistical difference between the lung function in the experimental group (P0.05); after the intervention of the control group, the FEV1/ FVC was significantly lower (P0.05), and the other indexes (FVC, FEV1, FEV1%, PEF) had no statistical difference (P0.05). After the intervention, there was no statistical difference between the groups (P0.05). 4. After the exercise-endurance intervention, the exercise endurance of the experimental group was significantly improved, and the walking distance in the six-minute group was significantly increased before the exercise[(315.00-62.53) m vs (371.34-67.74) m, P 0.01]; the six-minute walking distance of the control group was significantly reduced before the intervention[(315.05-60.89) m vs (301.57-61.67) m, P0.01]. After the intervention, the difference between the two groups was statistically significant[(-56.34-7.90) m vs (13.48-5.91) m, P0.01]. 5. The scores of SGRQ total score and total score of SGRQ in the experimental group were significantly lower after the intervention of the quality of life[St. George's Quality of Life Questionnaire (SGRQ) score] (P0.01), and the SGRQ of the control group (respiratory symptoms, activity limited, There was no significant change in the score and total score of the disease (P0.05). After the intervention, the scores of SGRQ and the total score of SGRQ were significantly lower in the experimental group than in the control group[(the score of respiratory symptoms was 5.20, 2.80 vs. 0.48, 2.58, P0.05); (the activity limited score, 5.80, 3.15 vs. 0.98, 4.50, P0.05); (disease impact score 5.18-2.31 vs-0.02-2.90, P0.05); (total score 5.32-1.41 vs-0.04-1.70, P0.05)]. Conclusion The combined vertical breathing exercise with reduced-lip and abdominal breathing can improve the symptoms of dyspnea and improve the endurance and quality of life in patients with moderate to severe COPD. Reduced-lip abdominal breathing combined with vertical breathing exercise is a safe and effective method for the rehabilitation of COPD patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.5
本文编号：2495451
[Abstract]:Objective To study the effects of the combined vertical breathing exercise on the symptoms of dyspnea, pulmonary function, exercise endurance and quality of life in patients with moderate to severe chronic obstructive pulmonary disease. Method 1.90 of the patients with moderate to severe chronic obstructive pulmonary disease (COPD) were collected in the hospital of the Third Hospital of Suzhou University (the first people's hospital in Changzhou City), and 90 cases of the patients with moderate to severe chronic obstructive pulmonary disease (COPD) were randomly divided into the experimental group and the control group according to the order of admission and the random number table method. 45 of the experimental group and 45 in the control group. 2. The experimental group and the control group received low-flow oxygen inhalation during the hospitalization, and the treatment and nursing measures such as the doctor's order medication, the health education, etc., all professors of the patient's lip-and-abdominal breathing exercise method, the control group's self-exercise, In the experimental group, the breathing exercise combined with the vertical breathing exercise is guided by the medical staff, and the training is carried out with the national music as the background,2 times a day, respectively in the morning and afternoon, and each time is 15 minutes. The patient was instructed to continue breathing exercise after discharge. The researchers followed up a weekly telephone to understand the changes in the patient's condition, the situation and feel of breathing exercises, and to receive guidance and supervision related to breathing exercises. Lasting for 3 months. The control group's telephone follow-up routine knowledge of the patient's condition and the condition of the medication, does not involve the guidance related to the breathing exercise. 3. Before and after the intervention, the symptoms of dyspnea, lung function, exercise endurance and quality of life of the two groups were evaluated. The results showed that there was no significant difference between the age, sex, the degree of culture, the severity of the disease, the course of the disease, the history of smoking, the smoking and the condition of the medication. In the experimental group,1 case was lost to follow-up,3 cases were lost to the control group, and 86 cases of the experimental group were completed, namely,44 cases in the experimental group and 42 in the control group. 2. After the intervention of the dyspnea symptom (m MRC dyspnea score), the dyspnea symptom of the experimental group was significantly reduced, and the score of the m MRC dyspnea was significantly lower (P0.01); and the score of the m MRC dyspnea in the control group was not significantly changed (P0.05). After the intervention, the scores of m-MRC-dyspnea in the experimental group were significantly lower than that in the control group (P0.05). After the intervention of pulmonary function, there was no statistical difference between the lung function in the experimental group (P0.05); after the intervention of the control group, the FEV1/ FVC was significantly lower (P0.05), and the other indexes (FVC, FEV1, FEV1%, PEF) had no statistical difference (P0.05). After the intervention, there was no statistical difference between the groups (P0.05). 4. After the exercise-endurance intervention, the exercise endurance of the experimental group was significantly improved, and the walking distance in the six-minute group was significantly increased before the exercise[(315.00-62.53) m vs (371.34-67.74) m, P 0.01]; the six-minute walking distance of the control group was significantly reduced before the intervention[(315.05-60.89) m vs (301.57-61.67) m, P0.01]. After the intervention, the difference between the two groups was statistically significant[(-56.34-7.90) m vs (13.48-5.91) m, P0.01]. 5. The scores of SGRQ total score and total score of SGRQ in the experimental group were significantly lower after the intervention of the quality of life[St. George's Quality of Life Questionnaire (SGRQ) score] (P0.01), and the SGRQ of the control group (respiratory symptoms, activity limited, There was no significant change in the score and total score of the disease (P0.05). After the intervention, the scores of SGRQ and the total score of SGRQ were significantly lower in the experimental group than in the control group[(the score of respiratory symptoms was 5.20, 2.80 vs. 0.48, 2.58, P0.05); (the activity limited score, 5.80, 3.15 vs. 0.98, 4.50, P0.05); (disease impact score 5.18-2.31 vs-0.02-2.90, P0.05); (total score 5.32-1.41 vs-0.04-1.70, P0.05)]. Conclusion The combined vertical breathing exercise with reduced-lip and abdominal breathing can improve the symptoms of dyspnea and improve the endurance and quality of life in patients with moderate to severe COPD. Reduced-lip abdominal breathing combined with vertical breathing exercise is a safe and effective method for the rehabilitation of COPD patients.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.5
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