摘要
目的采用免疫抑制剂和糖皮质激素等对稳定期间质性肺疾病(interstitial lung disease,ILD)患者进行治疗,当患者病情进入稳定期,药物会产生较多毒副作用,病情改善程度也不佳,因此本研究探讨ILD患者实施肺康复训练的可行性,以改善ILD患者预后。方法选取2017-01-01-2018-12-01新乡市中心医院参加"新乡市慢性气道疾病防治联盟"俱乐部的300例ILD患者为研究对象。根据性别、年龄组间有可比性的原则分为干预和对照组,每组各150例。两组患者均采用常规治疗,干预组在常规治疗的基础上加用肺康复训练。比较两组患者肺功能、运动能力、呼吸困难程度活质量、焦虑抑郁状态和生存率。结果训练1年后,干预组肺活量(vital capacity,VC)为(68.89±15.62)%,高于对照组的(65.11±14.96)%,t=1.983,P=0.048;干预组肺总量(total lung capacity,TLC)为(78.13±5.84)%,高于对照组的(71.28±9.74)%,t=2.569,P=0.012;干预组第一秒用力呼气量(forced expiratory volume in the first second,FEV1)为(75.12±6.49)%,高于对照组的(70.44±6.17)%,t=2.147,P=0.040;干预组一氧化碳弥散量(diffusion capacity for carbon monoxide of the lung,DLco)为(62.38±10.62)%,高于对照组的(58.62±11.47)%,t=2.504,P=0.022。干预组6分钟步行试验(6-minute walk test,6MWT)为(350.75±70.23)m,高于对照组的(321.64±59.83)m,t=2.279,P=0.037;干预组圣乔治呼吸问卷(St George’s breath questionnaire,SGRQ)评分为(43.37±7.94)分,低于对照组的(47.35±8.32)分,t=3.098,P=0.002。干预组医学研究会呼吸困难量表(medical research council scale,MRC)为1级的患者多于对照组,χ~2=4.273,P=0.043。干预组焦虑抑郁症状均减少,且优于对照组,χ~2=8.036,P=0.011。干预组患者训练后1年生存率为87.33%,高于对照组的76.00%,χ~2=7.158,P=0.019。结论肺康复治疗能够减轻ILD患者呼吸困难症状,提高运动能力,改善肺功能,缓解焦虑情绪,提高患者生活质量,提高生存率。随着时间的延长,综合康复治疗的效果更佳。
OBJECTIVE Immunosuppressant and glucocorticoid are used to treat the patients with interstitial lung disease(ILD)during the stable period.When the patient's condition entered the stable period,the drug would have more side effects and the degree of improvement is not good.Therefore,this study explores the feasibility of lung rehabilitation training for ILD patients to improve the prognosis of ILD patients.METHODS A total of 300ILD patients who participated in the club of"Xinxiang chronic airway disease prevention and control alliance"from January 1,2017to December 1,2018were selected as the research objects.According to the principle of comparability between gender and age groups,they were divided into intervention group and control group,150cases in each group.Both groups were treated with routine therapy,and the intervention group was treated with pulmonary rehabilitation training on the basis of routine therapy.The lung function,exercise ability,quality of life of dyspnea degree,anxiety and depression state and survival rate were compared between the two groups.RUSULTS One year after training,the vital capacity of the intervention group was(68.89±15.62)%,higher than that of the control group(65.11±14.96)%,t=1.983,P=0.048;the total lung capacity of the intervention group was(78.13±5.84)%,higher than that of the control group(71.28±9.74)%,t=2.569,P=0.012;the forced expiratory volume in the first second of the intervention group was(75.12±6.49)%,higher than that of the control group(70.44±6.17)%,t=2.147,P=0.040;diffusion capacity for carbon monoxide in the intervention group was(62.38±10.62)%,higher than that of the control group(58.62±11.47)%,t=2.504,P=0.022.The 6-minute walk test of the intervention group was(350.75±70.23)m,higher than that of the control group(321.64±59.83)m,t=2.279,P=0.037;the St George's breath questionnaire of the intervention group was(43.37±7.94),lower than that of the control group(47.35±8.32),t=3.098,P=0.002.The patients in the intervention group with MRC level 1were more than those in the control group,χ2=4.273,P=0.043.Compared with the control group,the anxiety and depression in the intervention group decreased,χ2=8.036,P=0.011.The 1-year survival rate of the intervention group was 87.33%,higher than 76.00%of the control group,χ2=7.158,P=0.019.CONCLUSIONS Pulmonary rehabilitation therapy can reduce the dyspnea symptoms of ILD patients,improve exercise ability,improve lung function,relieve anxiety,improve the quality of life of patients,and improve survival rate.With the extension of time,the effect of comprehensive rehabilitation treatment is better.
作者
秦沙沙
韩利娟
朱红蕾
张德河
QIN Sha-sha;HAN Li-juan;ZHU Hong-lei;ZHANG De-he(Department of Rehabilitation Medicine,Xinxiang Central Hospital,Xinxiang453000,P.R.China)
出处
《社区医学杂志》
2020年第8期603-607,共5页
Journal Of Community Medicine
关键词
稳定期间质性肺疾病
肺康复训练
肺功能
运动能力
呼吸困难程度
生活质量
焦虑抑郁
stable period of quality lung disease
pulmonary rehabilitation training
lung function
exercise capacity
dyspnea degree
quality of life
anxiety and depression
作者简介
第一作者:秦沙沙,女,河南新乡人,护师,主要从事康复护理的研究工作。Tel:86-373-2048999,E-mail:hc8vbo@163.com;通信作者:张德河,男,河南新乡人,副主任医师,康复医学科,主要从事康复治疗的临床研究工作。E-mail:zhangdh234@163.com
