田园 李国勤 徐慧莲 李春雨 屈建峰 刘玉山 楚晨 李慧

[摘要] 目的 觀察加用中医肺康复疗法与单纯药物治疗对慢性阻塞性肺疾病（COPD）稳定期患者的影响。 方法 选择于2015年11月～2016年11月北京市东城区第一人民医院就诊的COPD稳定期患者94例，采用随机数字表进行分组，康复组47例，对照组47例。对照组单纯药物治疗，康复组在药物治疗基础上联合中医肺康复疗法，统计治疗前后1年两组患者急诊入院次数及住院时间；分别于治疗前、治疗后1个月、治疗后3个月、治疗后6个月对COPD患者进行数据采集。检测指标包括圣乔治呼吸问卷（SGRQ）；1秒钟用力呼气容积（FEV1）、1秒钟用力呼气容积占预计值百分比（FEV1%pred）、用力肺活量（FVC）、1秒钟用力呼气容积占用力肺活量的比值 （FEV1/FVC）、每分钟最大通气量（MVV）；6分钟步行试验及BODE指数评分。并对治疗效果进行分析评价。 结果 两组患者治疗后住院次数均低于治疗前，且治疗后康复组年住院次数均低于对照组，差异有统计意义（P < 0.05）；康复组治疗后SGRQ评分均低于同期对照组（P < 0.05）；康复组治疗后1个月MVV优于对照组（P < 0.05）；治疗后3个月FEV1%pred、FVC、MVV优于对照组（P < 0.05）；治疗后6个月FEV1、FEV1%pred、FVC、MVV、FEV1/FVC均优于对照组（P < 0.05）；康复组治疗后6分钟步行试验结果均优于对照组（P < 0.05）；康复组治疗后BODE指数评分均低于对照组（P < 0.05）。 结论 中医肺康复模式能够提升COPD患者的日常生活能力和生存质量，提高活动耐力和呼吸肌功能，从而改善药物难以逆转的肺功能。

[关键词] 慢性阻塞性肺疾病；中医肺康复；日常生活能力；生存质量；活动耐力；呼吸肌功能；肺功能

[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0058-05

[Abstract] Objective To observe the effect of traditional Chinese medicine （TCM） lung rehabilitation therapy and drug treatment on patients with chronic obstructive pulmonary disease （COPD）. Methods From November 2015 to November 2016， 94 COPD stable patients were selected， by random number table， they were divided into rehabilitation group （47 cases） and control group （47 cases）. The control group was treated by simple drug therapy， and the rehabilitation group was treated with traditional Chinese medicine pulmonary rehabilitation therapy on the basis of drug treatment. The data were collected before treatment， 1 month after treatment， 3 months after treatment， 6 months after treatment， and the therapeutic effect was analyzed and evaluated. The indexes included St Georges Respiratory Questionnaire （SGRQ）； a second forced expiratory volume （FEV1）， forced expiratory volume in one second percentage of predicted value （FEV1%pred）， forced vital capacity （FVC）， forced expiratory volume in one second forced vital capacity ratio （FEV1/FVC）， per minute ventilation volume （MVV）； 6 minutes walk test and BODE score. And the effect of treatment was analyzed and evaluated. Results The number of admissions in two groups after the treatment were less than before the treatment， and that in rehabilitation group was less than control group， the differences were statistically significant （P < 0.05）. After the treatment， the SGRQ scores of the rehabilitation group was lower than control group （P < 0.05）； MVV detection in the rehabilitation group after 1 months treatment was better than control group at the same period （P < 0.05）； FEV1%pred， FVC and MVV detection after 3 months treatment were better than control group at the same time （P < 0.05）； FEV1， FEV1%pred， FVC， MVV and FEV1/FVC detection after 6 months treatment were better than control group at the same time （P < 0.05）； 6 minutes walking test results in rehabilitation group after treatment were better than the control group （P < 0.05）； the BODE index scores of rehabilitation group after treatment were lower than control group （P < 0.05）. Conclusion TCM pulmonary rehabilitation model can improve COPD patients daily living and quality of life， improve exercise tolerance and respiratory muscle function， thereby improve the lung function that drugs is difficult to reverse.

[Key words] Chronic obstructive pulmonary disease； TCM pulmonary rehabilitation； Activity of daily living； Quality of life； Exercise tolerance； Respiratory muscle function； Pulmonary function

慢性阻塞性肺疾病（COPD）是一种威胁公众健康、增加社会和经济负担，且尚待引起人们重视的疾病。COPD患者并发的呼吸肌的功能障碍、营养不良、心脏受损、感觉缺陷和心理障碍等的影响，加重了患者呼吸困难和生存质量降低。近年来研究肺康复训练能够改善患者的肺功能及血气交换，并进而改善患者的生存质量，目前日益受到关注[1]。……