倪文琴　孙雪东　周尧英

[摘要] 目的 探讨运动并呼吸训练对慢性阻塞性肺疾病（COPD）稳定期患者的影响。 方法 选取2018年1月至2019年9月本院呼吸科收治的COPD稳定期患者120例，将其分为观察组和对照组，每组各60例。对照组给予常规西医治疗方案，观察组在对照组基础上进行运动训练和呼吸训练。统计并比较两组患者入院时、训练4周、8周时的肺功能、运动功能、生活质量改善情况。 结果 观察组训练8周时的FEV1、FEV1/FVC均显著高于对照组（P<0.05）。观察组训练4周、8周时的日常生活活动、社会活动能力、抑郁、焦虑评分均显著低于对照组（P<0.05）。观察组训练4周、8周时的mMRC明显低于对照组，6MWD明显高于对照组（P<0.05）。 结论 运动并呼吸训练是一种有效的COPD稳定期康复措施。

[关键词] 运动训练;呼吸训练;慢性阻塞性肺疾病;肺功能

[中图分类号] R563          [文献标识码] B          [文章编号] 1673-9701（2021）06-0104-04

Effects of exercise combined with respiratory training on exercise capacity and lung function in patients with COPD

NI Wenqin   SUN Xuedong   ZHOU Yaoying

Department of Critical Care Medicine， Shaoxing People′s Hospital in Zhejiang Province， Shaoxing   312000， China

[Abstract] Objective To explore the effect of exercise and respiratory training on patients with stable disease of chronic obstructive pulmonary disease （COPD）. Methods A total of 120 patients with stable COPD who were admitted to the Department of Respiratory Medicine of our hospital from January 2018 to September 2019 were selected and divided into observation group and control group， with 60 cases in each group. The control group was given routine western medicine treatment， and the observation group was performed exercise training and respiratory training on the basis of the control group. The improvement of lung function， motor function and quality of life between the two groups at admission， 4 weeks and 8 weeks of training were compared. Results The FEV1 and FEV1/FVC in the observation group were significantly higher than those in the control group after 8 weeks of training（P<0.05）. The daily activity， social activity ability， depression and anxiety scores in the observation group after training for 4 weeks and 8 weeks of training were significantly lower than those in the control group （P<0.05）. The mMRC in the observation group was significantly lower than that in the control group after training for 4 weeks and 8 weeks， and the 6MWD in the observation group was significantly higher than that in the control group（P<0.05）. Conclusion Exercise combined with respiratory training is an effective rehabilitation measure for COPD during stable period.

[Key words] Exercise training; Respiratory training; Chronic obstructive pulmonary disease; Lung function

慢性阻塞性肺疾病（Chronic obstructive pulmonary disease，COPD）为呼吸系统常见病、多发病，主要特征为气流受限不完全可逆，为避免肺功能恶化应及时予以干预，延缓病情持续发展。临床常使用抗胆碱药物、糖皮质激素、茶碱类、β2肾上腺素受体激动剂等进行COPD治疗[1]。然而，伴随疾病的进展，炎症、气道阻力增加等病理生理学因素增加了机体的耗氧量，容易导致呼吸肌功能障碍与运动耐力下降，影响了疾病的治疗和康复，降低了患者的生活质量[2]。如何采取有效的方法，减轻气道阻塞、提高呼吸肌的收缩能力、增强呼吸肌的力量和耐力、改善肺功能，是COPD患者康復治疗的重要环节，现报道如下。

3 讨论

COPD相关的呼吸肌群功能康复内容主要包括基础的肺康复（健康教育、营养支持、心理及行为干预等）、呼吸肌康复训练（上肢训练、下肢训练等）、呼吸肌群康复锻炼方法（缩唇呼吸、腹式呼吸、对抗阻力呼吸等）[8-11]。本研究分析的运动并呼吸训练是在药物、营养、心理干预等基础治疗的前提下，将呼吸肌康复训练与呼吸肌群康复锻炼相结合的一种康复方法。……