胡玉洁 袁伟锋 李好华 伍伟玲

[摘要]目的觀察使用呼吸训练器进行肺康复对改善慢性阻塞性肺疾病患者肺功能及6 min 步行距离的影响。方法根据慢性阻塞性肺疾病全球倡议关于慢性阻塞性肺疾病诊断标准纳入2017年1月至2019年12月就诊于解放军南部战区空军医院的100例慢性阻塞性肺疾病稳定期患者，随机分为对照组（ n=50）与训练组（ n=50），两组患者均按照慢性阻塞性肺疾病全球倡议指南维持稳定期治疗，训练组患者同时按规律进行呼吸训练器锻炼。训练6个月后所有患者均进行6 min 步行试验、肺通气功能检查与慢性阻塞性肺疾病评估等检测。结果训练组与对照组相比，6 min 步行距离显著增加，慢性阻塞性肺疾病评估试验（CAT）得分也显著降低，差异有统计学意义（ P <0.05）。训练组的生活质量分值优于对照组，差异有统计学意义（ P <0.05）。结论对于慢性阻塞性肺疾病患者，除常规稳定期治疗外，给予积极的呼吸功能锻炼可以提高慢性阻塞性肺疾病患者的活动能力，改善生活质量。

[关键词]慢性阻塞性肺疾病;呼吸训练器;生活质量;6 min 步行试验;慢性阻塞性肺病评估测试

[中图分类号] R563.1  [文献标识码] A   [文章编号]2095-0616（2021）23-0178-04

Study on the respiratory trainer in improving quality of life of patients with stable chronic obstructive pulmonary disease

HU  Yujie1      YUAN  Weifeng2      LI  Haohua3      WU  Weiling1

1.Department of Respiratory and Critical Care Medicine， Air Force Hospital of Southern Theatre Command， the Liberation Army， Guangdong， Guangzhou 510062， China;2. Department of Respiratory Medicine， Guangzhou Eighth People's Hospital， Guangdong， Guangzhou 510060， China;3. Department of Respiratory and Critical Care Medicine， General Hospital of Southern Theatre Command， the Liberation Army， Guangdong， Guangzhou 510010，China

[Abstract] Objective To observe the effect of pulmonary rehabilitation using a respiratory trainer on improving lung function and 6-minute walking distance in patients with chronic obstructive pulmonary disease （COPD）. Methods A total of 100 patients with stable COPD attending the Air Force Hospital of the Southern Theatre Command of the Liberation Army from January 2017 to December 2019 were included according to the Global Initiative for Chronic Obstruction Lung Disease（GOLD） on the diagnostic criteria of COPD. All patients were randomly divided into the control group and the training group. Patients in both groups received treatment at the stable stage according to the GOLD Guidelines， and patients in the training group also received exercise with respiratory trainer on a regular basis. The 6-minute walk test， pulmonary ventilation function test and COPD assessment were performed on all the patients after 6 months of exercise. Results Compared with the control group， the 6-minute walk distance increased significantly and the COPD assessment score test （CAT） also reduced significantly in the training group after exercise， with statistically significant differences（P <0.05）. The quality of life scores of the training group were better than those of the control group， with statistically significant difference （P <0.05）. Conclusion For patients with COPD， in addition to conventional treatment at the stable stage， active respiratory function exercise is helpful to improve the mobility and quality of life of patients affected.

[Key words] Chronic obstructive pulmonary disease; Respiratory trainer; Quality of life;6-minute walk test; Chronic obstructive pulmonary disease assessment test

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是一种常见的以持续气流受限为特征的可以预防和治疗的疾病，气流受限进行性发展。COPD 的发病率和病死率逐年增高。自慢性阻塞性肺疾病全球倡议（Global Initiative for Chronic Obstructive Lung Disease， GOLD）发布以来，COPD 的治疗获得了长足进展，但是目前的所有治疗方法都不能阻止 COPD 患者肺功能的持续下降。GOLD 提出，除了药物治疗外，对患者进行肺康复训练是 COPD 稳定期治疗的重要组成部分[1-2]，但往往因患者的依从性不佳而影响疗效[3]。COPD 患者肺康复训练方法多样，采用简易、直观、参与度高、依从性好的锻炼手段可以提高康复治疗的效果。……