| 沈丽晓,柴书坤,史金英,王蕾萌,胡春莲.缩唇腹式呼吸联合不同呼吸康复训练治疗COPD急性加重期的疗效对比[J].中国康复,2025,40(11):650-654 |
| 缩唇腹式呼吸联合不同呼吸康复训练治疗COPD急性加重期的疗效对比 |
| Comparison of the efficacy of pursed-lip abdominal breathing training combined with different respiratory rehabilitation training in the treatment of acute exacerbation of COPD |
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| DOI：10.3870/zgkf.2025.11.002 |
| 中文关键词: 慢性阻塞性肺疾病 急性加重期 缩唇腹式呼吸训练 经鼻高流量湿化吸氧 呼吸训练器 膈肌起搏 |
| 英文关键词: chronic obstructive pulmonary disease acute exacerbation period pursed-lip abdominal breathing exercises high-flow nasal canula breathing training device diaphragmatic pacing |
| 基金项目:河北省卫生健康委员会医学科学研究课题（20241354） |
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| 中文摘要: |
| 目的：探究缩唇腹式呼吸训练分别联合经鼻高流量湿化吸氧（HFNC）、呼吸训练器、膈肌起搏在慢性阻塞性肺疾病急性加重期（AECOPD）患者中的临床疗效。方法：将150例AECOPD患者按照随机数字表法分为药物组（单纯药物治疗）、对照组（药物治疗+缩唇腹式呼吸训练）、观察组1（药物治疗+缩唇腹式呼吸训练+HFNC）、观察组2（药物治疗+缩唇腹式呼吸训练+呼吸训练器）、观察组3（药物治疗+缩唇腹式呼吸训练+膈肌起搏）共5组，每组各30例，比较各组的肺功能指标、动脉血气指标、6 min步行试验（6-MWT）结果、健康状况。结果：治疗2周后，各组的第一秒用力呼气末容积（FEV1）、用力肺活量（FVC）、第一秒用力呼气末容积占用力肺活量百分比（FEV1/FVC）、氧分压（PaO2）、血氧饱和度（SaO2）、6-MWT行走距离值均提高，残气量/肺总量、二氧化碳分压（PaCO2）、自我评估测试问卷（CAT）、改良英国医学研究委员会呼吸困难量表（mMRC）得分均较治疗前降低，且观察组（1、2、3）上述指标升高、降低均较对照组、药物组更明显（P＜0.05），对照组各项指标升高、降低均较药物组更明显（P＜0.05），3个观察组组间比较差异无统计学意义。结论：缩唇腹式呼吸训练分别联合HFNC、呼吸训练器、膈肌起搏在AECOPD患者中均有良好应用效果，能够有效改善患者肺功能和血气分析指标，增加患者步行距离，优化患者的健康状况。 |
| 英文摘要: |
| Objective: To explore the clinical efficacy of pursed-lip abdominal breathing training combined with high-flow nasal cannula oxygen therapy (HFNC), breathing trainer and diaphragm pacing in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 150 patients with AECOPD were divided into general group (drug therapy alone), control group (drug therapy+pursed-lip abdominal breathing training), observation group 1 (drug therapy+pursed-lip abdominal breathing training+HFNC), observation group 2 (drug therapy+pursed-lip abdominal breathing training+breathing trainer) and observation group 3 (drug therapy+pursed-lip-abdominal breathing training+diaphragm pacing) according to random number table method, with 30 cases in each group. Pulmonary function indexes, arterial blood gas indexes, 6-min walking test (6-MWT) results and health status of each group were compared. Results: After 2 weeks of treatment, the first second forced end-expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC，partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2) and 6-MWT walking distance of all groups were increased. Residual volume/total lung volume, partial pressure of carbon dioxide (PaCO2), COPD assessment test (CAT) and modified Medical Research Council Dyspnea Scale (mMRC) scores were all decreased, and the indexes of observation groups (1, 2, 3) were increased and decreased more significantly than those of control group and general group (P<0.05). The increase and decrease of all indexes in the control group were more obvious than those in the general group (P<0.05), and there was no statistically significant difference among the observation groups (1, 2, 3). Conclusion: pursed-lip breathing training combined with HFNC, breathing trainer and diaphragm pacing has good application effects in AECOPD patients, which can effectively improve the lung function and blood gas analysis indexes of patients, increase the walking distance of pa-tients, and optimize the health status of patients. |
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