噻托溴胺联合呼吸操训练治疗稳定期慢性阻塞性肺病患者的临床研究.docxVIP

噻托溴胺联合呼吸操训练治疗稳定期慢性阻塞性肺病患者的临床研究摘要:目的探讨噻托溴胺联合呼吸操训练对稳定期慢性阻塞性肺病（chronic obstructive pulmonarydisease,COPD）患者的肺通气功能、生活质量以及运动耐力的影响。方法选择2014年10月至12月稳定期COPD患者共73例，随机分为常规药物治疗组（A组，ｎ＝37）和呼吸操训练组（B组，ｎ＝36）。对A组患者常规吸入噻托溴胺，有氧疗指征者给予长期家庭氧疗。B组患者除应用噻托溴胺和（或）氧疗外，指导呼吸操训练，方法包括腹式呼吸、缩唇呼气及全身性呼吸体操。记录每例患者入组时及12周后的FEV1 占预计值的百分比（FEV1%Pred）、圣乔治呼吸疾病问卷（SGRQ）评分及6 min 步行距离（6MWD）。结果入组时２组患者的性别、平均年龄、肺功能分级、FEV1%Pred、SGRQ评分及6MWD均无显著差异（P0.05）。康复运动12周后两组患者FEV1%Pred、SGRQ评分及6MWD均较治疗前有显著变化。其中B组患者的SGRQ评分显著低于A组，B组患者的6MWD显著长于A组（P0.05）。结论在常规吸入长效抗胆碱能药物治疗外，配合呼吸操训练可更好的改善稳定期COPD患者的生活质量及运动耐力。关键词慢性阻塞性肺疾病；稳定期；噻托溴铵；呼吸操Clinical study of tiotropium combined with respiratory exercise in treatment of stable chronic obstructive pulmonary diseaseAbstract: Objective To explore the clinical effect of tiotropium combined with respiratory exercise in the treatment of stable chronic obstructive pulmonary disease (COPD), and to analyze its effects on pulmonary function， quality of life and exercise tolerance. Methods Stable COPD patients (73 cases) were selected from October to December 2014 for the study, which were randomly divided into medication group (Group A,n=37) and resipiratory exercise group (Group B, n=36). The patients in the Group A were administered with tiotropium, and long term home oxygen therapy was supplied to the patients requied treatment of oxygen therapy. The patients in the Group B were administered with respiratory exercise training on the basis of the Group A, including abdominal breathing, pursed lips breathing and systematic respiratory exercise. The patients in the two groups were treated for 12 weeks. Forced expiratory volume in one second percentage of expected value (FEV1%Pred), St George’s Respiratory questionnaire (SGRQ) score and 6 min walking distance (6MWD) were recorded before and after treatment of 12 weeks. ResultsBefore the treatment, There was no significant difference in gender , age, classification of lung function, FEV1%Pred , SGRQ or 6MWD between the two groups. After the treatment of 12 we