Abstract:

Objective　To investigate the effects of five-animal exercises combined with respiratory muscle exercise on the degree of dyspnea and lung function in patients with stable chronic obstructive pulmonary disease (COPD). Methods　A prospective analysis was conducted on 86 stable COPD patients admitted to Zhumadian Hospital of Traditional Chinese Medicine from October 2020 to October 2022. They were divided into two groups by the random number table method, with 43 patients in each group. The control group included 23 males and 20 females, aged (70.31±3.54) years. The observation group included 25 males and 18 females, aged (70.25±3.61) years. The control group underwent respiratory muscle exercise, and on the basis, the observation group was trained in combination with five-animal exercises for 3 months. The degree of dyspnea, lung function, blood gas indicators, exercise endurance, and quality of life were compared between the two groups. χ² test, t test, and rank sum test were used. Results　There were no statistically significant differences in the degree of dyspnea, lung function, blood gas indicators, exercise endurance, and quality of life between the two groups before intervention (all P>0.05). After intervention, there was a statistically significant differences in the classification of the modified British Medical Research Council Dyspnea Scale (mMRC) between the two groups (Z=2.131, P=0.033). The forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC in the observation group were (3.11±0.17) L, (3.33±0.36) L, and (93.39±5.86)%, which were higher than (2.04±0.15) L, (2.26±0.24) L, and (90.27±5.11)% in the control group, with statistically significant differences (t=30.948, P<0.001; t=16.217, P<0.001; t=2.631, P=0.010). The pulse oxygen saturation and arterial partial pressure of oxygen of the observation group were (91.93±5.73)% and (82.83±7.14) mmHg (1 mmHg= 0.133 kPa), which were higher than those of the control group [(86.84±5.09) % and (70.74±6.77) mmHg]; the arterial partial pressure of carbon dioxide was lower than that of the control group [(44.15±4.03) mmHg vs. (47.44±4.31) mmHg], with statistically significant differences (t=4.355, P<0.001; t=8.057, P<0.001; t=3.656, P<0.001). There was a statistically significant difference in the 6-min walking distance between the observation group and the control group [(438.69±26.73) m vs. (422.86±25.26) m] (t=2.823, P=0.006). The symptom, activity, and disease impact scores of the St. George's Respiratory Questionnaire (SGRQ) in the observation group were (43.76±3.60) points, (42.52±3.72) points, and (41.06±3.17) points, which were lower than those in the control group [(52.07±4.19) points, (53.08±4.13) points, and (50.15±3.73) points], with statistically significant differences (t=9.864, P<0.001; t=12.458, P<0.001; t=12.177, P<0.001). Conclusion　The combination of five-animal exercises and respiratory muscle exercise can alleviate the degree of dyspnea in stable COPD patients, regulate the blood gas indicators, and improve the exercise endurance, lung function, and quality of life.

Key words:

Stable phase of chronic obstructive pulmonary disease, Five-animal exercises, Respiratory muscle exercise, Dyspnea, Lung function

摘要：

目的　探究五禽戏联合呼吸肌锻炼对慢性阻塞性肺疾病（COPD）稳定期患者呼吸困难程度及肺功能的影响。方法　前瞻性分析驻马店市中医院2020年10月至2022年10月收治的86例COPD稳定期患者，按照随机数字表法分为两组，每组43例。对照组男23例，女20例，年龄（70.31±3.54）岁；观察组男25例，女18例，年龄（70.25±3.61）岁。对照组开展呼吸肌锻炼，观察组在对照组基础上联合五禽戏训练，均持续训练3个月。比较两组呼吸困难程度、肺功能、血气指标、运动耐力、生活质量水平。采用χ²检验、t检验、秩和检验。结果　两组干预前呼吸困难程度、肺功能、血气指标、运动耐力、生活质量比较差异均无统计学意义（均P>0.05）。干预3个月后，两组患者改良版英国医学研究委员会呼吸困难量表（mMRC）分级比较差异有统计学意义（Z=2.131、P=0.033）；观察组的第1秒用力呼气量（FEV₁）、用力肺活量（FVC）、FEV₁/FVC分别为（3.11±0.17）L、（3.33±0.36）L、（93.39±5.86）%，均高于对照组的（2.04±0.15）L、（2.26±0.24）L、（90.27±5.11）%，差异均有统计学意义（t=30.948，P<0.001；t=16.217，P<0.001；t=2.631，P=0.010）；观察组的经皮动脉血氧饱和度、动脉血氧分压分别为（91.93±5.73）%、（82.83±7.14）mmHg（1 mmHg=0.133 kPa），均高于对照组的（86.84±5.09）%、（70.74±6.77）mmHg，动脉血二氧化碳分压低于对照组［（44.15±4.03）mmHg比（47.44±4.31）mmHg］，差异均有统计学意义（t=4.355，P<0.001；t=8.057，P<0.001；t=3.656，P<0.001）；观察组的6 min步行试验与对照组比较［（438.69±26.73）m比（422.86±25.26）m］，差异有统计学意义（t=2.823，P=0.006）；观察组圣·乔治呼吸问卷（SGRQ）中症状、活动、疾病影响评分分别为（43.76±3.60）分、（42.52±3.72）分、（41.06±3.17）分，均低于对照组的（52.07±4.19）分、（53.08±4.13）分、（50.15±3.73）分，差异均有统计学意义（t=9.864，P<0.001；t=12.458，P<0.001；t=12.177，P<0.001）。结论　五禽戏联合呼吸肌锻炼能够减轻COPD稳定期患者呼吸困难程度，调节血气指标，提高运动耐力，改善肺功能及生活质量。

关键词:

慢性阻塞性肺疾病稳定期, 五禽戏, 呼吸肌锻炼, 呼吸困难, 肺功能