简化“六字诀”联合体外膈肌起搏对COPD稳定期患者肺康复的疗效评价

方英; 方群; 王世强; 徐一凯; 李琴; 陈梅

doi:10.16766/j.cnki.issn.1674-4152.002141

简化“六字诀”联合体外膈肌起搏对COPD稳定期患者肺康复的疗效评价

doi: 10.16766/j.cnki.issn.1674-4152.002141

浙江中医药大学附属第三医院呼吸内科，浙江杭州 310000

基金项目:

浙江省中医药科技计划项目 2020ZB133

详细信息

通讯作者:
方群，E-mail：644436445@qq.com

中图分类号: R563
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出版历程
- 收稿日期: 2020-10-31
- 网络出版日期: 2022-02-15

Efficacy evaluation of simplified 'six-word formula' combined with extracorporeal phrenic pace-making in pulmonary rehabilitation of patients with COPD stable period

Department of Respiratory Medicine, the Third Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 310000, China

摘要

摘要: 目的探究简化“六字诀”联合体外膈肌起搏在慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)稳定期患者肺康复治疗中的应用效果。方法选取2017年7月—2019年6月浙江中医药大学附属第三医院收治的120例COPD稳定期患者，按照随机数字表法分为4组，A组给予基础治疗，B组在A组基础上给予简化“六字诀”功法训练，C组在A组基础上给予体外膈肌起搏干预，D组在A组基础上给予简化“六字诀”功法训练联合体外膈肌起搏干预，每组30例，各组干预周期均为3个月。对比4组患者中医证候积分、BODE指数、生活质量、半年内急性加重次数。结果干预后，4组患者中医证候积分[(6.82±1.57)分、(5.26±1.34)分、(5.63±1.28)分、(4.52±1.15)分]、生活质量各维度评分及总分[(44.21±9.07)分、(37.91±8.65)分、(39.92±7.83)分、(32.42±8.26)分]、半年内急性加重次数[(4.25±1.26)次、(3.32±0.87)次、(3.86±1.03)次、(2.62±0.79)次]等指标均较干预前降低，D组明显低于A、B、C组，差异有统计学意义(P＜0.05);干预后4组BODE指数均较干预前下降，D组BODE指数[(4.21±1.04)分]均低于A、B、C组[(5.32±1.67)分、(4.84±1.40)分、(5.23±1.35)分]，与A、C组比较差异有统计学意义(均P＜0.05)。结论简化“六字诀”联合体外膈肌起搏用于COPD稳定期患者肺康复治疗中可有效缓解患者临床症状，增强肺功能，减少急性发作次数，降低BODE指数，提升生活质量。
- “六字诀”功法 /
- 体外膈肌起搏 /
- 慢性阻塞性肺疾病 /
- 肺功能 /
- 生活质量
Abstract: Objective To explore the effect of simplified 'six-word formula' combined with extracorporeal phrenic pace-making in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease (COPD) stable period. Methods A total of 120 patients with COPD stable period in our hospital were selected from July 2017 to June 2019, and they were randomly divided into four groups, with 30 cases in each group. Group A was given basic treatment, group B was given the simplified 'six-word formula' training on the basis of group A, group C was given extracorporeal phrenic pace-making on the basis of group A, and group D was given simplified 'six-word formula' training combined with extracorporeal phrenic pace-making on the basis of group A. The intervention period of each group was 3 months. The TCM syndrome score, BODE index, quality of life and times of acute exacerbation in half a year of the four groups were compared. Results After intervention, the scores of TCM syndromes (6.82±1.57, 5.26±1.34, 5.63±1.28, 4.52±1.15), the score of quality of life in each dimension and total scores (44.21±9.07, 37.91±8.65, 39.92±7.83, 32.42±8.26), and the number of acute exacerbations (4.25±1.26, 3.32±0.87, 3.86±1.03, 2.62±0.79) in half a year in the four groups of patients were decreased compared with those before the intervention. Group D had the lowest scores, and the difference was statistically significant (all P < 0.05). After the intervention, the BODE index of the four groups decreased. The BODE index of group D (4.21±1.04) was lower than that of group A, B and C (5.32±1.67, 4.84±1.40, 5.23±1.35, respectively), and the difference was statistically significant (all P < 0.05). Conclusion The simplified 'six-word formula' combined with extracorporeal phrenic pace-making in pulmonary rehabilitation can effectively alleviate the clinical symptoms of COPD stable period patients, enhance the pulmonary function, reduce the number of acute attacks, reduce the BODE index and improve the quality of life of COPD patients.
- 'Six-word formula' skill /
- Extracorporeal phrenic pace-making /
- Chronic obstructive pulmonary disease /
- Pulmonary function /
- Quality of life

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表 1 BODE指数评分标准

项目	0分	1分	2分	3分
BMI	>21	≤21
FEV₁%pred(%)	≥65	50~64	36~49	≤35
mMRC(分)	0~1	2	3	4
6MWD(m)	≥350	250~349	150~249	≤149

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表 2 4组COPD稳定期患者一般资料比较

组别	例数	性别(男/女，例)	年龄(x ±s，岁)	有吸烟史(例)	COPD病史(x ±s，年)	APACHE Ⅱ评分(x ±s，分)
A组	30	21/9	67.46±4.27	7	6.59±2.47	17.02±3.45
B组	30	18/12	66.73±5.03	5	7.28±2.80	16.13±4.26
C组	30	19/11	65.84±4.68	6	7.08±2.04	15.87±4.35
D组	30	23/7	67.27±4.53	9	6.53±2.12	16.59±3.82
统计量		2.241^a	0.735^b	1.673^a	0.719^b	0.487^b
P值		0.570	0.533	0.701	0.543	0.692
注：^a为χ²值，^b为F值。

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表 3 4组COPD稳定期患者中医证候积分比较(x ±s，分)

组别	例数	干预前	干预后	t值	P值
A组	30	11.65±2.43	6.82±1.57^a	9.144	＜0.001
B组	30	10.79±2.26	5.26±1.34^a	11.528	＜0.001
C组	30	11.14±2.63	5.63±1.28^a	10.318	＜0.001
D组	30	10.82±2.17	4.52±1.15	14.051	＜0.001
F值		0.846	15.310
P值		0.472	＜0.001
注：与干预后D组比较，^aP＜0.05。

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表 4 4组COPD稳定期患者BODE指数比较(x ±s，分)

组别	例数	干预前	干预后	t值	P值
A组	30	6.16±1.23	5.32±1.67^ab	2.218	0.030
B组	30	6.57±1.46	4.84±1.40	4.684	＜0.001
C组	30	6.21±1.28	5.23±1.35^a	2.885	0.005
D组	30	6.14±1.34	4.21±1.04	6.232	＜0.001
F值		0.693	3.998
P值		0.558	0.009
注：与干预后D组比较，^aP＜0.05;与干预后C组比较，^bP < 0.05。

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表 5 4组COPD稳定期患者生活质量比较(x ±s，分)

组别	例数	呼吸症状		活动受限		疾病影响		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
A组	30	58.42±12.18	51.32±8.24^ab	52.25±11.46	45.73±7.54^ab	38.72±10.65	35.54±8.47^ab	49.82±10.87	44.21±9.07^ab
B组	30	57.89±11.54	45.76±7.35^ab	50.63±12.87	36.56±6.38^ab	40.67±12.20	31.58±7.21^ab	49.70±11.59	37.91±8.65^ab
C组	30	57.37±13.06	49.12±8.63^ab	50.73±10.72	38.24±6.38^ab	38.26±11.43	32.28±6.42^ab	48.73±12.34	39.92±7.83^ab
D组	30	59.52±10.42	40.21±7.18^b	51.49±12.33	30.73±5.62^b	39.78±10.84	26.45±7.18^b	50.64±11.75	32.42±8.26^b
F值		0.181	11.319	0.121	26.989	0.275	7.840	0.135	10.032
P值		0.909	＜0.001	0.947	＜0.001	0.843	＜0.001	0.939	＜0.001
注：与干预后D组比较，^aP＜0.05;与同组干预前比较，^bP＜0.05。

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