Effects of Pulmonary Rehabilitation on Patients with Stable COPD of Different Severity_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

Department of Respiratory Medicine, The Third People's Hospital of Chengdu, Second Affiliated Hospital of Chongqing Medical University, Chengdu, Sichuan, 610031, China;

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Keywords：

Chronic obstructive pulmonary disease; Pulmonary rehabilitation; 6 minute walking test; Modified medical research council scale; Quality of life; Acute exacerbation frequency

DOI：

10.7507/1671-6205.2014033

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Objective To investigate the effect of pulmonary rehabilitation on pulmonary function,perception of dyspnea and quality of life in stable COPD patients of different severity. Methods 300 patients with COPD in stable stage were divided into a moderate COPD group (n=120),a severe COPD group (n=100) and a very severe COPD group (n=80). Each group was randomly subdivided into a control group and a treatment group. The treatment groups received pulmonary rehabilitation for 6 months in addition to usual care,and the control groups received usual care without pulmonary rehabilitation. Pulmonary function(FEV₁),6 minute walking distance (6MWD),modified medical research council (mMRC) scale,and acute exacerbation frequency of COPD were compared before and after intervention and among groups. Results After pulmonary rehabilitation for 6 months,the quality of life score and 6MWD were significantly improved in the treatment groups with moderate,severe,very severe COPD,and the increscent of 6MWD was greatest in the severe COPD patients. The mMRC of the patients with very severe COPD improved significantly after pulmonary rehabilitation(P<0.05). Lung function before and after the intervention in three groups all showed no significant difference (P>0.05). The acute exacerbation frequency of the severe COPD patients was significantly reduced by pulmonary rehabilitation (P<0.05), while there was no significant change in the moderate and very severe groups (P>0.05). Conclusion Pulmonary rehabilitation can improve exercise tolerance and quality of life of COPD patients with different severity,reduce acute exacerbation frequency in severe COPD,reduce the dyspnea degree in very severe COPD. Pulmonary rehabilitation is a cost-effective treatment for stable COPD.

Citation： Li Qun, Chen Feng, Wang Xiaoxia, Bao Yong, Chen Min. Effects of Pulmonary Rehabilitation on Patients with Stable COPD of Different Severity. Chinese Journal of Respiratory and Critical Care Medicine, 2013, 12(2): 130-135. doi: 10.7507/1671-6205.2014033 Copy

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16.	任蕾,李庆云,杜井波.三种肺康复方式联合干预老年 COPD 患者焦虑抑郁的效果.临床肺科杂志,2008,13:1123-1124.
17.	Bauerle O,Chrusch CA,Younes M.Mechanism by which COPD affects exercise tolerance.Am J Respir Crit Care Med,1998,157: 57-58.
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19.	邓述恺,杨小琼,李多,等.呼吸训练对慢性阻塞性肺病缓解期患者肺功能的影响.现代医药卫生,2007,23:2853-2854.
20.	曾雪峰,王晓霞,李凯,等.呼吸训练对稳定期慢性阻塞性肺疾病患者的影响.临床肺科杂志,2011,16:1318-1319.
21.	Sanchez Riera H,Montemayor Rubio T,Ortega Ruiz F,et al.Inspiratory muscle training in patients with COPD: effect on dyspnea,exercise performance,and quality of life.Chest,2001,120:748-756.
22.	Ramirez-Sarmiento A,Orozco-Levi M,Guell R,et al.Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes.Am J Respir Crit Care Med,2002,166:1491-1497.
23.	Weiner P,Magadle R,Beckerman M,et al.Maintenance of inspiratory muscle traning in COPD patients: one year follow-up.Eur Respir J,2004,23:61-65.

1. 刘升明,王小平,王大礼,等.广东部分地区慢性阻塞性肺疾病发病状况调查.中华医学杂志,2005,85:747-752.
2. 曾雪峰,王晓霞,包勇,等.成都市社区慢性阻塞性肺疾病流行病学调查.中国呼吸与危重监护杂志,2011,10:30-32.
3. Maltais F,Bourbeau J,Shapiro S,et al.Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease:a randomized trial.Ann Intern Med,2008,149:869-878.
4. 吴学敏,侯来永,白伟,等.呼吸训练对缓解期老年重度 COPD 患者生存质量及日常生活活动的影响.中国康复医学杂志,2006,21:307-310.
5. 周玉兰,刘翱,刘枢晓.慢性阻塞性肺疾病康复期患者呼吸肌功能锻炼临床观察.中国康复理论与实践,2005,11:848-849.
6. 慢性阻塞性肺疾病诊治指南(2007年修订版).中华医学会呼吸病学分会慢性阻塞性肺疾病学组.中华结核和呼吸杂志,2007,30:8-17.
7. 刘洪君,姚翠玲,许占英,等.呼吸操对慢性阻塞性肺病患者肺功能及血气的影响.临床肺科杂志,2006,11:63-64.
8. 张建华,刘惠俐,富丽芳.呼吸康复训练对老年慢性阻塞性肺部疾病病人生活质量的影响.中华护理杂志,2004,39:504-506.
9. Jone P W,Quirk FH,Baveystock CM,et al.The St George's Respiratory Questionnaire.Respir Med,1991,85(Suppl B):25-31.
10. 周灵,李庆云,时国朝.呼吸肌锻炼在COPD 肺康复治疗中的意义.临床肺科杂志,2007,12:271-173.
11. 陈文彬,程德云,主编.呼吸系统疾病诊疗技术.北京:人民卫生出版社,2000,400.
12. 胡向东.有氧训练和呼吸训练对COPD患者肺功能及生存质量影响.现代康复,2001,5:34-35.
13. Geddes EL,O'Brien K,Reid WD,et al.Inspiratory muscle training in adults with obstructive pulmonary disease:An update of a systematic review.Respir Med,2008,102:1715-1729.
14. GOLD Executive Committee.Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease (Revised 2011).www.goldcopd.com.
15. 方宗君,蔡映云,梁永杰.慢性阻塞性肺病患者抑郁症状及影响因素.健康心理学杂志,2000,8:431-443.
16. 任蕾,李庆云,杜井波.三种肺康复方式联合干预老年 COPD 患者焦虑抑郁的效果.临床肺科杂志,2008,13:1123-1124.
17. Bauerle O,Chrusch CA,Younes M.Mechanism by which COPD affects exercise tolerance.Am J Respir Crit Care Med,1998,157: 57-58.
18. Diaz O,Villafranca C,Ghezzo H,et al.Role of inspiratory capacity on exercise tolerance in COPD patients with and without tidal expiratory flow limitation at rest.Eur Respir J,2000,16:269-275.
19. 邓述恺,杨小琼,李多,等.呼吸训练对慢性阻塞性肺病缓解期患者肺功能的影响.现代医药卫生,2007,23:2853-2854.
20. 曾雪峰,王晓霞,李凯,等.呼吸训练对稳定期慢性阻塞性肺疾病患者的影响.临床肺科杂志,2011,16:1318-1319.
21. Sanchez Riera H,Montemayor Rubio T,Ortega Ruiz F,et al.Inspiratory muscle training in patients with COPD: effect on dyspnea,exercise performance,and quality of life.Chest,2001,120:748-756.
22. Ramirez-Sarmiento A,Orozco-Levi M,Guell R,et al.Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes.Am J Respir Crit Care Med,2002,166:1491-1497.
23. Weiner P,Magadle R,Beckerman M,et al.Maintenance of inspiratory muscle traning in COPD patients: one year follow-up.Eur Respir J,2004,23:61-65.

Chinese Journal of Respiratory and Critical Care Medicine

Effects of Pulmonary Rehabilitation on Patients with Stable COPD of Different Severity

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