Effect of Early Pulmonary Rehabilitation Combining Tuna （Exhalation and Inhalation） and Tuina on Exercise Endurance and Quality of Life in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Xue LAI; Shan LI; Wei WU; Feng GAO; Bin WANG

doi:10.13288/j.11-2166/r.2021.22.011

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Effect of Early Pulmonary Rehabilitation Combining Tuna （Exhalation and Inhalation） and Tuina on Exercise Endurance and Quality of Life in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

更新时间：2021-11-29

- Effect of Early Pulmonary Rehabilitation Combining Tuna （Exhalation and Inhalation） and Tuina on Exercise Endurance and Quality of Life in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
- Journal of Traditional Chinese Medicine Vol. 62, Issue 22, Pages: 1984-1987(2021)
- 作者机构：
  
  中国中医科学院望京医院，北京市朝阳区望京中环南路6号，100102
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2021.22.011
  CLC：
- Received：24 June 2021，
  
  Revised：2021-08-31，
  
  Published：17 November 2021
- 稿件说明：
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来薛,李珊,吴蔚等.早期运用吐纳联合推拿康复方案对慢性阻塞性肺疾病急性加重期重度患者运动耐力及生活质量的影响[J].中医杂志,2021,62(22):1984-1987.

LAI Xue,LI Shan,WU Wei,et al.Effect of Early Pulmonary Rehabilitation Combining Tuna （Exhalation and Inhalation） and Tuina on Exercise Endurance and Quality of Life in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Journal of Traditional Chinese Medicine,2021,62(22):1984-1987.
来薛,李珊,吴蔚等.早期运用吐纳联合推拿康复方案对慢性阻塞性肺疾病急性加重期重度患者运动耐力及生活质量的影响[J].中医杂志,2021,62(22):1984-1987. DOI： 10.13288/j.11-2166/r.2021.22.011.

LAI Xue,LI Shan,WU Wei,et al.Effect of Early Pulmonary Rehabilitation Combining Tuna （Exhalation and Inhalation） and Tuina on Exercise Endurance and Quality of Life in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Journal of Traditional Chinese Medicine,2021,62(22):1984-1987. DOI： 10.13288/j.11-2166/r.2021.22.011.

摘要

目的

观察早期运用吐纳联合推拿康复方案对慢性阻塞性肺疾病（COPD）急性加重期重度患者的临床疗效。

方法

66例COPD急性加重期重度患者随机分为治疗组和对照组各33例，两组患者均采用西医常规治疗方案进行治疗，治疗组在常规治疗基础上于入院3天内开始给予吐纳联合推拿康复方案，治疗3周，观察至入组第8周（随访时）。分别于治疗前、治疗后及随访时检测第一秒用力呼气容积（FEV1），测量六分钟步行距离（6MWD），进行慢性阻塞性肺疾病评估测试（CAT）评分，并采用Pearson相关分析法分析治疗前各指标间相关性。

结果

最终治疗组31例、对照组30例完成统计分析。两组患者治疗后及随访时FEVl、6MWD均明显高于本组治疗前，CAT评分均明显低于本组治疗前（

＜0.05或

＜0.01），且治疗组随访时FEVl、6MWD均明显高于本组治疗后，CAT评分低于本组治疗后（

＜0.05或

＜0.01）；而对照组仅6MWD随访时明显高于本组治疗后（

＜0.05），而FEVl、CAT评分差异无统计学意义（

＞0.05）。治疗前两组患者6MWD与FEV1存在显著的正向相关关系（

=0.333，

=0.009），6MWD与CAT评分存在显著的负向相关关系（

=-0.384，

=0.002）。

结论

吐纳联合推拿康复方案的早期（入院3天内）运用对COPD急性加重期重度患者的呼吸功能、运动耐力及生活质量均有一定的改善作用，并在停止治疗后仍然持续改善。

Abstract

Objective

To explore the clinical effect of early pulmonary rehabilitation therapy of Tuna （exhalation and inhalation） and Tuina on exercise endurance and quality of life of patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.

Methods

Totally， 66 AECOPD patients were randomly assigned to control group （33 cases） and treatment group （33 cases）. Patients in both groups were treated with conventional therapy； additionally， rehabilitation program combining Tuna and Tuina was performed in treatment group within 3 days after admission. Treatment lasted for 3 weeks， and was followed up till the 8th week since enrollment. The forced expiratory volume in the first second （FEV1）， the six-minute walking distance （6MWD） and the chronic obstructive pulmonary disease assessment test （CAT） score were assessed before and after treatment and at follow up. Pearson correlation analysis was performed to evaluate the correlations between the indicators.

Results

Compared to those before treatment， FEV1 and 6MWD significantly increased in both groups after treatment and at follow-up， while the CAT scores decreased （

＜0.05 or

＜0.01）； higher FEV1 and 6WMD as well as lower CAT score were found at follow-up than after treatment in the treatment group （

＜0.05 or

＜0.01）， while only higher 6WMD （

＜0.05） and not significant differences in the FEV1 and CAT score （

＞0.05） were shown in the control group when compared between after treatment and at follow up. There was a significant positive correlation between 6MWD and FEV1 （

=0.333，

0.009）， and a significant negative correlation between 6MWD and CAT （

=-0.384，

0.002） in both groups before treatment.

Conclusion

The early pulmonary rehabilitation combining Tuina and Tuna within three days after admission has a certain effect on improving the respiratory function， exercise endurance and quality of life of patients with AECOPD， which is lasting after the treatment.

关键词

Keywords

references

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JONES PW ， HARDIN G ， BERRY P ， et al . Development and first validation of the COPD assessment test ［J］. Eur Resoir ， 2009 ， 34 （ 3 ）： 648 - 654 .

BOILTON CE ， SINGH SJ ， WALKER PP ． Commentary：the British Thoracic Society guideline on pulmonary rehabilitation in adults ［J］． Thorax ， 2013 ， 68 （ 9 ）： 887 - 888 .

KON SS ， CANAVAN JL ， JONES SE ， et al . Minimum clinically important difference for the COPD assessment test： a prospective analysis ［J］. Lancet Respir Med ， 2014 ， 2 （ 3 ）： 195 - 203 .

GREENING NJ ， WILLIAMS JE ， HUSSAIN SF ， et al . An early rehabilitation intervention to enhance recovery during hospital admission for an exacerbation of chronic respiratory disease： randomized controlled trial ［J］. BMJ ， 2014 ， 349 ： g4315 . doi： 10.1136/bmj.g4315 http://dx.doi.org/10.1136/bmj.g4315 .

刘卫庭，姚宇 . 早期肺康复对慢性阻塞性肺疾病急性加重期患者肺功能及运动耐力的影响［J］. 中华物理医学与康复杂志， 2019 ， 41 （ 3 ）： 213 - 216 .

彭磊，夏卫明，何健忠，等 . 以“AECOPD危险窗”为介入点的早期中医肺康复对AECOPD患者的影响［J］. 中国中医急症， 2020 ， 29 （ 9 ）： 1583 - 1586 .

姬爱冬，宋新红，夏光宇，等 . 宋新红保健养生吐纳导引法教学经验［J］. 按摩与康复医学， 2017 ， 8 （ 6 ）： 72 - 75 .

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