抗阻联合有氧训练对老年慢性阻塞性肺疾病患者运动能力的疗效

doi:10.16138/j.1673-6087.2022.01.015

摘要/Abstract

摘要：

目的： 评价抗阻联合有氧训练对老年慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者运动能力的疗效。方法： 共80例老年稳定期COPD患者入选本研究,随机分入联合训练组和有氧训练组,分别给予有氧训练和（或）抗阻训练,共12周。最终完成有氧训练35例,联合训练37例。2组患者在治疗前后及随访3个月后,均进行肺功能、动脉血气分析、运动能力、生活质量、焦虑抑郁心理状态的评定,并对相关结果进行对比分析。结果： 在治疗后,联合训练组3 min步行距离（3 minutes walking distance,3MWD）、氧分压(partial pressure of oxygen,PaO₂)、体质量指数（body mass index,BMI)、圣乔治呼吸问卷（St George’s respiratory questionnaire, SGRQ）评分均较治疗前明显改善（均P<0.05）;3 MWD 及SGRQ评分在随访3个月后较其自身基线比较差异也有统计学意义（均P<0.05）;有氧训练组在3 MWD、PaO₂较治疗前明显改善（均P<0.05）。治疗后及随访3个月后,联合训练组在BMI、3 MWD 及SGRQ评分均较有氧训练组有明显改善（均P<0.05）;治疗后联合训练组抑郁状态较有氧训练组改善,但3个月后焦虑状态较有氧训练组严重（P<0.05）;2组患者在肺功能、动脉血气分析、心率、COPD评估测试方面比较,差异无统计学意义（均P>0.05）。结论： 对稳定期COPD的老年患者也能进行抗阻联合有氧训练,12周康复训练能明显改善其运动能力、生活质量及BMI,并且运动能力的疗效持续3个月以上,但对于肺功能影响不大。

关键词: 慢性阻塞性肺疾病, 抗阻训练, 有氧训练

Abstract:

Objective To evaluate the effects of resistance and aerobic training on the patients with chronic obstructive pulmonary disease (COPD). Methods A total of 80 gerontal patients with stable COPD were enrolled in this study. They were randomly assigned to a combination training group (resistance and aerobic training) or an aerobic training group, respectively, and received training for 12 weeks. Thirty-seven patients completed combined training and 35 patients completed aerobic training. The clinical information including lung function, arterial blood gas, exercise ability, St. George’s respiratary questionnaire (SGRQ) score, anxiety and depression status were evaluated, and compared among three time points(pre, post 12-week training, and 3-month follow-up). Results After 12-week training, the body mass index (BMI), partial pressure of oxygen(PaO₂), 3-minute walking distance(3MWD) and SGRQ scores in the combined training group were significantly improved compared with those before treatment(P<0.05). There were also significant differences in 3MWD and SGRQ scores after 3-month follow-up compared with their own baseline (P<0.05). The PaO₂ and 3MWD (after treatment and 3-month follow up) was significantly improved compared with those before treatment in aerobic training group(P<0.05). After 12-week training and 3-month follow-up, BMI, 3MWD and SGRQ scores in the combined training group were significantly improved compared with the aerobic training group (P<0.05), the depression state in the combined training group was also improved; while the anxiety state in the combined training group was worse than that in the aerobic training group after 3 months(P<0.05). There was no significant difference in pulmonary function, arterial blood gas analysis, heart rate and COPD assessment test between two groups(P>0.05).Conclusions The therapeutic efficacy of 12-week training of resistance and aerobic for the gerontal patients with stable COPD significantly improved their exercise ability, quality of life and BMI; and the effect on excise ability could last more than three months. However, it couldn’t make a significant change in pulmonary function.

Key words: Chronic obstructive pulmonary disease, Aerobic training, Resistance training

中图分类号:

仇丽雯, 许轶明, 张音, 沈宏华, 陈慎. 抗阻联合有氧训练对老年慢性阻塞性肺疾病患者运动能力的疗效[J]. 内科理论与实践, 2022, 17(01): 78-83.

QIU Liwen, XU Yiming, ZHANG Yin, SHEN Honghua, CHEN Shen. Evaluate therapeutic efficacy of resistance training and aerobic training for gerontal patients with chronic obstructive pulmonary disease[J]. Journal of Internal Medicine Concepts & Practice, 2022, 17(01): 78-83.

图/表 2

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参数	有氧训练组（n=35）	联合训练组（n=37）	P
年龄（岁）	75.6±7.9	76.6±5.7	0.344
男性	20（57.1）	22（59.5）	0.842
BMI（kg/m²）	21.78±2.37	22.10±2.26	0.549
吸烟[n(%)]	10（28.6）	15（40.5)	0.286
吸烟量（年支）	407±65	401±57	0.821
高血压[n（%）]	23（65.7）	22（59.5）	0.584
2型糖尿病[n（%）]	6（17.1）	8（21.6）	0.631
冠心病[n（%）]	8（22.9）	10（27.0）	0.683
FVC（L）	3.70±0.44	3.77±0.45	0.573
FEV₁（L）	2.40±0.38	2.50±0.42	0.284
FEV₁/FVC（%）	0.64±0.05	0.66±0.05	0.214
PaO₂（mmHg）	62.69±8.48	61.22±8.93	0.459
PaCO₂（mmHg）	46.94±4.96	47.81±7.59	0.570
心率（次/min）	78.97±10.37	79.51±12.87	0.845
CAT（分）	9.86±2.50	9.70±3.78	0.840
SGRQ（分）	15.46±7.75	16.65±7.77	0.520
3MWD（m）	116.66±44.78	117.62±41.97	0.925
HAMA（分）	4.00±3.27	5.05±3.24	0.174
HRSD（分）	9.11±3.72	8.03±3.48	0.205

参数	有氧训练组（n=35）	联合训练组（n=37）	P
BMI（kg/m²）
基线	21.78±2.37	22.10±2.26	0.549
治疗12周末	22.05±2.24	23.15±1.83^1）	0.025
随访3月末	21.51±2.30	22.80±2.17	0.017
FVC（L）
基线	3.70±0.44	3.77±0.45	0.573
治疗12周末	3.71±0.44	3.77±0.44	0.561
随访3月末	3.76±0.34	3.84±0.41	0.395
FEV₁（L）
基线	2.40±0.38	2.50±0.42	0.284
治疗12周末	2.41±0.37	2.53±0.43	0.202
随访3月末	2.51±0.37	2.60±0.40	0.331
FEV₁/FVC（%）
基线	0.64±0.05	0.66±0.05	0.214
治疗12周末	0.65±0.05	0.67±0.05	0.106
随访3月末	0.66±0.06	0.67±0.05	0.525
PaO₂（mmHg）
基线	62.69±8.48	61.22±8.93	0.459
治疗12周末	68.67±7.84^1）	70.89±7.88^1）	0.238
PaCO₂（mmHg）
基线	46.94±4.96	47.81±7.59	0.570
治疗12周末	45.31±4.46	47.62±5.65	0.059
心率（次/min）
基线	78.9±10.4	79.5±12.9	0.845
治疗12周末	79.3±10.8	80.0±13.3	0.803
随访3月末	78.6±9.3	83.7±13.8	0.068
CAT（分）
基线	9.86±2.50	9.70±3.78	0.840
治疗12周末	9.51±2.69	9.70±2.56	0.762
随访3月末	9.74±2.00	10.35±2.06	0.208
SGRQ（分）
基线	15.46±7.75	16.65±7.77	0.520
治疗12周末	14.94±6.45	11.75±4.23^1）	0.015
随访3月末	15.35±5.88	13.02±3.41^1）	0.042
3MWD（m）
基线	116.66±44.78	117.62±41.97	0.925
治疗12周末	139.48±44.31^1）	161.97±40.72^1）	0.028
随访3月末	133.00±51.04	155.43±42.32^1）	0.046
HAMA（分）
基线	4.00±3.27	5.05±3.24	0.174
治疗12周末	3.94±3.01	5.16±3.06	0.093
随访3月末	4.06±2.10	5.43±3.07	0.038
HRSD（分）
基线	9.11±3.72	8.03±3.48	0.205
治疗12周末	8.86±3.09	7.30±3.25	0.041
随访3月末	8.29±2.47	7.70±3.47	0.417