长期吸入糖皮质激素联合最大负荷吸气肌训练对稳定期慢性阻塞性肺疾病症状缓解及运动耐力的影响

Influence of long-term inhaled corticosteroids combined with maximum load inspiratory muscle training on symptom relief and exercise endurance in stable COPD

摘要:

目的 探讨长期吸入糖皮质激素联合最大负荷吸气肌训练对稳定期慢性阻塞性肺疾病（COPD）症状缓解及运动耐力的影响。方法 选取2019年7月—2022年2月江南大学附属医院收治的124例稳定期COPD患者，按随机数字表法将其分为研究组与对照组，每组62例。对照组接受长期吸入糖皮质激素治疗，研究组在对照组基础上另给予最大负荷吸气肌训练。两组均治疗6个月。比较两组肺功能、呼吸困难程度、免疫功能、运动耐力及生活质量。结果 研究组治疗前后第1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、FEV₁/FVC的差值高于对照组（P <0.05）。研究组治疗前后MRC呼吸困难量表评分的差值高于对照组（P <0.05）。研究组治疗前后CD3⁺、CD4⁺、CD4⁺/CD8⁺的差值高于对照组（P <0.05）。研究组治疗前后6 min步行距离的差值高于对照组（P <0.05）。研究组治疗前后COPD自我评估测试问卷评分的差值高于对照组（P <0.05）。结论 长期吸入糖皮质激素联合最大负荷吸气肌训练可促进稳定期COPD患者症状缓解，改善肺功能、免疫功能，提高生活质量与运动耐力。

Abstract:

Objective To investigate the influence of long-term inhaled glucocorticoid combined with maximum load inspiratory muscle training on symptom relief and exercise endurance of stable chronic obstructive pulmonary disease (COPD).Methods From July 2019 to February 2022, 124 patients with stable COPD were selected, and they were divided into a study group (62 cases) and a control group (62 cases) by random number table method. The control group received long-term inhaled glucocorticoid therapy, and the study group was additionally given inspiratory muscle training with maximum load. Both two groups were treated for 6 months. Lung function, dyspnea, immune function, exercise endurance and quality of life were compared between the two groups.Results The differences of forced expiratory volume (FEV₁), forced vital capacity (FVC) and FEV₁/FVC in the first second before and after treatment in the study group were higher than those in the control group (P < 0.05). The difference of MRC dyspnea scale before and after treatment in the study group was higher than that in the control group (P < 0.05). The difference values of CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the study group before and after treatment were higher than those in the control group (P < 0.05). The difference of 6-minute walking distance (6MWD) before and after treatment in the study group was higher than that in the control group (P < 0.05). The difference of COPD self-assessment test questionnaire (CAT) scores before and after treatment was higher in the study group than in the control group (P < 0.05).Conclusion Long-term inhaled corticosteroids combined with maximum load inspiratory muscle training can promote symptom relief, improve lung function, immune function, quality of life and exercise endurance in stable COPD patients.