序贯间歇门诊呼吸康复改善慢性阻塞性肺病急性加重患者出院后生活质量及肺功能的疗效研究

Study on the Efficacy of Sequential Intermittent Outpatient Pulmonary Rehabilitation in Improving Quality of Life and Lung Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease after Discharge

摘要: 比较序贯间歇门诊呼吸康复与居家呼吸康复对慢性阻塞性肺病急性加重(Acute exacerbations of chronic obstructive pulmonary disease, AECOPD)患者出院后肺功能及生活质量的改善效果。纳入2024年7月至2025年4月重庆市第十三人民医院出院的AECOPD患者78例(最终分析72例，门诊康复组35例，居家康复组37例)，根据患者意愿分为门诊康复组和居家康复组。门诊康复组每周接受3次规范化呼吸康复训练，居家康复组则依据个体化方案在家中自主训练。干预12周后，比较两组患者的6分钟步行试验(Six-minutes walking test, 6MWT)、慢性阻塞性肺疾病评估测试(COPD assessment test, CAT)、Borg评分、第1秒用力呼吸容积(Forced expiratory volume in one second, FEV1)、FEV1占预计值百分比(FEV1%pred)、用力肺活量(Forced vital capacity, FVC)占预计值百分比(FVC%pred)及FEV1/FVC的变化值。结果显示，门诊康复组在6MWT (74.80 ± 24.76米vs 28.88 ± 23.95米，P = 0.010)、CAT评分(−2.60 ± 1.14 vs −2.22 ± 1.20, P = 0.035)及Borg评分(−1.80 ± 0.91 vs −0.78 ± 0.44, P = 0.001)改善幅度方面显著优于居家康复组。两组患者治疗后的FEV1、FEV1%pred、FEV1/FVC变化值无统计学差异(P > 0.05)。研究发现，门诊呼吸康复较居家呼吸康复更能显著改善AECOPD出院患者的生活质量，但在肺功能改善方面两者差异不明显。

Abstract: This study compared the effects of sequential intermittent outpatient pulmonary rehabilitation versus home-based pulmonary rehabilitation on lung function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) after discharge. A total of 78 AECOPD patients discharged from the 13th People’s Hospital of Chongqing between July 2024 and April 2025 were enrolled (72 completed final analysis: 35 in outpatient group, 37 in home-based group), with group allocation based on patient preference. The outpatient group received standardized pulmonary rehabilitation training 3 times weekly, while the home-based group followed individualized self-training protocols. After 12 weeks of intervention, compare the changes in the following parameters between the two groups of patients: the six-minute walking test (6MWT), the COPD assessment test (CAT), Borg scale, forced expiratory volume in one second (FEV1), FEV1 as a percentage of predicted value (FEV1%pred), forced vital capacity (FVC) as a percentage of predicted value (FVC%pred), and FEV1/FVC ratio. Results demonstrated significantly greater improvements in the outpatient group for 6MWT distance (74.80 ± 24.76 m vs 28.88 ± 23.95 m, P = 0.010), CAT score reduction (−2.60 ± 1.14 vs −2.22 ± 1.20, P = 0.035), and Borg scale improvement (−1.80 ± 0.91 vs −0.78 ± 0.44, P = 0.001). No statistically significant differences were observed between groups for post-treatment changes in FEV1, FEV1%pred, or FEV1/FVC (P > 0.05). The study concludes that outpatient pulmonary rehabilitation provides superior quality of life benefits compared to home-based rehabilitation for post-discharge AECOPD patients, though both approaches show comparable effects on lung function improvement.