多种肺康复训练对慢性阻塞性肺疾病的作用并结合膈肌B超进行疗效评价

Assessing the Efficacy of Various Pulmonary Rehabilitation Training in Chronic Obstructive Pulmonary Disease with Diaphragmatic Ultrasound

摘要: 目的：研究多种肺康复训练对慢性阻塞性肺疾病(COPD)的作用并结合膈肌B超进行疗效评价。方法：纳入2023年3月~2024年9月在我院就诊并采多种肺康复训练联合常规药物治疗的50例COPD患者设为肺康复组，再同期纳入采用常规药物治疗的50例COPD患者设为对照组，收集两组呼吸困难症状评分、生活质量状况、运动耐力、肺功能指标、血气分析指标信息，并采用B超评估两组患者下膈肌活动度，并比较上述指标。结果：治疗后，两组患者改良英国医学研究委员会呼吸困难指数(mMRC)评分、慢阻肺评估测试(CAT)评分、圣乔治呼吸问卷(SGRQ)评分及二氧化碳分压(PaCO₂)水平均降低(P < 0.05)，且肺康复组低于对照组(P < 0.05)；两组患者6分钟步行试验(6MWT)水平、第一秒用力呼出气容积/用力肺活量比值(FEV1/FVC)水平、第一秒用力呼气容积占预计值百分比(FEV1%pred)水平、氧分压(PaO₂)水平、平静呼吸膈肌活动度及深呼吸膈肌活动度均升高(P < 0.05)，且肺康复组高于对照组(P < 0.05)。结论：综上所述，膈肌B超活动度测评能较好反映多种肺康复训练联合常规药物治疗COPD患者的效果，且多种肺康复训练联合常规药物治疗COPD，能有效缓解其呼吸困难情况，可显著提高其肺功能、生活质量、运动耐力，并改善其血气指标，临床疗效较佳。

Abstract: Objective: This paper aims to study the effect of various pulmonary rehabilitation training on chronic obstructive pulmonary disease (COPD) and to evaluate the efficacy in combination with diaphragmatic ultrasound. Method: Fifty patients with COPD who were treated in our hospital from March 2023 to September 2024 and received various pulmonary rehabilitation training combined with conventional drug therapy were included as the pulmonary rehabilitation group, and 50 patients with COPD who received conventional drug therapy during the same period were included as the control group. Information on exercise endurance, lung function indexes and blood gas analysis indexes of the two groups was collected. Ultrasound was used to evaluate the lower diaphragm activity of the two groups, and the above indexes were compared. Results: After treatment, the improved Medical Research Council dyspnea Index (mMRC) score, COPD assessment test (CAT) score, St. George’s Respiratory Questionnaire (SGRQ) score and the level of partial pressure of carbon dioxide (PaCO₂) were decreased in both groups (P < 0.05), and the pulmonary rehabilitation group was lower than the control group (P < 0.05). The level of 6-minute walking test (6MWT), ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC), percentage of forced expiratory volume in the first second to expected value (FEV1%pred), partial oxygen pressure (PaO₂), diaphragmatic activity in calm breathing and deep breathing were increased in both groups (P < 0.05), and pulmonary rehabilitation group was higher than control group (P < 0.05). Conclusion: In summary, the assessment of diaphragmatic activity can better reflect the effect of various pulmonary rehabilitation training combined with conventional drugs in the treatment of COPD patients, and various pulmonary rehabilitation training combined with conventional drugs in the treatment of COPD can effectively alleviate their dyspnea, significantly improve their lung function, quality of life, exercise endurance, and improve their blood gas index, and can achieve better pulmonary rehabilitation efficacy.