慢性阻塞性肺疾病（COPD）的肺康复计划包括呼吸训练：在潮式呼吸过程中改善过度充气和呼气流量。
Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing.
出版信息
J Thorac Dis. 2012 Jun 1;4(3):259-64. doi: 10.3978/j.issn.2072-1439.2012.03.17.
BACKGROUND
Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients' expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide "respiratory conditioning", a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization.
METHODS
Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation.
RESULTS
In participants ages 68±7 years, the FEV(1)% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV(1)% predicted nor FEV(1)/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest.
CONCLUSIONS
The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.
背景
肺康复通常可以缓解 COPD 患者的症状、增强运动耐力并改善健康相关生活质量（QOL），但肺功能的恢复仍存在争议。本分析针对我们创新的康复计划，旨在记录患者呼气气流受限、肺部症状和 QOL 的变化。该计划旨在提供“呼吸调节”，这是一种物理治疗师辅助的强化柔韧性训练，侧重于伸展和肋骨笼动员。
方法
1999 年至 2006 年期间，在顺天堂大学医院参加康复课程的 31 例 COPD 患者进行了分析。在肺康复前后测量了肺功能、潮式呼吸时呼气流量限制、6 分钟步行距离（6MWD）、呼吸肌力量和圣乔治呼吸问卷（SGRQ）。
结果
在年龄为 68±7 岁的参与者中，FEV(1)%预测值为 39.3±15.7%。6MWD、SGRQ 和呼吸肌力量在肺康复后显著改善。尽管 FEV(1)%预测值或 FEV(1)/FVC 没有显著受到影响，表明对气流受限的影响不大，但仰卧位和坐姿时的潮式呼吸中的呼气流量限制显著改善。此外，康复显著降低了 TLC%预测值、FRC%预测值、RV%预测值和 RV/TLC 值，表明静息时肺部过度充气减少。
结论
目前的结果表明，我们的呼吸调节康复计划显著降低了静息时肺部的过度充气和潮式呼吸时的呼气流量限制。在 COPD 患者中，整体肺功能改善、运动耐力增加、健康相关 QOL 得到提高。
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