Ahmed Safia, Sharma Neeraj, Patrikar Seema
Associate Professor (Respiratory Medicine), Command Hospital (Air Force), Bengaluru, India.
Graded Specialist (Respiratory Medicine), Command Hospital (EC), Kolkata, India.
Med J Armed Forces India. 2022 Apr;78(2):164-169. doi: 10.1016/j.mjafi.2020.09.001. Epub 2020 Nov 18.
Residual structural changes in the lung along with pulmonary impairment remain in a large number of patients of tuberculosis after microbiological cure. The aim of this study was to determine whether 12 weeks of a structured pulmonary rehabilitation program (PRP) administered along with antitubercular treatment improved the baseline measurement of pulmonary function, exercise capacity, and health-related quality of life (HRQOL).
A pilot study with single blind randomized control design was carried out in a tertiary care chest center. Spirometry, exercise capacity by 6-minute walk distance (6MWD), and HRQOL using St George respiratory questionnaire (SGRQ) score were evaluated in 62 patients, divided into 2 groups: intervention group (IG) (n = 31) and control group (CG) (n = 31) patients at baseline and at end of 12 weeks. IG completed 12 weeks of PRP.
Significant difference in forced expiratory volume in 1st second (FEV1) (2.94 L at baseline vs 3.18 L at end of 12 weeks of PRP, diff 0.239 L, p-0.001), forced vital capacity (FVC) (3.43 L vs 3.75L, p -0.00), 6MWD (440.6 m vs 574.6 m, p = 0.00), and SGRQ score of at baseline (24.5 m vs 11.1m, p = 0.00) was seen in the IG. At end of 12 weeks, there was statistically significant difference in FEV1(L) (p = 0.01, 95% CI -0.317 to -0.046), FVC(L) (p = 0.00, 95% CI -0.359 to -0.139),6MWD(m) (p = 0.00; 95% CI -101.6 to -49.57) between CG and IG. There was no statistically significant difference in SGRQ scores between the 2 groups (p = 0.231).
PRP administered along with treatment is beneficial in reducing residual pulmonary impairment.
大量肺结核患者在微生物学治愈后,肺部仍存在残留结构改变及肺功能损害。本研究旨在确定在抗结核治疗的同时进行为期12周的结构化肺康复计划(PRP)是否能改善肺功能、运动能力和健康相关生活质量(HRQOL)的基线测量值。
在一家三级护理胸部中心进行了一项单盲随机对照设计的试点研究。对62例患者进行了肺活量测定、通过6分钟步行距离(6MWD)评估运动能力以及使用圣乔治呼吸问卷(SGRQ)评分评估HRQOL,这些患者在基线时和12周结束时被分为两组:干预组(IG)(n = 31)和对照组(CG)(n = 31)。IG完成了12周的PRP。
干预组在第1秒用力呼气量(FEV1)(基线时为2.94L,PRP 12周结束时为3.18L,差值0.239L,p = 0.001)、用力肺活量(FVC)(3.43L对3.75L,p = 0.00)、6MWD(440.6m对574.6m,p = 0.00)以及基线时的SGRQ评分(24.5对11.1,p = 0.00)方面存在显著差异。在12周结束时,对照组和干预组之间在FEV1(L)(p = 0.01,95%CI -0.317至-0.046)、FVC(L)(p = 0.00,95%CI -0.359至-0.139)、6MWD(m)(p = 0.00;95%CI -101.6至-49.57)方面存在统计学显著差异。两组之间的SGRQ评分没有统计学显著差异(p = 0.231)。
在治疗的同时进行PRP有助于减少残留的肺功能损害。