标题：三球仪负荷呼吸训练器联合呼吸八段锦对脑卒中伴慢阻肺患者呼吸肌功能、肺功能、BODE评分及生存质量的影响

      作者：柳瑛，隋莹，苟平平    宝鸡市中心医院康复医学科，陕西 宝鸡 721008

      卷次： 2023年34卷12期

      【摘要】 目的 探讨三球仪负荷呼吸训练器联合呼吸八段锦在脑卒中伴慢阻肺患者中的应用效果。方法 选取2021年1月至2021年12月期间于宝鸡市中心医院就诊的120例脑卒中伴慢阻肺患者，采用随机数表法分为观察组和对照组各60例，对照组患者采用三球仪负荷呼吸训练器训练，观察组患者采取三球仪负荷呼吸训练器联合呼吸八段锦训，两组患者干预时间均为8周。比较两组患者干预前、干预4周及8周后的呼吸肌功能[最大吸气压(MIP)、最大呼气压(MEP)]、躯干损伤量表(TIS)评分、肺功能[第1秒用力呼气容积占预计值百分比(FVE1%)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、用力肺活量(FVC)]、呼吸运动功能[呼吸劳累感觉(POD)、BODE多维评分系统评分、6 min步行距离(6MWD)]及生存质量(HRQOL)评分。结果 干预4周、8周后，观察组患者的MIP、MEP和、TIS评分明显高于对照组，差异均有统计学意义(P<0.05)；干预8周后，观察组患者的FVC、FVE1%、FEV1/FVC明显高于对照组，差异均有统计学意义(P<0.05)；干预8周后，观察组患者的POD和BODE指数分别为(3.10±0.56)分、(3.56±0.92)分，明显低于对照组的(5.18±0.97)分、(5.35±1.00)分，6MWD为(22.35±3.12) m，明显长于对照组(17.87±2.01) m，差异均有统计学意义(P<0.05)；干预8周后，观察组患者的HRQOL量表中社会活动情况、日常生活能力、抑郁心理症状、焦虑心理症状维度评分分别为(11.28±1.54)分、(24.47±2.58)分、(13.19±1.38)分、(14.27±1.59)分，明显低于对照组的(13.42±2.66)分、(28.59±3.35)分、(16.48±2.16)分、(17.53±2.27)分，差异有统计学意义(P<0.05)。结论 三球仪负荷呼吸训练器联合呼吸八段锦能有效改善脑卒中伴慢阻肺患者呼吸肌功能、肺功能及躯干控制能力，减轻呼吸困难症状、提高运动耐力及日常生活能力，对提升患者生存质量、改善预后具有积极意义。
      【关键词】 三球仪负荷呼吸训练器；呼吸八段锦；脑卒中；慢阻肺；呼吸肌功能；肺功能
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2023）12—1696—05

Effects of three-ball load breathing trainer combined with breathing Baduanjin on respiratory muscle function,pulmonary function, body mass index, airflow obstruction, dyspnea, and exercise capacity index, and quality oflife in stroke patients with chronic obstructive pulmonary disease.
LIU Ying, SUI Ying, GOU Ping-ping. Departmentof Rehabilitation Medicine, Baoji Central Hospital, Baoji 721008, Shaanxi, CHINA
【Abstract】 Objective To explore the application effect of three-ball load breathing trainer combined withbreathing Baduanjin in stroke patients with chronic obstructive pulmonary disease. Methods A total of 120 patientswith stroke associated with chronic obstructive pulmonary disease treated in Baoji Central Hospital between January2021 and December 2021 were selected. All patients were divided into an observation group and a control group by ran-dom number table method, with 60 patients in each group. The patients in the control group were trained with thethree-ball load breathing trainer, and the patients in the observation group were trained with the three-ball load breathingtrainer combined with breathing Baduanjin training, for 8 weeks. The respiratory muscle function [maximum inspiratorypressure (MIP), maximum expiratory pressure (MEP)], torso injury scale (TIS) score, lung function [forced expiratoryvolume in one second as a percentage of predicted value (FVE1%), forced expiratory volume in one second/forced vitalcapacity (FEV1/FVC), forced vital capacity (FVC)], respiratory motor function [perception of dyspnea (POD), bodymass index, airflow obstruction, dyspnea, and exercise capacity (BODE), 6-minute walking distance (6MWD)], andhealth-related quality of life (HRQOL) scores before intervention, 4 weeks and 8 weeks after intervention were comparedbetween the two groups. Results After 4 and 8 weeks of intervention, the MIP, MEP, and TIS scores in the observationgroup were significantly higher than those in the control group, with statistically significance differences (P<0.05). After8 weeks of intervention, the FVC, FVE1%, and FEV1/FVC in the observation group were significantly higher than those inthe control group, with statistically significance differences (P<0.05). After 8 weeks of intervention, the POD and BODEindex in the observation group were (3.10±0.56) points and (3.56±0.92) points, respectively, which were significantly low-er than (5.18±0.97) points and (5.35±1.00) points in the control group, and the 6MWD was (22.35±3.12) m, significantlylonger than (17.87±2.01) m in the control group (P<0.05). After 8 weeks of intervention, the HRQOL scale scores of so-cial activity, daily living ability, depressive symptoms, and anxiety symptoms in the observation group were (11.28±1.54) points, (24.47±2.58) points, (13.19±1.38) points, (14.27±1.59) points, significantly lower than (13.42±2.66) points,(28.59±3.35) points, (16.48±2.16) points, and (17.53±2.27) points in the control group (P<0.05). Conclusion Thethree-ball load breathing trainer combined with breathing Baduanjin can effectively improve respiratory muscle function,lung function, and trunk control in stroke patients with chronic obstructive pulmonary disease, reduce dyspnea symp-toms, improve exercise endurance and daily living ability, which has positive significance to enhance the quality of sur-vival and improve the prognosis of patients.
      【Key words】 Three-ball load breathing trainer; Breathing Baduanjin; Stroke; Chronic obstructive pulmonary dis-ease; Respiratory muscle function; Lung function