有氧运动联合呼吸锻炼干预改善肺结核患者肺功能及运动耐力的作用

江巧敏 郭净 郑珍慧

[摘要] 目的 探讨有氧运动联合呼吸锻炼干预改善肺结核患者肺功能及运动耐力的作用。 方法 选取2018年1月至2019年4月在我院就诊的肺结核患者84例，采用随机数字表法分为两组，每组各42例。两组患者均予以DOTS方案抗结核治疗，对照组患者在此基础上予以饮食指导、用药指导和健康宣教等常规干预，观察组患者在对照组干预基础上加有氧运动和呼吸锻炼。两组均干预6个月。观察两组患者治疗前后肺功能、动脉血气分析及运动耐力的变化，并比较其临床效果。 结果 治疗6个月后，两组患者FEV1、FEV1/FVC和PEF均治疗较前明显上升）（P<0.05或P<0.01），且观察组患者上升幅度更显著（P<0.05）;同时两组患者PaO2和6MWT均较治疗前明显上升，PaCO2明显下降（P<0.05或P<0.01），且观察组患者变化幅度更显著（P<0.05）;观察组患者临床总有效率（95.24%）高于对照组（80.95%）（P<0.05）。 結论 有氧运动联合呼吸锻炼干预用于肺结核患者的效果较确切，能明显改善患者肺功能，纠正患者缺氧和二氧化碳潴留，提高运动耐力。

[关键词] 肺结核;有氧运动;呼吸锻炼;肺功能;血气分析;运动耐力

[中图分类号] R473.5          [文献标识码] A          [文章编号] 1673-9701（2021）03-0009-04

Effect of aerobic exercise combined with respiratory exercise intervention on improving pulmonary function and exercise endurance of patients with pulmonary tuberculosis

JIANG Qiaomin   GUO Jing   ZHENG Zhenhui

Department of Infectious Diseases， Lishui City Hospital of Traditional Chinese Medicine in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To explore the effect of aerobic exercise combined with respiratory exercise intervention on improving pulmonary function and exercise endurance in patients with pulmonary tuberculosis. Methods Eighty-four patients with pulmonary tuberculosis who were admitted in our hospital from January 2018 to April 2019 were randomly divided into two groups by random number table method， with 42 cases in each group. Patients in both groups received DOTS antituberculosis treatment. The patients in the control group received routine interventions such as dietary guidance， medication guidance and health education. Patients in the observation group were given aerobic respiration and exercise based on the intervention of the control group. The two groups were intervened for 6 months. The changes of pulmonary function， arterial blood gas analysis and exercise tolerance before and after treatment in two groups of patients were observed. And their clinical effects were compared. Results After 6 months of treatment， the FEV1， FEV1/FVC and PEF of the two groups were significantly higher than those before treatment（P<0.05 or P<0.01）， and the increase of the observation group was more significant（P<0.05）. The PaO2 and 6MWT of both groups were significantly higher than those before treatment， and the PaCO2 indicators were significantly decreased（P<0.05 or P<0.01）. The magnitude of change in the observation group was more significant（P<0.05）. The clinical effective rate of the observation group（95.24%） was higher than 80.95% in the control group（P<0.05）. Conclusion Aerobic exercise combined with respiratory exercise intervention on pulmonary tuberculosis patients has significant effect， which can significantly improve the patient′s pulmonary function， correct the patient′s hypoxia and carbon dioxide retention， and improve exercise endurance.

[Key words] Pulmonary tuberculosis; Aerobic exercise; Respiratory exercise; Pulmonary function; Blood gas analysis; Exercise endurance

肺结核是结核分枝杆菌引起的常见慢性肺部感染性疾病之一，具有起病较隐匿、早期诊断较困难、病情发展缓慢、病情复杂多变、治疗难度较大、病情复发率高等特点[1-2]。临床发现大多数肺结核患者死于肺功能衰竭及运动耐力下降，因此改善肺功能、提高运动耐力可改善肺结核患者转归和预后[3-4]。目前肺结核治疗主要以抗结核药物为主，但常规抗结核药物长期使用不良反应较明显，且不能修复受损的肺组织，因此，抗结核药治疗对肺结核患者肺功能的提高作用有限[5-6]。有氧呼吸和運动锻炼均是临床常用的改善肺功能的锻炼方法，但两者联合用于肺结核患者国内报道较少[7-8]。本研究旨在观察有氧运动联合呼吸锻炼干预改善肺结核患者肺功能及运动耐力的作用，现报道如下。……