内科

目的探讨甩手运动配合缩唇腹式呼吸锻炼对慢性阻塞性肺疾病（COPD）稳定期患者肺功能及生活质量的影响，为COPD稳定期患者肺康复锻炼提供科学依据。方法选取COPD稳定期患者120例为研究对象，随机分为两组，每组60例。两组患者均按呼吸内科常规对症治疗如抗感染、化痰、支气管解痉等，在此基础上，对照组给予常规护理，患者自主进行呼吸锻炼8周。观察组患者在常规对症治疗、护理的基础上，在专业人员指导下进行甩手运动配合缩唇腹式呼吸锻炼8 d，出院后继续进行康复锻炼8周。比较两组患者Borg呼吸困难评分、6分钟步行测定（6MWT）结果及圣乔治评分等的变化。结果锻炼后两组患者的Borg呼吸困难评分及6分钟步行试验（6MWT）结果均较干预前改善（P＜0.05），与对照组比较观察组患者改善更加显著，两组比较差异有统计学意义（P＜0.05）；观察组患者的日常活动量、社交活动、精神状况评分明显低于对照组，差异有统计学意义（P＜0.05）。结论甩手运动配合缩唇腹式呼吸锻炼可增强膈肌、腹肌、下胸部肌肉的活动，减少呼吸肌疲劳的发生，从而改善COPD患者肺的通气功能，提高患者的生活质量。

ObjectiveTo investigate the influence of hand-swinging exercise combined with shrinkage lip-abdominal breathing on pulmonary function and quality of life in patients with COPD stabilization, provide the scientific basis for pulmonary rehabilitation exercise. MethodsA total of 120 patients with stable COPD were selected and randomly divided into two groups, with 60 cases in each group.All patients in two groups received conventional treatment such as anti-infection, eliminating phlegm, bronchial spasmolysis, etc,and the control group was given routine nursing care while the observation group received hand-swinging exercise combined with shrinkage lip-abdominal breathing on the basis of conventional treatment, both groups received rehabilitation for 8 weeks. Borg dyspnea score, 6 minutes walk test (6MWT) and quality of life (QOL) of the two groups were observed. ResultsBorg dyspnea score and 6MWT of both control group and observation group were better than before treatment (P＜0.05), and there had been a greater improvement in observed group (P＜0.05);the score of daily activity, social activities and mental health in observed group were significantly lower than those in control group(P＜0.05). ConclusionsHand-swinging exercise combined with shrinkage lip-abdominal breathing can enhance the activity of diaphragmatic, abdominal muscles and breast muscle, relieve patients’respiratory muscle fatigue, improve the pulmonary function and quality of life.