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目的观察综合性行为干预在延缓慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者疾病进展中的作用。方法 COPD全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级为Ⅰ~Ⅱ级COPD患者100例,随机分为干预组和对照组各50例,干预组给予个体化的综合性行为干预计划,包括健康教育、戒烟及运动锻炼等;对照组未给予任何干预措施。分别于入组时及干预12个月后检测2组第1秒用力呼气容积(forced expiratory volume in one second,FEV1)和FEV1占预计值百分比(FEV1%),应用圣·乔治呼吸问卷量表(St.George’s Respiratory Questionnaire,SGRQ)评估患者的生活质量,并记录12个月内COPD急性发作次数。结果干预组入组前FEV1[(1.63±0.39)L]、FEV1%[(59.90±7.62)]、SGRQ评分[(35.6±14.1)分]与对照组[(1.71±0.68)L、(59.18±6.01)%、(34.5±11.8)分]比较差异无统计学意义(P>0.05);干预组干预12个月后FEV1[(2.19±0.51)L]、FEV1%[(62.27±5.72)]高于入组时及对照组[FEV1(1.69±0.57)L、FEV1%(58.39±5.98)],SGRQ评分[(29.6±11.5)分]低于入组时及对照组[(35.1±10.2)分],12个月内COPD急性发作次数[(0.79±0.12)次]低于对照组[(1.56±0.23)次],差异均有统计学意义(P<0.05)。结论综合性行为干预措施可延缓COPD患者疾病进展,减少急性发作次数,提高患者生活质量。
Objective To observe the effect of comprehensive behavioral intervention on the progression of the disease in patients with chronic obstructive pulmonary disease (COPD). Methods 100 patients with grade Ⅰ ~ Ⅱ COPD under Global Initiative for Chronic Obstructive Lung Disease (GOLD) were randomly divided into intervention group and control group (50 cases each). The intervention group was given individual comprehensive intervention program, Including health education, smoking cessation and sports training, etc. The control group did not give any interventions. The forced expiratory volume in one second (FEV1) and the percentage of predicted FEV1 (FEV1%) in two groups were measured at admission and 12 months after intervention respectively. The scores of St. George’s Respiratory Questionnaire (St. George’s Respiratory Questionnaire, SGRQ) to assess the patient’s quality of life and record the number of acute exacerbations of COPD within 12 months. Results Before intervention, FEV1 (1.63 ± 0.39) L, FEV1% (59.90 ± 7.62), SGRQ score (35.6 ± 14.1) and control group (1.71 ± 0.68) L and (59.18 ± (P <0.05). After intervention for 12 months, FEV1 [(2.19 ± 0.51) L] and FEV1% [(62.27 ± 5.72)] were significantly higher in intervention group than those in control group (6.01% vs 34.5 ± 11.8) The mean score of SGRQ score was (29.6 ± 11.5) points lower than that of control group [(FEV1 (1.69 ± 0.57) L, FEV1% (58.39 ± 5.98)] and control group [ ], The number of acute exacerbations of COPD within 12 months [(0.79 ± 0.12) times] was lower than that of the control group [(1.56 ± 0.23) times], the difference was statistically significant (P0.05). Conclusion Comprehensive behavioral interventions can delay the disease progression in patients with COPD, reduce the number of acute attacks and improve the quality of life of patients.