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基于mMRC分级制定的渐进性运动训练方案在基层医疗机构慢性阻塞性肺疾病患者呼吸康复中的应用

Application of progressive exercise training based on mMRC grading in respiratory rehabilitation for patients with chronic obstructive pulmonary disease in a primary healthcare setting

    摘要
  • 摘要:
    目的 探讨基于改良版英国医学研究委员会呼吸困难量表（modified Medical Research Council dyspnea scale, mMRC）分级制定的渐进性运动训练方案，在基层医疗机构慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）患者呼吸康复中的应用效果。
    方法 选择2022年8月1日至2024年7月30日在上海市闵行区颛桥社区卫生服务中心诊治的106例COPD患者作为研究对象，按1∶1随机分为试验组与对照组，每组53例。对照组给予常规治疗，试验组在常规治疗基础上联合基于mMRC分级制定的渐进性运动训练。持续治疗4周后，比较两组患者6分钟步行试验（6-minute walk test, 6MWT）距离、COPD评估测试（COPD assessment test, CAT）问卷评分、mMRC分级、慢性阻塞性肺疾病全球倡议（Global Initiative for Chronic Obstructive Lung Disease, GOLD）分级和肺功能等指标变化。
    结果 两组患者治疗后6MWT距离、CAT评分、mMRC分级、GOLD分级及肺功能指标均较治疗前改善（P＜0.05）；试验组6MWT距离、CAT评分、mMRC分级、GOLD分级及肺功能指标改善优于对照组（P＜0.05）。
    结论 基于mMRC分级制定的渐进性运动训练可以改善COPD患者呼吸康复效果，尤其能提高患者肺功能和活动耐量。

     

    Abstract:
    Objective To explore the efficacy of progressive exercise training based on the modified Medical Research Council dyspnea scale (mMRC) grading in respiratory rehabilitation for patients with chronic obstructive pulmonary disease (COPD) at a primary healthcare setting.
    Methods A total of 106 patients with COPD admitted to Zhuanqiao Community Health Service Center in Shanghai from Aug.1, 2022 to Jul. 30, 2024 were selected as research subjects. They were randomly divided into a study group and a control group in a 1∶1 ratio, with 53 patients in each group. The control group received conventional treatment, while the study group received conventional treatment combined with progressive exercise training. After 4 weeks of continuous treatment, the changes in the 6-minute walk test (6MWT), COPD assessment test (CAT) score, mMRC grading, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading and pulmonary function were compared between the two groups.
    Results Patients in both groups showed improvements in 6MWT distance, CAT score, mMRC grading, GOLD grading, and pulmonary function compared to baseline (P＜0.05). Moreover, the study group had better improvements in 6MWT distance, CAT score, mMRC grading, GOLD grading, and pulmonary function than the control group (P＜0.05).
    Conclusions Conventional treatment combined with progressive exercise training based on mMRC grading can enhance the effect of respiratory rehabilitation in patients with COPD, particularly in improving pulmonary function and exercise tolerance.

     

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