南方医科大学学报2016，Vol.36Issue(8)：1069-1074,6.DOI:10.3969/j.issn.1673-4254.2016.08.07
呼吸肌肉锻炼加序贯无创正压通气在稳定期重度慢阻肺患者中的应用：临床随机对照试验
Inspiratory muscle training followed by non- invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease:a randomized controlled trial
摘要
Abstract
Objective To investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD). Methods This investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function. Results Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05). Conclusion Inspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.关键词
慢性阻塞性肺疾病/无创正压通气/呼吸肌肉锻炼/肺康复Key words
chronic obstructive pulmonary disease/noninvasive ventilation/inspiratory muscle training/pulmonary rehabilitation引用本文复制引用
周露茜,黎晓莹,李允,郭炳鹏,关力理,陈新,罗裕文,罗鹏,陈荣昌..呼吸肌肉锻炼加序贯无创正压通气在稳定期重度慢阻肺患者中的应用：临床随机对照试验[J].南方医科大学学报,2016,36(8):1069-1074,6.基金项目
国家自然科学基金（81361128004）；广东省科技厅公益研究与能力建设专项资金项目（2014A020215033）；广州医科大学科研基金（2014c22）Supported by National Natural Science Foundation of China (81361128004) （81361128004）
