“三级医院-社区卫生服务机构-家庭医护人员/患者参与慢阻肺环形管理”模式治疗慢性阻塞性肺疾病的疗效评价

Cuiling Feng, Yufeng Meng, Jian-hui Wang, Zhiyun Yang, Wei Zhou, Yun-sheng Gao, Xiaoqin Yao, Guang-jun Xue, Xiaotian Liu, Lei Li, Linyang Wang, Chengxiang Wang, Fengsen Li
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引用次数: 1

摘要

目的:评价“三级医院-社区卫生服务机构-家庭医护人员/患者参与慢阻肺环形管理”模式治疗慢阻肺的疗效。方法:邀请516例处于病情稳定期的COPD患者参加本组随机分组试验,试验组260例,对照组256例。所有患者均采用常规药物治疗。试验组的综合干预包括教育活动、体育活动和药物治疗。同时,试验组根据自身情况分为八段锦组和其他运动组,分析COPD评估试验(CAT)、改良医学研究会呼吸困难量表(mMRC)、急性加重次数和肺活量测定。结果:环形治疗12个月后,治疗组患者CAT评分下降3.76,mMRC量表下降0.45,两次以内急性加重次数增加到75%,优于对照组([公式:见正文])。八段锦组的CAT和mMRC量表得分下降幅度远大于其他运动亚组([公式:见正文])。结论:“三级医院-社区卫生服务机构-家庭医护人员/患者参与慢阻肺环形管理”模式可以缓解慢阻肺稳定期患者的症状,提高生活质量,降低病情恶化的风险,且比药物管理更为一体化。八段锦作为具有中国特色的肺部康复运动,由于其在提高生活质量方面比体育运动更突出,值得进一步推广。
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Evaluation of the curative effect of “Tertiary hospitals–Community Health Service Institutions–Family health care workers/Patients to participate in the annular management of COPD” model in the treatment of chronic obstructive pulmonary disease
Objective: To evaluate the curative effect of “Tertiary hospitals–Community Health Service Institutions–Family health care workers/patients to participate in the annular management of COPD” model in the treatment of chronic obstructive pulmonary disease (COPD). Methods: 516 patients with COPD in the stable period of the disease were invited to participate in this cluster randomized trial with 260 patients in the trial group, and the other 256 in the control group. All the patients were treated with the routine medicine regimen. The integrated intervention for the trial group includes educational activity, physical activity and pharmacotherapy. Meanwhile, the trial group subdivided into Baduanjin group and other exercises group according to their own situations, COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) Dyspnea Scale, number of acute exacerbation and spirometry were analyzed before, 6 months post and 12 months post. Results: After 12 months of annular management, CAT score of patients in the management group decreased 3.76, mMRC scale decreased 0.45, the number of acute exacerbation less than twice increased to 75%, which were superior to those of the control group ([Formula: see text]). Decreasing score of CAT and mMRC scale in Baduanjin group were much more than that in other exercise subgroup ([Formula: see text]). Conclusion: “Tertiary hospitals–Community Health Service Institutions–Family health care workers/patients to participate in the annular management of COPD” model can alleviate the symptoms of patients with stable COPD, improve the life quality and reduce the risk of exacerbation, and is more integrated than medication management. Baduanjin as Chinese characteristic pulmonary rehabilitation exercise is worthy of further promotion due to better outstanding other than sports in improving the quality of life.
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