天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (8): 1010-1014.doi: 10.11958/20150401

• 临床研究 • 上一篇    下一篇

不同时期施行肺康复对COPD 患者抑郁及焦虑的改善效果比较

李毅， 李月川△   

  1. 天津市胸科医院呼吸与危重症科 （邮编300222）
  • 收稿日期:2015-12-16 修回日期:2016-03-24 出版日期:2016-08-15 发布日期:2016-08-22
  • 通讯作者: 李月川 E-mail: liyuechuandoctor@126.com E-mail:lisalie5252@hotmail.com
  • 作者简介:李毅 （1980）， 男， 主治医师， 硕士， 主要从事慢性阻塞性肺疾病诊治方面研究
  • 基金资助:
    天津市科技计划项目 （13ZCZDSY02000）

Comparison of effects of pulmonary rehabilitation on depression and anxiety at different stages in patients with chronic obstructive pulmonary disease

LI Yi, LI Yuechuan△   

  1. Department of Respiratory Intensive Care Unit, Tianjin Chest Hospital, Tianjin 300222, China
  • Received:2015-12-16 Revised:2016-03-24 Published:2016-08-15 Online:2016-08-22
  • Contact: LI Yuechuan E-mail: liyuechuandoctor@126.com E-mail:lisalie5252@hotmail.com

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摘要： 摘要： 目的 比较不同时期施行肺康复方案对慢性阻塞性肺疾病 （COPD） 患者抑郁及焦虑的影响。方法 天津市胸科医院呼吸与危重症科因 COPD 急性加重住院患者 97 例， 随机分为稳定期康复组 （稳定期组， 39 例） 及加重期康复组 （加重期组， 58 例）； 2 组患者均在急性期症状好转及急性期感染控制后 （T1） 进行基线评估， 加重期组立即行 12 周 （T2） 肺康复训练； 稳定期组患者在此期间仅接受常规药物治疗及肺康复宣教， 至症状缓解并维持稳定 12 周（T2） 进行第 2 次基线评估， 随后开始进行 12 周 （T3） 肺康复训练。观察 2 组患者在不同时期的抑郁评分及焦虑评分的变化。结果 2 组患者在 T1 时期的社会人口学基线资料比较差异无统计学意义 （均 P＞0.05）。组内比较， 稳定期组患者贝克抑郁自评量表 （BDI） 评分在 T3 时低于 T1 及 T2 （均 P＜0.05）， 但 T1 与 T2 比较， BDI 差异无统计学意义（P＞0.05）； 加重期组患者 BDI 评分在 T2 时低于 T1 （P＜0.05）。组间比较， 2 组患者 T1 时期的 BDI 评分差异无统计学意义 （P＞0.05）； 加重期组患者在 T2 时的 BDI 评分低于稳定期组 T2 及 T3 时期的 BDI 评分 （P＜0.05）， 差异均有统计学意义 （P＜0.05）。组内比较， 稳定期组患者焦虑-状态特质量表 （STAI） 评分在 T3 时低于 T1 及 T2 （均 P＜ 0.05）， 但 T1 与 T2 比较， STAI 评分差异无统计学意义 （P＞0.05）； 加重期组患者 STAI 评分在 T2 时低于 T1 （P＜ 0.05）。组间比较， 2 组患者 T1 时期的 STAI 评分差异无统计学意义 （P＞0.05）； 加重期组患者在 T2 时的 STAI 评分低于稳定期组 T2 时的 STAI 评分 （P＜0.05）， 而与稳定期组 T3 时的 STAI 评分比较差异无统计学意义 （P＞0.05）。结论 与稳定期肺康复相比， 急性加重期 COPD 患者进行早期的肺康复训练可以更早更好地改善抑郁及焦虑状态。

关键词: 肺疾病, 慢性阻塞性, 抑郁, 焦虑, 急性加重期, 肺康复

Abstract: Abstract: Objective To observe the effects of pulmonary rehabilitation (PR) on depression and anxiety at different stages of chronic obstructive pulmonary disease (COPD) patients. Methods Ninety-seven COPD patients hospitalized in Department of Respiratory Intensive Care Unit, Tianjin Chest Hospital, were randomly divided into two groups: control group (n=39) and acute exacerbation COPD (AECOPD) group (n=58). Patients in both groups were assessed for baseline date when symptoms were improved from acute phase (T1). Then patients in control group were received pharmaco- therapy and rehabilitation publicity without PR. When symptoms was relieved and stable (T2), patients were given 12-week PR (T3). The Beck depression inventory (BDI) scores and State- Trait Anxiety Inventory (STAI) scores were observed in both groups respectively. Results There were no statistics differences in baseline data in both groups (P＞0.05). In control group, the BDI score was significantly lower at T3 than that of T1 and T2 (F=5.309, P＜0.05). But there was no significant difference in BDI between T1 and T2 (P＞0.05). Similarly in AECOPD group, the BDI score was significantly lower at T2 than that of T1 (t=3.612, P＜0.05). At T1, there was no significant difference in BDI score between both groups (P＞0.05). At T2 the BDI score was significantly lower in AECOPD group than that of control group, and also which was lower than that of T3 of control group (P＜0.05). In control group, the STAI score was significantly lower at T3 than that of T1 and T2 (F=9.852, P＜0.05), but there was no significant difference in STAI between T1 and T2 (P＞0.05). The STAI score was significantly lower in T2 than that of T1 in AECOPD group (t=5.091, P＜0.05). There was no significant difference in STAI score at T1 between two groups (P＞0.05). There was significantly lower STAI score at T2 in AECOPD group than that of control group (P＜0.05), while there was no significant difference in STAI score at T3 between two groups (P＞0.05). Conclusion Pulmonary rehabilitation at early stage may reduce the degree of depression and anxiety in AECOPD patients.

Key words: pulmonary disease, chronic obstructive, depression, anxiety, exacerbation, pulmonary rehabilitation