摘要
目的探讨慢性病管理对慢性阻塞性肺疾病(COPD)患者的肺功能(FEV_1、FEV_1pred%)、圣乔治呼吸问卷评分(SGRQ评分)及急性加重次数的影响。方法选取本院经肺功能检查确诊且处于临床稳定期的COPD患者256例,随机分为慢性病管理组和自然病程对照组。依照2015年GOLD进行综合评估,将患者分为A、B、C、D四个亚组,进行SGRQ评分。每三个月随访一次,患者的病情、药物应用情况均记入各自的病历档案。慢性病管理组患者进行六期COPD相关知识集中培训,和吸烟者共同制订戒烟策略,给予规范药物治疗方案,指导患者康复锻炼。自然病程对照组仅记录病情变化及药物应用情况,不加以干预。两组患者管理持续时间为一年。比较分析两组患者及A、B、C、D四个亚组患者肺功能、SGRQ评分及急性加重次数。结果两组患者慢性病管理前后肺功能、SGRQ评分无显著差异,管理组急性加重次数明显少于对照组。四个亚组患者比较分析表明A组患者肺功能、SGRQ评分较前无显著改变;管理组的B组、C组患者肺功能、SGRQ评分较前显著改善,对照组的B组、C组患者肺功能、SGRQ评分较前恶化,但变化不显著;D组患者肺功能较前均显著下降,管理组的SGRQ评分较前增加,但无显著性改变,对照组SGRQ评分较前显著增加,两组患者SGRQ评分比较差异无显著性。B组、C组患者急性加重次数管理组明显低于对照组,A组、D组患者急性加重次数管理组和对照组相比无显著差异。结论对COPD患者进行慢性病管理,未能显著改善其肺功能、SGRQ评分,但减少了急性加重次数;可以改善B组、C组患者的肺功能、SGRQ评分,减轻其症状、减少急性加重次数和提高生命质量,而对A组、D组患者无显著影响。
Objective To study the effects of chronic disease management on pulmonary function（ FEV_1,FEV_1 pred %）,St. George＇s respiration Questionnaire score（ SGRQ score） and acute exacerbation of chronic obstructive pulmonary disease（ COPD）. Methods 256 cases of COPD patients diagnosed by pulmonary function were randomly selected,and then randomly divided into the Chronic Disease management Group and the Natural Course control group. After the patients were enrolled,they were divided into four groups： A,B,C and D according to the combined evaluation of GOLD 2015,and the SGRQ score was also performed. Followed up every three months,the patient ＇s condition,drug applications were recorded in their respective medical records. Patients in chronic disease management group received six stages of COPD related knowledge training,and smokers work together to develop a smoking cessation strategy,according to the patient＇ s combined assessment of the group to give normative drug treatment program, guide patients rehabilitation exercise. The patients in the natural course control group only recorded the change of the condition and the application of the medicine,without intervention. Two groups of patients were administered for one year.The lung function,SGRQ score and exacerbation times of two groups of patients and four subgroups of A,B,C and D were compared and analyzed. Results there was no significant difference in lung function and SGRQ score between the two groups before and after the management of chronic diseases. The number of acute exacerbations in the management group was significantly less than that in the control group. A comparative analysis of the four subgroups of patients showed that the lung function and SGRQ score of Group A were not significantly changed; The lung function and SGRQ score of the Group B and C in the management group were significantly improved,and the lung function of Group B and C in the control group was lower than before,the SGRQ score was increased,but the change was not s
出处
《中华肺部疾病杂志（电子版）》
CAS
2017年第5期525-529,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金资助项目(81302016)
关键词
肺疾病
慢性阻塞性
患者教育
生活质量
随访研究
Pulmonary disease, chronic obstructive
Patient education
Quality of life
Follow-up study
