Evaluation of the effect of graded exercise rehabilitation on patients with acute exacerbation of chronic obstructive pulmonary disease

doi:10.3761/j.issn.0254-1769.2025.09.006

Abstract

Abstract:

Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease，and to provide references for clinical nursing practice. Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group（with 35 cases in each group）. The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines，and the control group implemented routine exercise rehabilitation. After intervention，the lung function，blood gas analysis，oxygenation index，6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups. Results Finally，34 cases were included in the experimental group and 35 cases in the control group. After intervention，the forced expiratory volume in the first second of the experimental group was improved compared with the control group （P<0.05）. The 6-minute walking test of the experimental group was higher than that of the control group（P<0.05）. The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group（P<0.05）. There was no significant difference in blood gas analysis and oxygenation index between the 2 groups（P<0.05）. Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function，improve their exercise endurance，and reduce non-invasive mechanical ventilation-related complications.

Key words: Acute Exacerbation, Pulmonary Disease，Chronic Obstructive, Graded Exercise Rehabilitation, Nursing Care

摘要：

目的探讨分级运动康复对慢性阻塞性肺疾病急性加重期患者的影响，为临床护理实践提供参考。方法采用便利抽样法，选取2023年9月—12月遵义市某三级甲等医院呼吸内科的70例慢性阻塞性肺疾病急性加重期患者为研究对象，随机分为试验组和对照组（每组各35例），试验组实施基于“全球慢性阻塞性肺疾病倡议指南2023版”下的分级运动康复，对照组实施常规运动康复，两组均干预至出院。干预后，比较两组肺功能、血气分析、氧合指数、运动耐力、无创机械通气相关并发症发生率。结果最终试验组纳入34例，对照组纳入35例。干预后，试验组第1秒用力呼气容积较对照组有所改善（P<0.05）；试验组6 min步行试验距离优于对照组（P<0.05）；试验组无创机械通气相关并发症总发生率较对照组低（P<0.05）；两组血气分析、氧合指数比较，差异无统计学意义（P>0.05）。结论实施基于全球慢阻肺倡议指南下的分级运动康复能帮助慢性阻塞性肺疾病急性加重期患者改善呼吸功能，提高运动耐力，减少无创机械通气相关并发症的发生。

关键词: 急性加重期, 肺疾病，慢性阻塞性, 分级运动康复, 护理

YANG Nana, CHENG Chuanli, ZENG Hui, FU Dandan, WANG Yan, CHEN Yue, RAN Hongmin, FAN Hongjing, LONG Xia. Evaluation of the effect of graded exercise rehabilitation on patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2025, 60(9): 1062-1067.

杨娜娜, 程传丽, 曾慧, 符丹丹, 王燕, 陈悦, 冉宏敏, 范红静, 龙霞. 分级运动康复对慢性阻塞性肺疾病急性加重期患者的效果评价[J]. 中华护理杂志, 2025, 60(9): 1062-1067.

Figures/Tables 5

Table 1 Graded exercise rehabilitation for patients with AECOPD

Table 2 Comparison of general data between the 2 groups[case（percentage，%）]

Table 3 Comparison of pulmonary function between the 2 groups after intervention（$\bar{x} \pm s$）

Table 4 Comparison of blood gas analysis and oxygenation index between the 2 groups（mmHg，$\bar{x} \pm s$）

Table 5 Comparison of 6-minute walking distance between the 2 groups before and after intervention （m，$\bar{x} \pm s$）

References 17

[1]	中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会, 陈荣昌, 等. 慢性阻塞性肺疾病诊治指南(2021年修订版)[J]. 中华结核和呼吸杂志, 2021, 44(3):170-205.
	Chronic Obstructive Pulmonary Disease Group of the Respiratory Medicine Branch of the Chinese Medical Association,Chronic Obstructive Pulmonary Disease Working Committee of the Respiratory Medicine Branch of the Chinese Medical Doctor Association, Chen RC, et al. Guidelines for the diagnosis and management of chronic obstructive pulmonary disease(revised version 2021)[J]. Chin J Tuberc Respir Dis, 2021, 44(3):170-205.
[2]	Yang T, Cai BQ, Cao B, et al. Exacerbation in patients with stable COPD in China:analysis of a prospective,52-week,nationwide,observational cohort study(REAL)[J]. Ther Adv Respir Dis, 2023,17:17534666231167353.
[3]	陈庆梅, 崔妙玲, 麻月娥, 等. 慢性阻塞性肺疾病急性加重期患者症状群及前哨症状的调查研究[J]. 中华护理杂志, 2022, 57(23):2891-2897. DOI
	Chen QM, Cui ML, Ma YE, et al. Investigation of symptom clusters and sentinel symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Chin J Nurs, 2022, 57(23):2891-2897. DOI
[4]	谭春苗, 姜芬, 王小环, 等. 多组分运动训练方案对老年COPD病人四肢骨骼肌功能的影响[J]. 护理研究, 2023, 37(22):4106-4110.
	Tan CM, Jiang F, Wang XH, et al. Effect of multi-component exercise training program on appendicular skeletal muscle function in elderly patients with COPD[J]. Chin Nurs Res, 2023, 37(22):4106-4110.
[5]	López-López L, Calvache-Mateo A, Rodríguez-Torres J, et al. A feasibility and efficacy randomized controlled trial of two exercise programs in severe AECOPD patients with resting hypoxemia[J]. Healthcare, 2021, 9(9):1102.
[6]	刘卫庭, 姚宇. 早期肺康复对慢性阻塞性肺疾病急性加重期患者肺功能及运动耐力的影响[J]. 中华物理医学与康复杂志, 2019, 41(3):213-216.
	Liu WT, Yao Y. Effect of early pulmonary rehabilitation on pulmonary function and exercise endurance in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Chin J Phys Med Rehabil, 2019, 41(3):213-216.
[7]	Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis,management and prevention of chro-nic obstructive pulmonary disease(2023 report)[EB/OL].(2023) [2023-11-15]. https://goldcopd.org/2022-gold-reports-2/.
[8]	武亮, 郭琪, 胡菱, 等. 中国呼吸重症康复治疗技术专家共识[J]. 中国老年保健医学, 2018, 16(5):3-11.
	Wu L, Guo Q, Hu L, et al. Chinese consensus of respiratory rehabilitation treatment experts[J]. Chin J Geriatr Care, 2018, 16(5):3-11.
[9]	张义静, 李娟, 孙丽, 等. 慢性阻塞性肺疾病患者早期简易肺康复方案的构建及应用[J]. 中华护理杂志, 2020, 55(5):690-695. DOI
	Zhang YJ, Li J, Sun L, et al. Construction of an early simple pulmonary rehabilitation programme for patients with COPD and its evaluation of effectiveness[J]. Chin J Nurs, 2020, 55(5):690-695. DOI
[10]	张钰, 刘元, 张文亮, 等. 短期肺康复程序对男性慢性阻塞性肺疾病急性加重期患者运动能力和生活质量的影响[J]. 中华物理医学与康复杂志, 2020, 42(2):146-151.
	Zhang Y, Liu Y, Zhang WL, et al. The effect of short-term pulmonary rehabilitation on the exercise ability and life quality of male patients with acute exacerbations of chronic obstructive pulmonary disease[J]. Chin J Phys Med Rehabil, 2020, 42(2):146-151.
[11]	杨莉, 冯小利, 潘海燕, 等. 慢性阻塞性肺疾病急性加重期患者应用呼吸康复干预对其肺功能的影响[J]. 山西医药杂志, 2022, 51(1):104-107.
	Yang L, Feng XL, Pan HY, et al. Effect of respiratory rehabilitation intervention on pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Shan-xi Med J, 2022, 51(1):104-107.
[12]	Figueiredo RIN, Azambuja AM, Cureau FV, et al. Inspiratory muscle training in COPD[J]. Respir Care, 2020, 65(8):1189-1201. DOI PMID
[13]	Marillier M, Bernard AC, Vergès S, et al. Locomotor muscles in COPD:the rationale for rehabilitative exercise training[J]. Front Physiol, 2020,10:1590.
[14]	Silva BSA, Lira FS, Rossi FE, et al. Inflammatory and metabolic responses to different resistance training on chronic obstructive pulmonary disease:a randomized control trial[J]. Front Physiol, 2018,9:262.
[15]	Matthew Nicklas J, Gordon AE, Henke PK. Resolution of deep venous thrombosis:proposed immune paradigms[J]. Int J Mol Sci, 2020, 21(6):2080.
[16]	李有霞, 郑则广, 刘妮, 等. 慢性阻塞性肺疾病住院患者误吸与远期生存的相关性分析[J]. 中华结核和呼吸杂志, 2021, 44(9):800-805.
	Li YX, Zheng ZG, Liu N, et al. Correlation between aspiration and long-term survival of inpatients with chronic obstructive pulmonary disease[J]. Chin J Tuberc Respir Dis, 2021, 44(9):800-805.
[17]	Keirns BH, Koemel NA, Sciarrillo CM, et al. Exercise and intestinal permeability:another form of exercise-induced hormesis?[J]. Am J Physiol Gastrointest Liver Physiol, 2020, 319(4):G512-G518.