作者：廖佳星1，龚放华1，熊子欣1，马文婷2，方群垚2，龙微2

单位：

1.410005 湖南省长沙市，湖南省人民医院2.410081 湖南省长沙市，湖南师范大学

Units：

1.The People's Hospital of Hunan Province, Changsha 410005, China2.Hunan Normal University, Changsha 410081, China

关键词：

　慢性阻塞性肺疾病；稳定期；老年人；正念减压疗法；肺康复训练；疲劳；心肺功能

Keywords：

Chronic obstruction pulmonary disease; Stable period; Aged; Mindfulness-based stress reduction;Pulmonary rehabilitation; Fatigue; Cardiorespiratory function

CLC：

R 563.9

DOI：

10.12114/j.issn.1008-5971.2021.00.153

Funds：

湖南省自然科学基金科卫联合项目（2018JJ6019）；湖南省卫生健康委科研计划项目（20200347）

摘要：

背景　研究表明，50%~70% 的慢性阻塞性肺疾病（COPD）患者伴有疲劳感，故减轻疲劳也是COPD 患者的主要治疗目的之一。肺康复训练可以增加肌肉耐力，减轻呼吸困难，提高心肺功能；正念减压疗法可以疏散压 力、管理情绪、改善疲劳。但正念减压疗法联合肺康复训练治疗COPD 的相关研究报道较少。目的　探讨正念减压疗 法联合肺康复训练对老年COPD 稳定期患者疲劳程度及心肺功能的影响。方法　采用方便抽样法，选取2018 年6 月— 2019 年7 月湖南省人民医院呼吸内科收治的80 例老年COPD 稳定期患者作为研究对象，根据计算机随机编码将其分 为对照组（n=40）和观察组（n=40）。对照组患者采用常规护理及健康指导，观察组患者在此基础上给予正念减压疗 法联合肺康复训练。比较两组患者干预前及干预后12 周多维疲劳量表（MFI-20）评分、肺功能指标〔包括第1 秒用 力呼气容积占预计值的百分比（FEV1%）、呼气峰值流速（PEF）及用力肺活量（FVC）〕及6 min 步行距离（6MWD）。 结果　观察组患者干预后12 周综合疲劳、体力疲劳、活动减少、动力下降、脑力疲劳评分及MFI-20 总分低于对照组 （P ＜ 0.05）。观察组患者干预后12 周FEV1% 高于对照组，PEF、FVC 大于对照组，6MWD 长于对照组（P ＜ 0.05）。 结论　正念减压疗法联合肺康复训练能有效减轻老年COPD 稳定期患者疲劳程度，改善患者心肺功能。

Abstract：

　Background　Studies have shown that 50%-70% of patients with chronic obstructive pulmonary disease (COPD) had fatigue, so reducing fatigue is one of the main treatment purposes of COPD patients. Pulmonary rehabilitation can increase muscle endurance, relieve dyspnea and improve cardiopulmonary function; mindfulness-based stress reduction can relieve stress, managing emotions and improve fatigue. However, there are few reports about mindfulness-based stress reduction combined with pulmonary rehabilitation in the treatment of COPD. Objective　To explore the impact of mindfulness-based stress reduction combined with pulmonary rehabilitation on the fatigue and cardiorespiratory function in elderly patients with stable COPD. Methods　Using convenience sampling method, 80 elderly patients with stable COPD admitted to the Department of Respiratory Medicine, the People's Hospital of Hunan Province from June 2018 to July 2019 were selected as the research objects. They were randomly divided into control group (n=40) and observation group (n=40) by computer random coding. The control group was given routine nursing and health guidance, while the observation group was given mindfulness-based stress reduction combined with pulmonary rehabilitation based on the control group. The score of Multi Dime-nsional Fatigue Inventory 20 (MFI-

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