Effects of bundled pulmonary rehabilitation on pulmonary function and inflammatory factors in patients with moderate or severe stable chronic obstructive pulmonary disease / 中国医师进修杂志

ABSTRACT

Objective:To observe the effects of bundled pulmonary rehabilitation on static pulmonary function, cardiopulmonary exercise function and inflammatory factors in patients with moderate or severe stable chronic obstructive pulmonary disease (COPD).Methods:Sixty moderate or severe COPD patients in stable phase from December 2017 to October 2018 in Affiliated Zhongshan Hospital of Dalian University were selected. The patients were divided into control group and rehabilitation group by random digits table with 30 cases each. The patients of control group received routine medicine therapy, and the patients of rehabilitation group received bundled pulmonary rehabilitation besides routine medicine therapy. Pulmonary function, cardiopulmonary exercise function and inflammatory factors in each group were tested before treatment and 3, 6 month after treatment.Results:In control group, there were no statistical differences in the pulmonary function, including the forced expired volume in one second (FEV 1), FEV 1 as percentage of predicted (FEV 1%pred), FEV 1/forced vital capacity (FVC); cardiopulmonary exercise function, including the peak load, peak VO 2, peak VO 2 as percentage of predicted (peak VO 2% pred), peak VO 2/kg, peak VE 3 and 6 months after treatment compared with those before treatment ( P>0.05); in rehabilitation group, there were no statistical differences in the indexes 3 months after treatment compared with those before treatment ( P>0.05), the indexes 6 months after treatment were significantly improved compared with those before treatment and 3 months after treatment ( P < 0.05). In control group, the C-reactive protein (CRP) and interleukin (IL-6) before treatment and 3 months after treatment and tumor necrosis factor-α (TNF-α) before treatment and 3, 6 months after treatment had no significant difference ( P > 0.05); the CRP and IL-6 6 months after treatment were significantly lower than those before treatment and 3 months (5.48 ± 0.91) mg/L vs. (6.26 ± 0.99) and (6.09 ± 0.97) mg/L, (9.17 ± 1.04) ng/L vs. (10.83 ± 1.79) and (10.29 ± 1.53) ng/L, P < 0.05. In rehabilitation group, the CRP, IL-6 and TNF-α 3 and 6 months after treatment were significantly lower than previous phase (5.21 ± 0.87) and (5.67 ± 0.91) mg/L vs. (6.15 ± 0.92) mg/L, (8.56 ± 1.17) and (10.03 ± 1.61) ng/L vs. (11.06 ± 2.01) ng/L, (7.16 ± 1.33) and (8.05 ± 1.62) ng/L vs. (8.97 ± 2.05) ng/L, P < 0.05. In rehabilitation group, the CRP, IL-6 and TNF-α before and after treatment were negatively correlated with pulmonary function (FEV 1, FEV 1% pred and FEV 1/FVC) and cardiopulmonary exercise function (peak load, peak VO 2, peak VO 2% pred, peak VO 2/kg and peak VE) ( r=- 0.641 to - 0.884, P < 0.01). Conclusions:Bundled pulmonary rehabilitation in patients with moderate or severe stable COPD can improve pulmonary function and cardiopulmonary exercise function and reduce inflammatory factors.