多光谱照射联合常规治疗在慢性阻塞性肺疾病急性加重期患者中的临床应用

doi:10.3969/j.issn.1004-583X.2025.01.004

摘要/Abstract

摘要：

目的探究多光谱照射联合常规治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)的疗效。方法选取2022年1月至2023年11月就诊于河北省人民医院的AECOPD患者86例,根据随机数字表法分为观察组(n=42)和对照组(n=44)。对照组应用常规治疗,观察组在常规治疗的基础上,应用多光谱照射治疗。比较两组治疗前后24 h内临床资料差异。结果治疗后两组改良呼吸困难指数量表评分、碱性磷酸酶、血清淀粉样蛋白A、白细胞、中性粒细胞绝对值、6 min步行试验、维生素D、Ca²⁺、氧合指数差异均有统计学意义(P<0.05),慢性阻塞性肺疾病全球倡议肺功能分级、C-反应蛋白、第1秒用力呼气容积占用力肺活量的百分比、一秒用力呼气容积占预计值的百分比、P⁵⁺、嗜酸性粒细胞差异均无统计学意义(P>0.05)。结论多光谱照射联合常规治疗应用于AECOPD患者,能够更好地增加患者机体的氧含量,改善患者呼吸困难的主观感受,提高患者维生素D水平,增强患者的运动耐力,更好地控制炎症反应。

关键词: 肺疾病, 慢性阻塞性, 物理治疗, 多光谱照射治疗, 维生素D

Abstract:

Objective To investigate the efficacy of multispectral irradiation combined with conventional therapy on the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 86 patients with AECOPD who were treated in Hebei General Hospital from January 2022 to November 2023 were selected and divided into observation group (n=42) and control group (n=44) according to a random number table. Patients in the control group were treated with conventional therapy, and those in the observation group were treated with multispectral irradiation plus conventional therapy. The clinical data within 24 hours before and after treatment were compared between the two groups. Results There were significant differences in the modified medical research council score, alkaline phosphatase, serum amyloid A, white blood cell, absolute neutrophil count, 6-meter walking test, vitamin D, Ca²⁺, and oxygenation index between groups after treatment (P<0.05), while there were no significant differences in the Global Initiative for Chronic Obstructive Lung Disease grading, C-reactive protein, forced expiratory volume in one second/forced vital capacity, forced expiratory volume in 1 second percentage of predicted, P⁵⁺, and eosinophil(P>0.05). Conclusion The application of multispectral irradiation combined with conventional therapy on AECOPD patients can better increase their oxygen content, subjective perception of breathing difficulties, vitamin D levels, exercise endurance, and inflammatory response.

Key words: pulmonary disease, chronic obstructive, physical therapy, multispectral irradiation therapy, vitamin D

中图分类号:

R563.9

周智明, 茹意, 李萍, 平芬. 多光谱照射联合常规治疗在慢性阻塞性肺疾病急性加重期患者中的临床应用[J]. 临床荟萃, 2025, 40(1): 27-32.

Zhou Zhiming, Ru Yi, Li Ping, Ping Fen. Clinical application of multispectral irradiation combined with conventional therapy on acute exacerbation of chronic obstructive pulmonary disease[J]. Clinical Focus, 2025, 40(1): 27-32.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2025.01.004

https://huicui.hebmu.edu.cn/CN/Y2025/V40/I1/27

图/表 3

表1 两组一般资料比较

Tab.1 General information between groups

组别	例数	年龄(岁)	性别[例(%)]		身高(m)	体重(kg)	BMI(kg/m²)
组别	例数	年龄(岁)	男性	女性	身高(m)	体重(kg)	BMI(kg/m²)
观察组	42	70.00(64.00,74.00)	31(73.8)	11(26.2)	1.65±0.08	65.30±13.33	24.02±4.55
对照组	44	70.00(64.75,73.25)	35(79.5)	9(20.5)	1.67±0.08	65.35±12.91	23.49±3.95
$Z$ /χ²/ $t$ 值		-0.113	0.396		-0.876	0.104	0.620
$P$ 值		0.910	0.529		0.384	0.918	0.537

表1 两组一般资料比较

Tab.1 General information between groups

组别	例数	年龄(岁)	性别[例(%)]		身高(m)	体重(kg)	BMI(kg/m²)
组别	例数	年龄(岁)	男性	女性	身高(m)	体重(kg)	BMI(kg/m²)
观察组	42	70.00(64.00,74.00)	31(73.8)	11(26.2)	1.65±0.08	65.30±13.33	24.02±4.55
对照组	44	70.00(64.75,73.25)	35(79.5)	9(20.5)	1.67±0.08	65.35±12.91	23.49±3.95
$Z$ /χ²/ $t$ 值		-0.113	0.396		-0.876	0.104	0.620
$P$ 值		0.910	0.529		0.384	0.918	0.537

表2 两组治疗前后病情严重程度比较

Tab.2 The severity of disease between groups before and after treatment

组别	例数		mMRC量表评分(分)		6MWT(m)				FEV₁/FVC
组别	例数		治疗前	治疗后	治疗前		治疗后		治疗前		治疗后
观察组	42		3(3,3)	3(2,3)^*	226.90±60.74		306.43±73.49^*		0.46±0.11		0.50±0.14^*
对照组	44		3(3,3)	3(3,3)	210.24±88.30		216.50(169.25,303.50)^*		0.48±0.12		0.48±0.11
$Z$ / $t$ 值			-1.260	-2.728	0.798		-3.858		-0.736		1.006
$P$ 值			0.208	0.006	0.427		<0.001		0.463		0.317
组别		FEV₁%pred						GOLD分级
组别		治疗前				治疗后		治疗前		治疗后
观察组		40.70(36.48,43.90)				46.30(38.78,54.83)^*		3(3,3)		3(2,3)^*
对照组		40.60(36.11,49.70)				43.45(38.26,57.70)^*		3(2.75,3)		3(2,3)
$Z$ / $t$ 值		-0.436				-0.799		-1.037		-0.518
$P$ 值		0.663				0.424		0.300		0.605

表2 两组治疗前后病情严重程度比较

Tab.2 The severity of disease between groups before and after treatment

组别	例数		mMRC量表评分(分)		6MWT(m)				FEV₁/FVC
组别	例数		治疗前	治疗后	治疗前		治疗后		治疗前		治疗后
观察组	42		3(3,3)	3(2,3)^*	226.90±60.74		306.43±73.49^*		0.46±0.11		0.50±0.14^*
对照组	44		3(3,3)	3(3,3)	210.24±88.30		216.50(169.25,303.50)^*		0.48±0.12		0.48±0.11
$Z$ / $t$ 值			-1.260	-2.728	0.798		-3.858		-0.736		1.006
$P$ 值			0.208	0.006	0.427		<0.001		0.463		0.317
组别		FEV₁%pred						GOLD分级
组别		治疗前				治疗后		治疗前		治疗后
观察组		40.70(36.48,43.90)				46.30(38.78,54.83)^*		3(3,3)		3(2,3)^*
对照组		40.60(36.11,49.70)				43.45(38.26,57.70)^*		3(2.75,3)		3(2,3)
$Z$ / $t$ 值		-0.436				-0.799		-1.037		-0.518
$P$ 值		0.663				0.424		0.300		0.605

表3 两组治疗前后实验室资料比较

Tab.3 Laboratory data between groups before and after treatment

组别	例数		VD(ng/ml)						Ca²⁺(mmol/L)							P⁵⁺(mmol/L)
组别	例数		治疗前			治疗后			治疗前				治疗后			治疗前			治疗后
观察组	42		19.08±4.97			24.12±4.98^*			2.15(2.08,2.22)				2.26±0.09^*			1.12±0.19			1.21±0.22^*
对照组	44		20.19±5.62			18.32±5.14^*			2.19(2.10,2.25)				2.15(2.07,2.27)^*			1.11±0.21			1.10±0.24
$Z$ / $t$ 值			-1.218			4.992			-1.505				-3.644			-0.250			1.555
$P$ 值			0.226			<0.001			0.132				<0.001			0.803			0.124
组别	ALP(U/L)							OI(mmHg)							CRP(mg/L)
组别	治疗前				治疗后			治疗前			治疗后				治疗前			治疗后
观察组	69.10(56.83,81.03)				59.70(53.15,69.68)^*			328.95±47.67			413.45±46.48^*				17.99(6.82,41.32)			2.78(1.46,4.27)^*
对照组	70.55±19.04				70.05±16.70			338.00±51.51			355.00±42.47^*				9.11(0.92,23,96)			3.00(0.72,17.18)^*
$Z$ / $t$ 值	-0.251				-2.402			-0.979			5.847				-1.858			-0.658
$P$ 值	0.802				0.016			0.330			<0.001				0.063			0.511
组别		SAA(mg/L)					WBC(×10⁹/L)					ANC(×10⁹/L)					EOS(%)
组别		治疗前		治疗后			治疗前			治疗后		治疗前		治疗后			治疗前			治疗后
观察组		46.08 (15.04,88.55)		2.62 (1.68,4.26)^*			9.05±3.01			6.11 (4.64,7.85)^*		6.91±2.84		3.94 (2.97,5.28)^*			0.85 (0.10,2.15)			2.40 (1.08,3.43)^*
对照组		14.14 (2.30,77.03)		8.09 (1.74,56.94)^*			7.32 (6.12,9.52)			7.05 (5.78,9.13)		5.58 (3.90,7.72)		4.83 (3.76,6.40)^*			1.25 (0.38,2.73)			1.55 (0.28,3.48)
$Z$ / $t$ 值		-1.629		-2.393			-1.654			-2.626		-1.391		-2.307			-1.283			-1.504
$P$ 值		0.103		0.017			0.098			0.009		0.164		0.021			0.200			0.133

表3 两组治疗前后实验室资料比较

Tab.3 Laboratory data between groups before and after treatment

组别	例数		VD(ng/ml)						Ca²⁺(mmol/L)							P⁵⁺(mmol/L)
组别	例数		治疗前			治疗后			治疗前				治疗后			治疗前			治疗后
观察组	42		19.08±4.97			24.12±4.98^*			2.15(2.08,2.22)				2.26±0.09^*			1.12±0.19			1.21±0.22^*
对照组	44		20.19±5.62			18.32±5.14^*			2.19(2.10,2.25)				2.15(2.07,2.27)^*			1.11±0.21			1.10±0.24
$Z$ / $t$ 值			-1.218			4.992			-1.505				-3.644			-0.250			1.555
$P$ 值			0.226			<0.001			0.132				<0.001			0.803			0.124
组别	ALP(U/L)							OI(mmHg)							CRP(mg/L)
组别	治疗前				治疗后			治疗前			治疗后				治疗前			治疗后
观察组	69.10(56.83,81.03)				59.70(53.15,69.68)^*			328.95±47.67			413.45±46.48^*				17.99(6.82,41.32)			2.78(1.46,4.27)^*
对照组	70.55±19.04				70.05±16.70			338.00±51.51			355.00±42.47^*				9.11(0.92,23,96)			3.00(0.72,17.18)^*
$Z$ / $t$ 值	-0.251				-2.402			-0.979			5.847				-1.858			-0.658
$P$ 值	0.802				0.016			0.330			<0.001				0.063			0.511
组别		SAA(mg/L)					WBC(×10⁹/L)					ANC(×10⁹/L)					EOS(%)
组别		治疗前		治疗后			治疗前			治疗后		治疗前		治疗后			治疗前			治疗后
观察组		46.08 (15.04,88.55)		2.62 (1.68,4.26)^*			9.05±3.01			6.11 (4.64,7.85)^*		6.91±2.84		3.94 (2.97,5.28)^*			0.85 (0.10,2.15)			2.40 (1.08,3.43)^*
对照组		14.14 (2.30,77.03)		8.09 (1.74,56.94)^*			7.32 (6.12,9.52)			7.05 (5.78,9.13)		5.58 (3.90,7.72)		4.83 (3.76,6.40)^*			1.25 (0.38,2.73)			1.55 (0.28,3.48)
$Z$ / $t$ 值		-1.629		-2.393			-1.654			-2.626		-1.391		-2.307			-1.283			-1.504
$P$ 值		0.103		0.017			0.098			0.009		0.164		0.021			0.200			0.133

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