Effect Of Pulmonary Rehabilitation Training On Lung Function,Exercise Capacity And Quality Of Life In Patients With Advanced Non-Small Cell Lung Cancer

Objective:This study intervenes in patients with advanced non-small cell lung cancer through short-term and planned pulmonary rehabilitation training,and explores the impact of lung rehabilitation on improving the exercise ability and quality of life of lung cancer patients during chemo-therapy,with a view to promoting the promotion and research of non-drug treatment in lung cancer patients.Methods:From January 2020 to June 2021,86 patients with ad-vanced non-small cell lung cancer who were hospitalized for chemotherapy in the Affiliated Hospital of the Jining Medical College were randomly di-vided into rehabilitation group and control group,with 43 cases in each group.The control group was given“routine respiratory care+chemother-apy”.On the basis of chemotherapy,the patients in the experimental group intervened in combination with pulmonary rehabilitation training,includ-ing health education and dietary care for patients,and guided patients to perform a total of 30-60 minutes of aerobic exercise and respiratory muscle exercise every day.Patients were comprehensively evaluated using pulmo-nary function measurement,six-minute walking experiment,BODE multi-dimensional index,dyspnea scale（m MRC,Borg）,and quality of life ques-tionnaire（SF-36）after 8 weeks of treatment.Results:（1）Basic information of the study population:83 patients with NSCLC were finally included in this study,including 41 cases in the reha-bilitation group and 42 cases in the control group.The differences between the two groups in age,body mass index,smoking history,COPD history,disease type,stage,lung function（FEV₁,FVC,FEV₁/FVC,MVV）,six-minute walking distance,dyspnea index（m MRC,Borg score）,BODE,and SF-36 scores in each domain were not statistically significant（P<0.05）and were comparable.（2）Pulmonary function indices:intra-group comparison showed that the pulmonary function indices（FEV₁,FVC,FEV₁/FVC,MVV）were sig-nificantly higher in the rehabilitation group after 8 weeks of training com-pared with those before training（P<0.05）.The control group without reha-bilitation training showed an increasing trend in lung function indexes（FEV₁,FVC,FEV₁/FVC,MVV）after 8 weeks of treatment,but the differ-ence was not statistically significant（P>0.05）.Comparison between groups showed that the pulmonary function indices（FEV₁,FVC,FEV₁/FVC,MVV）were higher in the rehabilitation group than in the con-trol group after 8 weeks of training（P<0.05）.The differences in d FEV₁,d FVC,d FEV₁/FVC,and d MVV between the two groups were statistically significant（P<0.05）.（3）Degree of dyspnea:When comparing within groups,the dyspnea scores（m MRC and Borg scores）of patients in the rehabilitation and con-trol groups were significantly lower after 8 weeks of training（P<0.05）.When compared between groups,the dyspnea scores（m MRC and Borg scores）in the rehabilitation group were significantly lower than those in the control group after 8 weeks of training（P<0.05）.（4）Six-minute walking distance（6MWT）:compared within groups,the 6MWT was significantly higher in the rehabilitation group after 8weeks of training compared with that before training（P<0.05）.There was no significant increase in 6MWT in the non-rehabilitation control group after 8 weeks compared to before（P>0.05）.When compared between groups,the 6MWT after 8 weeks of training was significantly higher in the rehabilitation group than in the control group（P<0.05）,and the difference d6MWT between the two groups was statistically significant（P<0.05）.（5）BODE multidimensional scores:intra-group comparison showed that the BODE index of the rehabilitation group decreased significantly after 8 weeks of training（P<0.05）,while the BODE index of the control group did not decrease significantly（P>0.05）.Comparison between groups showed that the BODE index of the rehabilitation group was significantly lower than that of the control group after 8 weeks of training（P<0.05）.（6）SF-36 Quality of Life Questionnaire:Intra-group comparison showed that the scores of 6 quality of life indicators（physical function,physical role,pain perception,health self-assessment,social function and mental health）,physical total score（PCS）and mental total score（MCS）in the rehabilitation group were significantly higher than before 8 weeks（P<0.05）,with no significant change in role emotion and energy compared with before 8 weeks（P>0.05）.In the control group,there was no significant improvement in the quality of life indicators,total physical scores（PCS）and total psychological scores（MCS）（P>0.05）.In comparison between groups,the scores of 6 indicators（physical function,pain perception,health self-assessment,energy,social function,mental health domain）,physical total score（PCS）and mental total score（MCS）in the rehabilita-tion group increased significantly after 8 weeks of training compared with the control group（P<0.05）.（7）In the rehabilitation group,the pulmonary function（FEV₁,FVC,MVV）,6MWT and SF-36 quality of life scale（PCS,MCS）of COPD patients and non-COPD patients improved significantly before and after 8weeks of training,but the difference was not statistically significant（P>0.05）.Conclusion:Pulmonary rehabilitation training can improve lung function,improve lung ventilation and enhance lung capacity,reduce the degree of dyspnea,and beneficially improve exercise capacity and quality of life in patients with advanced non-small cell lung cancer during chemo-therapy in the short term.In addition,in patients with advanced non-small cell lung cancer who received pulmonary rehabilitation training,improve-ments in lung function,exercise capacity and quality of life were not asso-ciated with the presence of COPD.Pulmonary rehabilitation training can be applied to the multidisciplinary treatment of patients with advanced lung cancer and deserves continued in-depth study.