Research On The Effect Of Traditional Chinese Medicine Pulmonary Rehabilitation On Exercise Tolerance And Brain Function In Patients With Mild To Moderate COPD

Background:COPD has been listed as the third most common chronic disease in China and has become a major disease burden of China.However,COPD awareness rate,lung function test rate,diagnosis rate,of China is low.Therefore,disease prevention and control are under severe pressure.Compared with the application of inhaled preparations,the pulmonary rehabilitation of patients with stable COPD,especially the traditional Chinese medicine pulmonary rehabilitation that adds traditional exercises,can play a more effective role in systemic exercise,significantly improving the patient’s exercise capacity,and delaying the decrease of lung function.In addition,TCM pulmonary rehabilitation can also improve patients’ anxiety and depression,improve their mental endurance and the capacity of social adaptation,and at the same time alleviate the patients’ cognitive function,mental state and other brain function decline caused by chronic hypoxia.However,there is no further strong evidence for the effect of TCM pulmonary rehabilitation on patients’ exercise endurance and brain function.There are few reports on changes in mental state,the changes in CPET related indicators that affect exercise endurance during exercise,the interpretation of cognitive ability,brain function,and MRI from the perspective of brain function.Purpose:To study the changes in exercise endurance related values,changes in respiratory symptoms,cognition,psychological scales,and brain function differences in ALFF,ReHo,DC values,etc.,in the cardiopulmonary exercises of patients after rehabilitation exercises.To provide a more objective basis for the effectiveness of TCM pulmonary rehabilitation.Methods:Using a randomized control method,40 patients with stable mild-to-moderate COPD who met the criteria for discharge were randomly divided into a test group of 20 cases and a control group of 20 cases.After recording baseline data of exercise cardiopulmonary,brain function MRI and related scales were collected.The control group received conventional intervention.The experimental group added traditional Chinese pulmonary rehabilitation based on traditional exercises on the basic intervention of the control group.After 6 weeks of intervention,exercise cardiopulmonary,brain f-MRI and related scale data were collected tested,and data analysis.Among them,the f-MRI data is analyzed and processed by DPARSF software,to get the difference images and data of the two groups of ALFF,ReHo,and DC.Results:There is no statistical difference between the two groups of patients in all baseline data1.CPET results1.1 Exercise durationAlthough the experimental group failed to significantly increase the duration of exercise after intervention,there was an upward trend(P=0.091),and the control group’s exercise duration decreased(P=0.022).1.2 Results of METS and VO2MAX and their percentage of predicted valueMETS:The difference between the two groups after the intervention was statistically significant(P=0.042),and the control group had a significant downward trend after the intervention(P=0.06).V02MAX and percentage of predicted value:The difference between V02MAX after intervention was statistically significant(P=0.043),while the control group had a downward trend before and after intervention(P=0.061).There is no statistically significant difference in the percentage of the actual value of this value to the predicted value,but it can also be found that the control group has a downward trend after intervention(P=0.076).1.3 Results of VE/VCO2,VD/VT,AT and their percentage of predicted value VE/VCO2:The differences were not statistically significant.VD/VT:The differences were not statistically significant.AT and its percentage of predicted value:After the intervention,the difference of AT was not statistically significant.The result of AT percentage of predicted value was the same as the above result.but it can be found that the control group had a downward trend before and after the intervention(P=0.069).2.Results of each scale2.1 CAT and its classification and mMRC scale resultsAfter the intervention,the CAT score of the experimental group was significantly improved(P=0.001).Compared with the control group,there was also a significant difference(P=0.034);there were no statistically significant differences in the CAT grading,but after the intervention,the CAT grading of the experimental group showed a reduction in symptoms That is,the trend of the direction change when the grade number becomes smaller(P=0.083).There were no statistically significant differences in mMRC classification.2.2 Semantic fluency and number span scoring resultsSemantic fluency score:The differences between the two groups after intervention(P=0.014),the experimental group before and after intervention(P=0.043),and the control group before and after intervention(P=0.003)are statistically significant.The group rose from the previous.Digital breadth score:The difference between the two groups after the intervention(P=0.033)and the control group before and after the intervention(P=0.029)was statistically significant.The control group was lower than before,and the test group had a higher score than the control group after the intervention.23.3 SAS and SDS scale resultsSAS scale:There was no statistically significant difference in the scores,and the experimental group could see a downward trend compared with before the intervention(P=0.067).There were no statistically significant differences in SAS classification.SDS scale:There is no statistically significant difference in scores,but the experimental group can see a downward trend compared with before the intervention(P=0.087);and the control group is higher than the experimental group after the intervention(P=0.069).There were no statistically significant differences in SDS classification.3.Brain fMRI resultsAfter the intervention,the ALFF values of the two groups in the right superior temporal gyrus(BA38)and the left occipital pole were different(P<0.05),and there were differences in the ReHo value of the left inferior temporal gyrus(BA20/21)(P<0.05);The DC values of the left central anterior gyrus(BA6)and superior frontal gyrus(BA6)are different(P<0.05).Conclusion:6 weeks of traditional Chinese medicine exercises for pulmonary rehabilitation can not significantly change all aspects of exercise endurance and brain function in patients with mild to moderate COPD at the same time,but in the duration of exercise,METS,VO2MAX,CAT and other symptoms Tables,SAS,SDS and other emotional scales,semantic fluency,number breadth scores,etc.all have improved trends or statistically significant differences.At the same time,evidence of changes in related brain regions is found in fMRI,so fMRI can be used as a research method in exploring the effectiveness of changes in brain function of TCM pulmonary rehabilitation.