Non-pharmacological Intervention Study In Patients With Mild Cognitive Impairment After Stable COPD

1 Objective To observe the effect of 12-week music exercise therapy on early intervention in patients with mild cognitive impairment(MCI)after stable chronic obstructive pulmonary disease(COPD).In order to improve the recovery of such patients,treatment provides a clinical and theoretical basis.2 Methods The clinical data of 90 patients with MCI secondary to COPD from March 2017 to December 2017 were collected.The patients were randomly divided into group A(exercise therapy group),group B(music and exercise therapy group)and group C(control group)with 30 cases in each group.All the three groups were given general treatment and COPD pulmonary rehabilitation propaganda materials were issued.The main endpoint event was the change of Montreal Cognitive Assessment Scale(Mo CA)score before and after intervention.The secondary endpoint event was the change of T lymphocyte level in blood and the correlation between T lymphocyte and Mo CA score.The follow-up period was 12 weeks.3 Results 3.1 Baseline comparison There was no significant difference(P > 0.05)between the general condition(gender,education level,smoking,age,body mass index)and baseline clinical data(course of disease,severity of illness,medication,etc.)of the three groups before intervention.There was no significant difference in the baseline of each evaluation index(Montreal Cognitive Assessment Scale,CD3+,CD4+,CD8+)among the three groups(P> 0.05),and the three groups were comparable.3.2 Montreal Cognitive Assessment Scale(Mo CA)score Mo CA scores of patients in group A and group B were higher than those before intervention,and the difference was statistically significant(P< 0.01).Mo CA scores of patients in group C after intervention were not significantly different from those before intervention(P> 0.05).Compared with group C,Mo CA scores of group B and group A were higher than those of group C,and the difference was statistically significant(P < 0.01).Compared with group A,Mo CA score of group B was higher than that of group A,and the difference was statistically significant(P < 0.05).Exercise therapy can improve the cognitive level of patients with stable COPD secondary MCI,and exercise music therapy is better than exercise therapy alone in improving the cognitive level.3.3 Level of subsets of blood lymphocytes Before and after the intervention,the concentrations of CD3+ and CD4+ in group A and group B were higher than before,while the concentrations of CD8+ were lower than before,and the difference was statistically significant(P < 0.01).There was no significant difference in the concentration of T lymphocyte subtypes in group C compared with that before intervention(P > 0.05).Compared with group C,the levels of CD3+ and CD4+ in groups A and B were higher than those in group C,and the concentrations of CD8+ were lower than those in group C,with statistically significant differences(P< 0.01).Compared with group A,the concentrations of CD3+ and CD4+ in group B were higher than those in group A,and the concentrations of CD8+ were lower than those in group A,with statistically significant differences(P< 0.01).Exercise therapy can improve the immune level of patients with stable COPD secondary MCI,and the effect of music exercise therapy is better than that of exercise therapy alone.3.4 Correlation analysis between blood lymphocyte subsets and Mo CA score Blood CD3+ and CD4+ levels were positively correlated with Mo CA score(P<0.01),while CD8+ was negatively correlated with Mo CA score(P<0.01),and the difference was statistically significant(P<0.01).Lymphocyte subsets are closely related to the occurrence and development of cognitive dysfunction.4 Conclusion 1.Exercise therapy can improve the cognitive function of patients with stable COPD secondary MCI and enhance the immune level.2.Music exercise therapy is superior to exercise therapy alone in improving the cognitive and immune functions of patients.This method is economical,feasible and of great clinical value.3.Immune system dysfunction is closely related to the occurrence and development of MCI.