Effect Of Liuzijue Training On Exercise Ability In Stable COPD Patients: A Randomized Controlled Study

Objective: 1.To study the effect of Liuzijue training on exercise capacity of stable COPD patients.2.To research the effect of Liuzijue training on stable COPD patients with different TCM syndromes.Methods: 70 patients with stable COPD were selected as the research subjects in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine.After a one-week lead-in period,all patients received standard treatment,smoking cessation advice and health education.And then they were randomly divided into two groups using a random number table.The experimental group received Liuzijue training,while the control group did not receive any rehabilitation exercise intervention,for a course of 12 weeks.The data were measured at 4 time points at baseline,4th,8th,and 12 th week,including 6MWD,Borg CR10 score,lowest Sp O2 d uring 6MWT,1-minute heart rate recovery,Brief-BESTest score,BMI,and MAC.We evaluated the effectiveness of Liuzijue training for exercise ability by comparing the changes of outcome indicators at each time point before and after intervention.Furthermore,the test group was divided into different types of TCM syndromes,and the effect of Liuzijue training on different syndrome types was evaluated.IBM SPSS 21.0 was used for data analysis.Pearson chi-square test,two independent samples t-test and Mann-Whitney U test were used for comparison between the two groups.Paired t-test and paired Wilcoxon test were used for intragroup comparison.Repeated measurement data were analyzed by repeated measurement analysis of variance.Results: 70 stable COPD patients were enrolled at baseline(35 in the test group and 35 in the control group).Finally,59 cases were included in the analysis(29 cases in the experimental group and 30 cases in the control group).During the trial,10 patients dropped out(5 withdrew spontaneously,4 were lost to follow-up and 1 was hospitalized for acute exacerbation),and 1case was excluded due to unqualified questionnaire.1.Compared with before and after intervention: Baseline-12 th week,the changes of6 MWD in experimental group(44.76±62.627)> control group(-1.23±33.901),the lowest Sp O2 in test group(1.28±3.954)>control group(-1.27±4.402),1-minute heart rate recovery in test Group(4.69±2.509)>control group(-0.93±2.947),the differences were statistically significant(P<0.05).2.Compared at different time points after intervention:Intra-group comparison: 6MWD in the test group increased slightly from baseline to 4th week,with an average increase of 13.87 m during 4-8th week(t=-3.643,P=0.001),and an average increase of 17.48 m during 8-12 th week(t=-7.322,P=0.000));the lowest Sp O2 was relatively stable at baseline-8th week,and increased significantly at 8-12 th week(Z=-2.887,P=0.004);1-minute heart rate recovery increased slightly at baseline-8th week,with an average increase of 3.27 times/min during 8-12 th week(t=-4.740,P=0.000).The lowest Sp O2 of the control group decreased significantly from baseline to 4th week(Z=-2.022,P=0.043),and then the decline was delayed.Comparison between groups: The time factor(F=7.151,P=0.006)and group factor(F=4.088,P=0.048)affecting 6MWD were statistically significant,and there was an interaction between the two factors(F=8.113,P=0.003).The group effect of the lowest Sp O2(F=4.109,P=0.047)and the interaction effect between time and group were statistically significant(F=3.597,P=0.031).The time factor(F=4.760,P=0.007),group factor(F=4.191,P=0.045),and their interaction effect(F=12.634,P=0.000)affecting 1-minute heart rate recovery were statistically significant.3.The test group was further divided into syndrome of qi deficiency group(18 cases)and syndrome of both qi and yin deficiency group(11 cases).Subgroup analysis showed that the exercise ability of the patients with qi deficiency syndrome was better than that of both qi and yin deficiency syndrome,but there was no significant difference between the groups(all P>0.05).Borg CR10 scores of patients with qi deficiency syndrome were more stable than those with both qi and yin deficiency syndrome(F=4.378,P=0.046);BMI showed a decreasing trend over time in both groups(F=4.437,P=0.006);6MWD(F=6.617,P=0.002),minimum Sp O2(F=3.306,P=0.037)and 1-minute heart rate recovery(F=6.612,P=0.002)all showed an increasing trend with time.Conclusion:1.The 12-week Liuzijue training can effectively improve the exercise capacity of patients with stable COPD.2.Overall,exercise ability of patients with qi deficiency syndrome is better than that with both qi and yin deficiency syndrome.Among them,the leg fatigue state of patients with qi deficiency syndrome was more stable than that of patients with both qi and yin deficiency syndrome.However,there is no difference in the effect of Liuzijue training on the exercise ability of patients with different syndrome types.