太極氣功體操訓練對肺葉切除術後病患肺功能、身體活動力與生活品質之促進效果

The Effect of Tai-Chi-Qui-Gong Exercises on Patients' Pulmonary Function, Exercise Capacity, and Quality of Life after Lobectomy

本研究旨在評估10個動作之太極氣功體操訓練對肺葉切除術病患肺功能、身體活動力與生活品質之促進效果，採類實驗研究設計法，於北部某醫學中心之胸腔外科病房，以立意取樣先選取控制組及再選取實驗組各20名肺葉切除術後病患，實驗組病人於術後第一天開始3個動作之「太極氣功體操運動」，逐日增加至第五天10個動作，而控制組不提供運動訓練，兩組病患皆於術前二天、術後一週及術後一個月接受肺功能、六分鍾步行距離之測量，術前二天與術後一個月接受生活品質卷調查。研究資料主要使用之統計為：獨立t檢定、配對t檢定、二因子變異數分析（two way ANOVA）、重覆測量ANOVA及Pearson相關係數。研究結果顯示：實驗組病患肺功能之潮氣容積（total volume,V（上標 T）明顯進步，而控制組則否；實驗組病患身體活動力逐日進步，術後一週之六分鍾之行走距離可回復至術前狀況，術後一個月則比術前更好，而控制組則仍未能恢復；實驗組病患之生活品質明顯優於控制組。太極氣功體操運動介入措施，可顯著改善肺葉切除術後病患之肺功能、身體活動力並使提昇生活品質，可提供胸腔外科病房術後運動訓練之參攷。

The purpose of this study was to evaluate the effect of Tai-Chi-Qui-Gong (TCQG) practice on patients' pulmonary function, activity capacity, and quality of life after lobectomy. Subjects admitted at a chest surgical ward of a medical center in Taipei city were included voluntarily after signing informed consents. The first 20 subjects were assigned to the control group, and the next 20 were assigned to the experimental group. Subjects in the experimental group received a training class on 10 motions of TCQG two days before surgery. They began to practice the TCQG exercises twice per day from the first postoperative day. They started with three motions on the first day, increasing to 10 on the fifth day. The control group received standard post-lobectomy care, which did not include the TCQG exercises. All subjects received measures on pulmonary function and six-minutes walk distance (6MWD) two days prior to the operation, as well as one week, and one month after the operation. Quality of life was measured two days before the operation and one month after the operation. The major statistical procedures applied in data management included: Chi-square, two-way ANOVA, independent-T test, and repeated-measures ANOVA. The p value level of ＜.05 was used as the significant level. The results indicated that subjects in the experimental group had significant improvement in their tidal volume and 6MWD after lobectomy, while subjects in the control group did not. The 6MWD of the subjects in the experimental group reverted to the preoperative status at the end of the first week, and was even better one month later. The postoperative quality of life of the subjects in the experimental group was significantly better than that of in the control group. These findings indicate that 10 motions of TCQG exercise were effective in improving pulmonary function, activity capacity, and quality of life of patients after lobectomy.