比較兩種運動訓練計畫對慢性阻塞性肺疾病合併胃食道逆流病人胃食道逆流症狀、運動耐力與健康相關生活品質之成效

Comparison of two different exercise training program on improving gastroesophageal reflux symptoms, exercise endurance and uality of life among chronic obstructive pulmonary disease patients with comorbid gastroesophageal reflux symptoms

胃食道逆流疾病為慢性阻塞性肺病急性惡化風險因子，然而對於慢性阻塞性肺病合併胃食道逆流症狀的病人，以復健運動改善疾病症狀之相關研究仍相當闕乏。本研究目的在比較步行運動與橫膈訓練對慢性阻塞性肺疾病合併胃食道逆流症狀病人改善胃食道逆流症狀之成效，並進一步了解對於運動耐力與COPD健康相關生活品質改善程度。本研究採用平行隨機控制實驗法，以立意選樣方式將研究對象38人，以隨機區組分派方法分配成步行運動組、橫膈訓練組與控制組共三組，進行為期8週運動訓練介入。結果顯示，介入後單組前後測比較，橫膈訓練與步行運動皆能改善胃食道逆流症狀；步行運動在運動耐力與COPD健康相關生活品質亦有顯著的改善差異。更進一步的，在控制相關影響變項後，步行運動組在介入後比控制組（參考組）在胃食道逆流症狀惡化分數上減少5.828分並且達到顯著（p<0.05）。本研究結果建議，步行運動能有效改善慢性阻塞性肺病合併胃食道逆患者之胃食道逆流症狀。

Gastroesophageal reflux (GER) is a risk factor for the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) among COPD patients with comorbid GER symptom. However, studies investigating the efficacy of rehabilitate exercises on improving GER symptoms in this population are lacking. This study’s aim was to explore the effectiveness of walking exercise and diaphragmatic training on improving GER symptoms, exercise endurance, and breathing difficulty in daily lives among COPD patients with comorbid GER symptoms. This study adopted parallel random controlled trial methodology and used block randomization to assign 38 study subjects to three study arms: walking exercise group, diaphragmatic training group or control group prior to conducting an eight-week intervention. Following the intervention, one group pre-post analysis indicated that the diaphragmatic training group and the walking exercise group experienced substantially improved GER symptoms. The walking exercise group experienced both improved exercise endurance and COPD health-related quality of life. Furthermore, after adjusting for confounding variables, the walking exercise group’s GER symptom value was shown to have decreased by 5.828 points, which was significantly greater than the reference group (p<0.05). The results of this study suggested that walking exercise was more efficient on the improvement of GER symptoms in COPD patient comorbid GER symptoms.