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背景：目前关于药物阻止或延缓类风湿关节炎关节的破坏，减轻疼痛的治疗研究较多，但是，有氧运动训练结合药物治疗对类风湿关节炎患者生活质量有何影响? 目的：应用类风湿关节炎患者生活质量专业量表评估有氧运动训练结合药物治疗与单纯药物治疗的效应。 设计：随机对照实验。 单位：泸州医学院附属医院康复医学科及风湿病科。 对象：泸州医学院附属医院康复医学科、风湿病科2003-12／2004-07收治类风湿关节炎患者148例。纳入126例，男24例，女102例，均自愿参加。随机分为有氧训练组85例和对照组41例。 方法：有氧训练组在接受以甲氨蝶呤为主的药物治疗基础上，进行4次／周的有氧运动训练，30min／次，共12周。对照组只接受常规的药物治疗，运用《类风湿关节炎患者生活质量量表》在治疗前以及治疗3个月后对两组患者进行评分。测评方法：生活质量量表中每一问题按1～5分五级评分，计算各亚表分值，应用极距加权法得出生活质量总分。为消除治疗前初始值的影响，两组间生活质量的比较采用改善值[即(治疗前值-治疗后值)]和改善百分率[即(改善值／治疗前值)×100％]。 主要观察指标：类风湿关节炎患者治疗前后生活质量量表评分。 结果：按意向处理分析，共有患者148例，纳入126例，进入结果分析126例。①有氧训练前两组患者生活质量评分比较：有氧训练组生理、心理、社会功能、健康自我认识、总体生活质量与对照组差异均无显著性意义(有氧训练组：17，19，14，20，1．8分；对照组：17．5，20，14，21，1．7分，P>0．05)。②有氧训练后两组患者生活质量评分比较：有氧训练组生理、心理、社会功能、健康自我认识、总体生活质量评分均高于对照组(有氧训练组：3．5，2．0，3．0，20，3．4分；对照组：2．0，1．4，1．6，0，2．0分，P<0．05)。③两组患者治疗后生活质量改善情况：有氧训练组生理、心理、社会功能、健康自我认识和总体生活质量评分均较治疗前显著改善(12％～28％)，优于对照组。 结论：有氧运动训练较单纯药物治疗对类风湿关节炎患者的心理及健康自我认识能力有明显改善，提高了患者的关节活动功能和运动参与意识。
BACKGROUND: At present, there are many researches on the prevention and treatment of rheumatoid arthritis and the pain relief by rheumatoid arthritis. However, what is the effect of aerobic exercise training combined with medical treatment on the quality of life of rheumatoid arthritis? Purpose: The quality of life of patients with arthritis scale to assess aerobic exercise training combined with drug treatment and drug effect. Design: Randomized controlled experiment. Unit: Luzhou Medical College Affiliated Hospital of Rehabilitation Medicine and Rheumatology. PARTICIPANTS: Department of Rehabilitation Medicine, Affiliated Hospital of Luzhou Medical College, Department of Rheumatology, Dec. 2003 to Dec. 2004, 148 patients with rheumatoid arthritis were admitted. Including 126 cases, 24 males and 102 females, all volunteered to participate. Randomly divided into aerobic training group 85 cases and control group 41 cases. Methods: The aerobic training group received 4 times a week of aerobic exercise training on the basis of methotrexate-based drug therapy for 30 minutes for 12 weeks. The control group received only regular medical treatment. The patients were scored before treatment and after 3 months of treatment using the Quality of Life Scale of Rheumatoid Arthritis Patients. Evaluation methods: Quality of Life Scale for each question 1 to 5 points five grades, calculate the subscale scores, the use of polar distance weighted average quality of life score. To eliminate the effect of initial treatment, the quality of life improvement was compared between the two groups (ie, pretreatment - posttreatment) and improvement (ie, improvement / pretreatment x 100%). MAIN OUTCOME MEASURES: Quality of life scale of patients with rheumatoid arthritis before and after treatment. Results: According to the intention-to-treat analysis, a total of 148 patients, including 126 cases, entered the results of 126 cases. ① Comparison of quality of life before and after aerobic training: There was no significant difference in the quality of life between the two groups before and after aerobic training: physical training, psychological training, social functioning, self-awareness of health, overall quality of life and control group (aerobic training group: 17,19, 14,20,1.8 points; control group: 17.5,20,14,21,1.7 points, P> 0.05). ②After aerobic training, the scores of quality of life in two groups were compared: the scores of physical, psychological, social function, self-awareness of health and overall quality of life in aerobic training group were higher than those in control group (aerobic training group: 3.5,2.0 , 3.0,20,3.4 points; control group: 2.0,1.4,1.6,0,2.0 points, P <0.05). ③The improvement of quality of life in both groups after treatment: The physical, psychological, social functions, self-awareness of health and total quality of life of the aerobic exercise group were significantly improved (12% -28%) compared with those before treatment, which were better than the control group. Conclusion: Aerobic exercise training improved the mental and health self-awareness of patients with rheumatoid arthritis compared with simple drug therapy, and improved the patient’s joint function and motor participation awareness.