AIM: To investigate the effects of respiratory training plus nutritional support on quality of life (QOL), pulmonary function and analytical indexes of blood gases in patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation. METHODS: (1) Fifty-seven patients (38 males and 19 females) with C0PD at acute exacerbation, who were selected from the Department of Science and Education, Union Hospital affiliated to Fujian Medical University from March 2000 to May 2005, were randomly divided into training plus nutrition group (n = 29) and control group (n = 28). (2) The patients in the training plus nutrition group were treated by respiratory training and nutritional support (the respiratory training were exerted after having meal or overdoses, every training lasted for fifteen minutes, three times every day. The method of respiratory training: inhaling with nose, expiration with pursed lips, the time of inhaling lasted for 2 seconds and the time of expiration lasted for 10 seconds at least, meanwhile, the patients could not feel exertive was regarded as a rule; the nutritional support was applied three times every day by Ruidai, a kind of nutrients). The standard diets of patients were adopted by patients in the control group; other therapies were same in two groups, and four weeks as a period of therapy. (3) The qualities of lives in all patients were valuated before and after treatment by questionnaire of the qualities of lives of patients with COPD (the questionnaire contained four factors concluding 35 sub-factors: the activity of daily living, the capacity of social activities, the mental symptoms of depression and anxieties respectively including 13, 7, 8 and 7 sub-factors; any sub-factor was valuated as four grades, namely from 1 score to 4 score, and the score was higher, the quality of live was worse; that the scores of all factors were added was total score, then the totally average score was calculated according to the total score). (4) The blood gases (arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and the saturation of oxygen in arterial blood (SaO2)) and the pulmonary function (the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC)) were respectively analyzed by blood gases analyzer (made in America) and the pulmonary function determinator (made in Germany), then, according to the FEV1 and FVC, the ratio of the actual FEV1 to the pre-estimated FEV1 and the ratio of the actual FEV1 to the FVC were calculated. (5) The t test was adopted in the intergroup comparison. RESULTS: All the 57 COPD patients entered the analysis of results. (1) The total average score of QOL, the scores of activity of daily living, ability in social activity, symptoms of depression and anxieties: There were no obvious differences between the two groups before treatment (p > 0.05), the scores at 4 weeks after treatments were obviously lower than those before treatment in both groups (p < 0.05 to 0.01), also markedly lower in the training plus nutrition group than in the control group (p < 0.05). (2) The ratio of the actual FEV1 to the pre-estimated FEV1 and the ratio of the actual FEV1 to the FVC: Before treatment, there were no differences between the two groups before treatment (p > 0.05). Those in the training plus nutrition group after 4 weeks were obviously higher than those before treatment and those in the control group after 4 weeks (p < 0.05 to 0.01). Those in the control group after 4 weeks were unobviously higher than those before treatment (p > 0.05). (3) PaO2 and SaO2: before treatment, there were no differences between the two groups. They were enhanced significantly in training plus nutrition group and control group after four weeks (p < 0.01), and there were remarkable differences between the two groups group (p < 0.05). Moreover, there were no differences in the PaCO2 between the two groups before treatment.

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