[Abstract] Objective: Cough and dyspnea are the main features of patients with chronic obstructive pulmonary disease (COPD), and the decrease in lung capacity and exercise tolerance in patients with COPD is currently recognized. The efficacy of current clinical treatments in improving lung function and daily living ability in COPD is not satisfactory. The purpose of this study was to investigate the effect of respiratory control training with physical exercise training on the cardiopulmonary function of patients with chronic obstructive pulmonary disease. Subjects and methods: The subjects were all patients diagnosed with moderate and severe COPD, aged 54-73 years old, hospitalized in the respiratory department of our hospital. 68 cases were randomly divided into two groups: 38 cases in the treatment group; given pharmacological treatment combined with active circulation and limb training for 10 minutes each time three times a day. In the control group, there were 30 patients who did not receive the above rehabilitation treatment. All patients were treated for 20 days, and six-minute walk test, blood gas analysis and pulmonary function measurement were performed before and after the treatment. Results: After the treatment, there was a very significant increase in the indexes of the treatment group compared with the control group. Conclusion: The active circulation technique with upper and lower limb exercise training has a significant effect on improving the lung function of patients. Chronic obstructive lung disease (COPD) is a common and frequent disease of the respiratory system and a major chronic disabling and fatal disease, which has been an important public health problem in China and seriously endangers people’s health. In recent years, while the prevalence of cardiovascular and cerebrovascular diseases has been decreasing, the prevalence of COPD has been increasing year by year in the world. The epidemiological survey of COPD in China shows that the number of deaths caused by COPD in China is about 1 million every year, and COPD is the fourth most common respiratory disease in urban areas and the first in rural areas. The main symptoms of chronic obstructive pulmonary emphysema are dyspnea and cough, which lead to the decrease of patients’ daily living ability and the loss of patients’ working ability, which is a heavy burden to families and society. 1. Subjects and methods 1. 1. 2. Exclusion criteria 1. age >54 or >73 years old; 2. combined with serious diseases of heart, liver, kidney and blood system; 3. confusion unable to cooperate with treatment.1, 2 General data 68 patients with COPD were selected according to the national unified diagnostic criteria. The patients were divided into 38 cases in the active circulation and extremity training treatment group hereafter referred to as group A, and 30 cases in the drug-only control group hereafter referred to as group B, according to the randomization table. The age of the patients was 33-75 years old, with a mean of 61.9 years old ± 6.7 years old; there was no significant difference in the distribution of gender, age and disease type between the two groups. Comparable. 1.3, Treatment All patients were treated with expectorant cough, antispasmodic and asthma. Some patients were treated with antibiotics to correct acid-base imbalance and electrolyte disturbance. The treatment group was treated with active circulation including (respiratory control, postural sputum removal, coughing) and limb training, three times a day for 10 minutes each time for 20 days. 1.4 , observation indexes and methods 1.4.1, pulmonary function tests: force spirometry FVC, -second force expiratory volume FVC1, one-second expiratory volume ratio percentage FVC1%. 1.4.2, laboratory indicators arterial blood gas analysis: arterial partial pressure of oxygen PO2, arterial partial pressure of carbon dioxide PCO2 1.4.3, observation of 6-minute walk test distance 1.4.4, observation of symptoms and signs such as fatigue, dyspnea, panic and shortness of breath, and make records. 1.5, efficacy assessment criteria. Significant effect: 1.Signs and symptoms improved significantly, blood gas analysis, lung function indicators and 6-minute walk test indicators have improved; 2.Invalid symptoms and signs did not improve, or even aggravated. No change or aggravation of blood gas analysis, lung function indexes and 6-minute walk test indexes. 2. Results 2.1. The results of efficacy observation are shown in Table 1, Table 2 and Table 3. The comparison of blood gas analysis indexes before and after treatment between the two groups is shown in Table 1. The comparison of 6-minute walk distance test indexes before and after treatment between the two groups is shown in Table 2. The comparison of lung function indexes before and after treatment between the two groups is shown in Table 3. Table 1. Comparison of blood gas analysis indexes before and after treatment Subgroup PaO2 PaCO2 Before treatment After treatment Before treatment After treatment Treatment group 8.73± 2.68 10.55±1.50} 8.43±2.20 6.15±0.67} Control group 8.82±2.19 10.03±2.17| 8.12±2.08 6.95±1.23| Note}P<0.01 compared with pre-treatment;|P<0.05 compared with pre-treatment;@P<0.01 compared between groups;>0.05 Treatment group and control group PaCO2 was significantly lower before and after treatment (P＜0.01,P＜0.05), PaO2 was significantly higher (P＜0.01,P＜0.05), PaCO2 and PaO2 improved significantly in the treatment group compared with the control group vP＜0.05) Table 2 Comparison of 6-minute walking distance test before and after treatment Treatment group Control group Before treatment After treatment Before treatment After treatment 206±19.8 m (319.5±24.3 m 217.3± 15.6 m 278.6±19.8 m The 6-minute walk test distance improved significantly before and after treatment in the treatment group compared with the control group vP<0.05) Table 3 Comparison of lung function indexes before and after treatment between the two groups Parameter Treatment group Control group Before treatment After treatment Before treatment After treatment FVC 1.38±0.35 1.84±0.29| 1.41 ±0.41 1.56±0.34} FEV1 0.71±0.23 1.14±0.26| 0.69±0.21 0.89±0.24|} FEV% 48.76±13.24 62.07±13.62| 50.13±14.35 54.28±14.67@ FEV1MFVC 0.51±0.02 0.55±0.03| 0.53±0.03 0.03| 0.53±0.03 0.55±0.02|Note:|P0.01 compared with pre-treatment;}P0.01 compared with treatment group;@P0.05 compared with treatment group; There was no significant difference between the two groups in the comparison of FVC, FEV1, FEV% and FEV1MFVC before treatment vP＞0.05w; After treatment, the treatment group FVC, FEV1, FEV% and This suggests that the treatment group can improve pulmonary ventilation function to some extent. 3 .Discussion In this paper, after active circulation and upper and lower limb exercise in 68 patients with chronic obstructive pulmonary emphysema, all indexes of pulmonary function were significantly improved after 20 d of exercise. Among them, the maximum ventilation volume was significantly improved compared with that before treatment; the residual/total ratio was reduced significantly. From the above results, it is clear that the main cause of dyspnea in patients with COPD is related to respiratory muscle fatigue. Respiratory muscles belong to skeletal muscles, providing suitable inspiratory resistance can improve the contraction force, endurance and efficiency of respiratory muscles, which can prevent respiratory fatigue amidships and its mechanism can make respiratory muscle tissue hollowing and physiological metabolic changes through exercise It is known that respiratory muscles mainly have two types of muscle fibers or motor units consisting of type 1, namely slow muscle SO, also known as red muscle, which has rich capillaries, small contraction force, fast recovery, and is responsible for continuous, rhythmic movement, and has the ability to fight fatigue. Rhythmic movement, has a role in fighting fatigue. Type II is the fast muscle, also known as white muscle. The contraction force is strong, the recovery threshold is high, and it is easy to fatigue. It has three subtypes: Ⅱa fast red muscle fibers, F, G,, Ⅱb fast white muscle fibers, FG, and 1 c undifferentiated type,. Respiratory muscle contractility depends mainly on FG while endurance depends mainly on SO and F0G. and endurance exercise mainly affects FG After exercise, muscle fibers become thicker, capillary density glycogen content, myoglobin concentration, and mitochondrial number are increased. Animal experiments have demonstrated that increasing respiratory resistance increases diaphragmatic blood flow by lO-20 times. Exercise also adjusts the ratio of fast and slow muscle fibers, while the resistance of the respiratory system itself is 4 to 7 times higher than normal in patients with COPD, and dyspnea is a common symptom. Dyspnea is related to consciousness or psychological factors. Application of upper and lower limb function for exercise, there is also an active circulatory effect, so that the feeling of dyspnea is reduced and the secretions of the respiratory tract are excluded. The main cause of dyspnea in patients with chronic obstructive pulmonary emphysema is related to respiratory muscle fatigue. Active circulation with upper and lower limb exercises is an important treatment measure during the rehabilitation period.