不同训练时间的有氧运动干预轻中度阿尔茨海默病的临床研究  

A clinical research of aerobic exercises with different training time in the treatment of mild to moderate Alzheimer's disease

作　　者：燕兰云[1] 王蔚[1] 沈飞飞[1] 杨思雨[1] 王炜[1] 汪琴[1] 王彤 吴婷[1] 

机构地区：[1]南京医科大学第一附属医院神经内科,210029 [2]南京医科大学第一附属医院康复医学中心

出　　处：《中国康复医学杂志》2015年第8期771-776,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金(30901578);江苏省"六大人才高峰"第八批高层次人才资助项目项目;江苏省高校"青蓝工程"中青年学术带头人培养对象项目(JX2161015003);江苏省卫生厅"科教兴卫工程"重点人才项目(RC2011072);江苏省卫生厅"科教兴卫工程"开放课题(XK20200905);苏州市科技局科技发展计划项目(SYSD2011044)

摘　　要：目的:探讨不同训练时间的有氧运动对轻中度阿尔茨海默病(AD)患者的作用。方法:将54例AD患者随机分为有氧运动A组(18例)、有氧运动B组(18例)和对照组(18例),有氧运动组采用踩脚踏车的运动方式,接受强度为70%最大运动能力的有氧运动训练,A组每周2h训练,B组每周1h训练,持续6个月。分别在入组前、入组3个月、入组6个月时,采用MMSE、ADAS-cog、Barthel指数、NPI和NPI-D进行AD相关评价。结果:A组有氧运动能明显改善患者的认知能力和精神神经症状,3个月和6个月时的MMSE评分从基线值19.1±3.1分别增加至21.4±2.5、24.2±1.8;ADAS-cog评分从基线值19.9±2.7分别降低至17.5±2.2、14.9±1.7;Barthel指数评分从基线值35.0±2.8分别增加至39.3±2.0、43.4±2.2;以上差异均有显著性意义(P<0.05)。NPI评分变化值3个月时为-1.8±5.2,6个月时为-1.6±4.2,后者有显著性意义(P<0.05);NPI-D评分变化值3个月和6个月分别为-1.9±3.1和-1.5±2.6,两者均有显著性差异(P<0.05)。B组仅在有氧运动早期(3个月时)可改善患者的认知功能(P<0.05),MMSE评分从基线值19.1±2.8增加至20.3±2.0,ADAS-cog评分从基线值20.1±2.5降低至18.3±2.5,对患者日常生活活动能力和精神神经症状无有益影响。Barthel指数与MMSE、ADAS-cog分值的变化无相关关系(r=0.136,r=0.77)。结论:6个月的每周2h的有氧运动较3个月的有氧运动在改善AD患者的认知功能、生活能力、神经精神症状以及对照顾者的困扰评分方面获益较多。Objective： To investigate the effect of aerobic exercises with different training time on mild to moderate Alzheimer＇s disease patients.Method： Fifty-four AD patients were divided into aerobic exercise group（A group and B group,18 patients separately）and control group（18 patients）.A group was trained 2h per week,while B group was trained 1h per week,the training lasted 6 months. At the beginning,third month and sixth month of aerobic exercise,every patient was evaluated with MMSE,ADAS-cog, Barthel index, NPI and NPI-D.Result： After acrobic exercise in A group patient＇s cognitive ability and mental neurological symptoms improved obviously and the difference was statistically significan（tP〈0.05）. After 3 months and 6months training,the MMSE scores from the baseline 9.1± 3.1 increased to 21.4±2.5 and 24.2±1.8 respectively, The ADAS-cog scores from the baseline 19.9±2.7 decreased to 17.5±2.2 and 14.9±1.7 respectively, BI scores from the baseline35.0 ± 2.8 increased to 39.3 ± 2.0,43.4 ± 2.2, at the end of the third month and sixth month,the changes of NPI scores were-1.8±5.2 and-1.6±4.2 respectively, compared with the baseline,the latter had significant difference（P〈0.05）, the changes of NPI-D scores were-1.9±3.1 and-1.5±2.6,both had significant differences（P〈0.05）.In B group patient＇s cognitive ability was improved just at the early phase（3 months）. There was no correlation between BI and the changes of MMSE,ADAS-cog.Conclusion： AD patients after 2h per week aerobic exercise for 6 months could get more benefits on cognitive ability,activities of daily living,mental neurological symptoms and scores of caregivers compared to 3months of aerobic exercise.

关 键 词：阿尔茨海默病 有氧运动 认知能力 

分 类 号：R749.16[医药卫生—神经病学与精神病学]