呼吸肌训练对阻塞性睡眠呼吸暂停综合征患者的治疗效果  

Therapeutic effect of respiratory muscle training on patients with obstructive sleep apnea syndrome

作　　者：戴威[1] 舒丹妮 戴元荣[2] 施盛乔 刘宝华[1] DAI Wei;SHU Danni;DAI Yuanrong;SHI Shengqiao;LIU Baohua(Department of Neurorehabilitation,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院神经康复科,浙江温州325027 [2]温州医科大学附属第二医院呼吸与危重症医学科,浙江温州325027

出　　处：《温州医科大学学报》2022年第5期371-375,共5页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(Y20180607)。

摘　　要：目的:研究呼吸肌训练对阻塞性睡眠呼吸暂停综合征(OSAS)患者的睡眠呼吸暂停症状、睡眠质量以及肺功能等方面的治疗效果。方法:选取2019年1月至2020年12月温州医科大学附属第二医院就诊的40例OSAS患者,随机分成2组,每组20例。对照组给予减重、运动锻炼等常规治疗;观察组在此基础上指导呼吸肌训练。收集入组前、治疗6周后2组患者的体质量指数(BMI)、肺通气功能、Epworth嗜睡量表(ESS)、匹兹堡睡眠质量指数(PSQI)、呼吸紊乱指数(AHI)、最低血氧饱和度(LSaO_(2))等数据进行比较分析。结果:治疗前两组患者一般情况、肺功能及睡眠质量差异无统计学意义(P>0.05)。治疗6周后,观察组与对照组相比,AHI、PSQI评分、ESS评分均显著降低,LSaO_(2)升高,差异有统计学意义(均P<0.05)。观察组患者6周后的潮气量(VT)、深吸气量(IC)、肺活量(VC)、最大通气量(MVV)、最大呼气中段量(MMEF)、最大吸气压(MIP)、最大呼气压(MEP)较对照组明显升高(均P<0.05)。多元线性回归分析显示:AHI改善值=0.998×MIP改善值+0.022×IC改善值+0.011×MMEF改善值-0.001×MVV改善值-0.652×MEP改善值+8.915。结论:呼吸肌训练可有效地改善OSAS患者的呼吸暂停症状、肺功能及睡眠质量。Objective:To study the therapeutic effect of respiratory muscle training on sleep apnea symptoms,sleep quality and lung function in patients with obstructive sleep apnea syndrome(OSAS).Methods:Forty OSAS patients treated in the Second Affiliated Hospital of Wenzhou Medical University from January 2019 to December 2020 were randomly divided into two groups.The control group was given routine treatment such as weight control and exercise,while the observation group was given guided respiratory muscle training on this basis.The data of body mass index(BMI),pulmonary ventilation function,Epworth Sleepiness Scale(ESS),Pittsburgh sleep quality index(PSQI),respiratory disorder index(AHI)and lowest oxygen saturation(LSaO_(2))of the patients in two groups were collected and analyzed.Results:There was no significant difference in general condition,pulmonary function and sleep quality between the two groups before treatment(P>0.05).After 6 weeks of treatment,compared with the control group,the observation group had significantly lower AHI,PSQI score and ESS score and the increased LSaO_(2)than before,with statistical difference(P<0.05).After 6 weeks,the tidal volume(VT),inspiratory capacity(IC),vital capacity(VC),maximum ventilation volume(MVV),maximum mid expiratory volume(MMEF),maximum inspiratory pressure(MIP),the maximum expiratory pressure(MEP)of the observation group were significantly higher than those in the control group(P<0.05).The improvement value of AHI before and after 6 weeks was correlated with that of MIP,MMEF,MEP,MVV and IC,showing statistical significance(P<0.05).Conclusion:Respiratory muscle rehabilitation training combined with general routine treatment can effectively improve daytime symptoms and pulmonary function of OSAS patients.

关 键 词：呼吸肌训练 阻塞性睡眠呼吸暂停 肺功能 睡眠质量 

分 类 号：R493[医药卫生—康复医学]