渐进性抗阻呼吸综合康复方案对卒中后抑郁患者的临床疗效  

Clinical efficacy of progressive resistance respiratory comprehensive rehabilitation in patients with post-stroke depression

作　　者：高民 肖桂红[1] 葛书萍 秦存宇 仝以漫 李欣欣 陈爽 GAO Min;XIAO Guihong;GE Shuping;QIN Cunyu;TONG Yiman;LI Xinxin;CHEN Shuang(Xuzhou Rehabilitation Hospital,Xuzhou,Jiangsu 221003,China;Xuzhou Central Hospital,Xuzhou,Jiangsu 221009;Xuzhou Medical University,Xuzhou,Jiangsu 221004)

机构地区：[1]徐州市康复医院,江苏徐州221003 [2]徐州市中心医院,江苏徐州221009 [3]徐州医科大学,江苏徐州221004

出　　处：《徐州医科大学学报》2025年第1期74-78,共5页Journal of Xuzhou Medical University

基　　金：徐州市重点研发计划项目(KC22214);国家卫健委医药卫生科技发展研究中心项目(WKZX2023HK0120)。

摘　　要：目的 探究渐进性抗阻呼吸综合康复方案对卒中后抑郁(PSD)患者的临床疗效。方法 选取2022年9月—2024年1月于徐州康复医院就诊的60例PSD患者,收集临床资料进行分析。采用随机数字表法将患者分为观察组和对照组,每组30例。对照组接受常规康复诊疗,观察组在对照组的基础上增加渐进性抗阻呼吸综合康复方案,2组患者干预时间均为4周。比较2组患者干预前和干预4周后的呼吸肌功能[最大吸气压(MIP)和最大呼气压(MEP)]、焦虑和抑郁量表(SAS和SDS)评分、6分钟步行试验距离、自主神经功能指标[静息心率(HRrest)、峰值心率(HRpeak)、运动结束后恢复1分钟心率(HRR1)、静息收缩压和舒张压(SBPrest和DPBrest)、峰值收缩压和舒张压(SBPpeak和DPBpeak)]、改良Bathel指数(MBI)评分。结果 干预4周后,观察组患者的6分钟步行距离大于对照组,MIP、MEP高于对照组,差异均有统计学意义(P<0.05)。观察组患者的SAS、SDS评分低于对照组,MBI评分高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后HRR1高于对照组,HRrest、HRpeak、SBPrest低于对照组,差异有统计学意义(P<0.05)。结论 渐进性抗阻呼吸综合康复方案能有效改善PSD患者的呼吸肌功能、自主神经功能紊乱,提高运动能力及日常生活活动能力,对提升患者生存质量有临床价值。Objective To explore the clinical efficacy of a progressive resistance respiratory comprehensive rehabilitation program in patients with post-stroke depression(PSD).Methods A total of 60 PSD patients who were admitted to Xuzhou Rehabilitation Hospital from September 2022 to January 2024 were selected and their clinical data were collected for analysis.The patients were randomly divided into two groups(n=30):an observation group and a control group.The control group received conventional rehabilitation treatment,while the observation group underwent the progressive resistance respiratory comprehensive rehabilitation program in addition to the conventional rehabilitation treatment.Both groups were subject to interventions for four weeks.Then,both groups were compared for respiratory muscle function [maximum inspiratory pressure(MIP) and maximum expiratory pressure(MEP)],anxiety and depression scale(SAS and SDS) scores,6-minute walking test distance,autonomic function indicators [resting heart rate(HRrest),peak heart rate(HRpeak),heart rate recovery 1 minute after exercise(HRR1),resting systolic/diastolic blood pressure(SBPrest and DBPrest),and peak systolic/diastolic blood pressure(SBPpeak and DBPpeak)],and modified Barthel index(MBI) scores before and after the intervention.Results After four weeks of intervention,the observation group showed longer 6-minute walking distance,higher MIP and MEP than the control group(P<0.05).The SAS and SDS scores in the observation group decreased,but the MBI scores increased,compared with those in the control group(P<0.05).The observation group also showed increases in HRR1,and decreases in HRrest,HRpeak,and SBPrest,compared with the control group(P<0.05).Conclusions The progressive resistance respiratory comprehensive rehabilitation program can effectively improve respiratory muscle strength,correct autonomic dysfunction,enhance exercise capacity,and improve activities of daily living in PSD patients.This program holds clinical value in enhancing the quality of life of patients.

关 键 词：呼吸训练 脑卒中 抑郁 自主神经功能 日常生活活动能力 呼吸肌功能 

分 类 号：R493[医药卫生—康复医学]