循经透刺联合系统呼吸训练治疗颈髓损伤后肺功能障碍临床观察  

Clinical effect of meridian penetration combined with systemic respiratory training on pulmonary dysfunction after cervical spinal cord injury

作　　者：王佳怡 王琼[1] 胡笛[1] 谢佳佳 潘江[1] 周文娟[1] WANG Jiayi;WANG Qiong;HU Di;XIE Jiajia;PAN Jiang;ZHOU Wenjuan(Department of Acupuncture and Massage Rehabilitation,the First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007)

机构地区：[1]湖南中医药大学第一附属医院针灸推拿康复科,湖南长沙410007

出　　处：《河北中医》2025年第2期292-295,299,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：湖南省残疾人联合会康复科研项目(编号:2023XK0203)。

摘　　要：目的观察循经透刺联合系统呼吸训练治疗颈髓损伤后肺功能障碍临床疗效。方法将108例颈髓损伤后肺功能障碍患者按照随机数字表法分为2组,对照组54例(后退出2例)予系统呼吸训练治疗,治疗组54例(后退出2例)在对照组基础上予循经透刺治疗。2组均治疗4周。观察2组治疗前后肺功能指标[用力肺活量(FVC)、第1 s用力呼气容积(FEV_(1))、呼气流速峰值(PEF)及最大自主通气量(MVV)],膈肌功能(膈肌活动度、膈肌厚度、膈肌运动幅度),相关呼吸评分量表(改良呼吸困难指数量表、Borg气促量表)评分,血气分析指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]及肺部感染发生率。结果2组治疗后FVC、FEV_(1)、PEF、MVV均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后膈肌活动度、膈肌厚度、膈肌运动幅度均较本组治疗前升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。2组治疗后改良呼吸困难指数量表、Borg气促量表评分均较本组治疗前降低(P<0.05),且治疗组治疗后低于对照组(P<0.05)。2组治疗后PaO_(2)、PaO_(2)/FiO_(2)均较本组治疗前升高(P<0.05),PaCO_(2)降低(P<0.05),且治疗组治疗后改善程度均优于对照组(P<0.05)。治疗组肺部感染发生率为7.69%(4/52),对照组肺部感染发生率23.08%(12/52),治疗组低于对照组(χ^(2)=4.727,P<0.05)。结论循经透刺联合系统呼吸训练治疗可提高颈髓损伤后肺功能障碍患者的肺功能及膈肌功能,改善患者呼吸状况,降低肺部感染发生率。Objective To investigate the clinical effect of meridian penetration combined with systemic respiratory training on pulmonary dysfunction after cervical spinal cord injury(CSCI).Methods Totally 108 patients with pulmonary dysfunction after CSCI were randomly assigned into treatment group(n=54,2 cases dropped off)and control group(n=54,2 cases dropped off).All patients were managed by systemic respiratory training,and those in treatment group were additionally treated with meridian penetration.Treated for 4 weeks,the aim was to compare pulmonary function indexes(forced vital capacity[FVC],forced expiratory volume in one second[FEV_(1)],peak expiratory flow[PEF],maximal voluntary ventilation[MVV]),diaphragmatic function(diaphragmatic motility,diaphragm thickness,diaphragmatic movement range),modified Medical Research Council(mMRC)dyspnea scale,Borg dyspnea scale,blood gas analysis indexes(partial pressure of arterial oxygen[PaO_(2)],partial pressure of carbon dioxide[PaCO_(2)],PaO_(2)/fraction of inspired oxygen[PaO_(2)/FiO_(2)]),incidence of pulmonary infection.Results After treatment,FVC,FEV_(1),PEF and MVV in the both groups were significantly increased(P<0.05),which were significantly higher in the treatment group than in the control group(P<0.05).The diaphragmatic motility,diaphragm thickness,diaphragmatic movement range in the both groups were significantly increased(P<0.05),the increase in the treatment group was more common than the control group(P<0.05).The mMRC dyspnea scale and Borg dyspnea scale scores in the both groups were significantly decreased(P<0.05),the decrease in the treatment group was more prevalent compared with the control group(P<0.05).After treatment,significantly increased PaO_(2)and PaO_(2)/FiO_(2),and decreased PaCO_(2)were found in the both groups(all P<0.05),and the treatment group was superior to the control group for PaO_(2),PaO_(2)/FiO_(2)and PaCO_(2)(all P<0.05).The incidence of pulmonary infection in the treatment group was significantly lower than that in the control group(7.6

关 键 词：颈髓损伤 肺功能障碍 针刺疗法 呼吸训练 

分 类 号：R256.1[医药卫生—中医内科学] R245.31[医药卫生—中医学]