呼吸功能训练对帕金森病患者膈肌及姿势稳定性的影响  

The Effects of Respiratory Training on Diaphragm and Postural Stability in Patients with Parkinson's Disease

作　　者：范杰诚[1] 王佳良 赵艳君 郭培武 张淑云[1] 于海宁 FAN Jiecheng;WANG Jialiang;ZHAO Yanjun;GUO Peiwu;ZHANG Shuyun;YU Haining(Weifang People's Hospital,Weifang,Shandong 261000;The First Affiliated Hospital of Shandong Second Medical University,Weifang,Shandong 261000)

机构地区：[1]潍坊市人民医院,山东潍坊261000 [2]山东第二医科大学第一附属医院,山东潍坊261000

出　　处：《中医康复》2025年第4期18-23,共6页Traditional Chinese Medicine Rehabilitation

基　　金：潍坊市卫健委科研项目(wfwsjk-2019-155)。

摘　　要：目的:探讨呼吸功能训练对帕金森病患者呼吸功能、膈肌运动及姿势稳定性的影响。方法:纳入符合入选标准的原发性帕金森病患者60例,采用随机数字表法将其随机分为治疗组和对照组各30例,两组患者均给予常规药物治疗和康复训练,每周进行3次训练,每次60 min,共进行24周训练:治疗组在常规训练基础上增加呼吸功能训练,每周5天,共进行24周训练。分别于治疗前、治疗12周和治疗24周后,评估两组患者的呼吸功能,包括第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)和第1秒用力呼气容积占用力肺活量百分比(FEV_(1)%),采用肌骨超声评估膈肌功能,包括膈肌移动度、膈肌厚度、膈肌增厚率,并采用UPDRS Ⅲ量表对两组患者的姿势稳定性进行评定。结果:治疗12周时,两组患者膈肌移动度、膈肌增厚率、FEV_(1)、FVC、FEV_(1)%及UPDRS Ⅲ量表评分较治疗前均有显著改善(P<0.05),并且对同时间点治疗组与对照组的上述指标进行比较,发现治疗组改善更为显著(P<0.05);治疗24周后,两组上述指标亦均较治疗前进一步改善(P<0.05),治疗组膈肌移动度、膈肌增厚率及FEV_(1)、FVC、FEV_(1)%及UPDRS Ⅲ量表评分改善更为显著(P<0.05),且与组内治疗12周时相比亦有进一步改善。结论:呼吸功能训练能明显改善帕金森病患者的呼吸功能和膈肌运动功能(膈肌厚度分数、膈肌移动度),提高患者姿势稳定性。Objective:To investigate the effects of respiratory training on diaphragm and postural stability of patients with Parkinson's disease.Methods:60 patients with idiopathic Parkinson's disease who met the inclusion criteria were included and randomly divided into the control group(n=30)and the treatment group(n=30).Both groups received routine drugs and rehabilitation training,including core control training,balance training,aerobic training,and gait training.While the treatment group was additionally given respiratory function training,including abdominal breathing training and inspiratory muscle training.Diaphragm movement(DD,DTei,DTee and DTF),respiratory function(FEV_(1),FVC and FEV_(1)%),and postural stability(UPDRS Ⅲ scores)were assessed before treatment,3 months and 6 months after treatment respectively.Results:At 12 weeks of treatment,the diaphragm mobility,diaphragm thickness rate,FEV_(1),FVC,FEV_(1)%and UPDRS Ⅲ scale scores in both groups of patients showed significant improvement compared to those before treatment(P<0.05).Moreover,when comparing these indicators between the treatment group and the control group at the same time point,the treatment group exhibited more significant improvements(P<0.05).After 24 weeks of treatment,the aforementioned indicators in both the treatment and control groups further improved compared to before treatment(P<0.05).The treatment group showed more noticeable improvements in diaphragm mobility,diaphragm thickness rate,FEV_(1),FVC,FEV_(1)%,and UPDRS Ⅲ scale scores(P<0.05),and there was also further improvement compared to the 12-week treatment results within the treatment group.Conclusion:Respiratory training can improve diaphragm movement and postural stability and respiratory function of patients with Parkinson's disease.

关 键 词：帕金森病 呼吸功能训练 膈肌 姿势稳定 

分 类 号：R493[医药卫生—康复医学]