呼吸训练对帕金森病患者肺功能和运动功能的效果

doi:10.3969/j.issn.1006-9771.2021.03.012

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (3): 320-324.doi: 10.3969/j.issn.1006-9771.2021.03.012

呼吸训练对帕金森病患者肺功能和运动功能的效果

厉坤鹏¹,周宗磊²,张梓楠¹(),施伯翰¹,陈浩¹,罗云¹,朱燕¹

^1.上海市第二康复医院神经康复科，上海市 200441
^2.四川大学华西公共卫生学院/四川大学华西第四医院，四川成都市 610041

收稿日期:2020-06-02 修回日期:2020-07-06 出版日期:2021-03-25 发布日期:2021-04-02
通讯作者: 张梓楠 E-mail:312523418@qq.com
作者简介:厉坤鹏(1988-)，男，汉族，河南开封市人，硕士，主治医师，主要研究方向：神经康复|张梓楠，女，硕士，副主任医师，主要研究方向：肺康复。
基金资助:
上海市卫生和计划生育委员会科研课题计划面上项目(201740184);上海市卫生和计划生育委员会科研课题计划青年项目(20184Y0179);上海市宝山区科学技术委员会医学卫生项目(19-E-26)

Effects of Respiratory Training on Pulmonary Function and Motor Function for Patients with Parkinson's Disease

Kun-peng LI¹,Zong-lei ZHOU²,Zi-nan ZHANG¹(),Bo-han SHI¹,Hao CHEN¹,Yun LUO¹,Yan ZHU¹

^1.Department of Neurorehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai 200441, China
^2.West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China

Received:2020-06-02 Revised:2020-07-06 Published:2021-03-25 Online:2021-04-02
Contact: Zi-nan ZHANG E-mail:312523418@qq.com
Supported by:
Shanghai Municipal Health and Family Planning Commission Scientific Research Plan (General)(201740184);Shanghai Municipal Health and Family Planning Commission Scientific Research Plan (Youth)(20184Y0179);Shanghai Baoshan Science and Technology Commission Medical and Health Project(19-E-26)

摘要/Abstract

摘要： 目的

探讨呼吸训练对帕金森病患者肺功能和肢体运动功能的影响。

方法

2018年1月至2019年11月选取上海市第二康复医院原发性帕金森病住院患者60例，随机分为对照组(n = 30)和观察组(n = 30)，两组均予常规康复，观察组采用Power Breathe训练系统予呼吸训练。治疗前和治疗4周后，测量患者肺功能，采用统一帕金森病评定量表(UPDRS)第Ⅱ、Ⅲ部分和改良Barthel指数(MBI)进行评定。

结果

治疗后，两组UPDRS第Ⅱ、Ⅲ部分和MBI评分均改善(|t| > 2.550, P < 0.05)；观察组用力肺活量(FVC)、第一秒用力呼气容积(FEV₁)、50%肺活量时的最大呼气流速(MEF₅₀)明显升高(|t| > 2.838, P < 0.01)，对照组无明显变化(|t| < 1.058, P > 0.05)；与对照组相比，观察组FVC、FEV₁、MEF₅₀、MBI和UPDRS第Ⅱ部分评分均改善更多(|t| > 2.191, P < 0.05)。

结论

增加呼吸训练能显著改善帕金森病患者肺功能，从而提高患者的日常生活能力，但并不能进一步改善患者的运动功能。

关键词: 帕金森病, 呼吸训练, 肺功能, 运动功能

Abstract: Objective

To explore the effects of respiratory training on pulmonary and motor function for patients with Parkinson's disease.

Methods

From January, 2018 to November, 2019, 60 inpatients with idiopathic Parkinson's disease from the Second Rehabilitation Hospital of Shanghai were randomly divided into control group (n = 30) and experimental group (n = 30). All the patients accepted routine rehabilitation, while the experimental group accepted respiratory training with Power Breathe in addition. They were measured the pulmonary function, and assessed with Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and modified Barthel Index (MBI) before and four weeks after treatment.

Results

The scores of UPDRS II and III, and MBI improved in both groups after treatment (|t| > 2.550, P < 0.05), while the forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁) and maximum expiratory flow rate at 50% vital capacity (MEF₅₀) increased in the experimental group (|t| > 2.838, P < 0.01), but did not in the control group (|t| < 1.058, P > 0.05). FVC, FEV₁, MEF₅₀, MBI score and UPDRS II score improved more in the experimental group than in the control group (|t| > 2.191, P < 0.05).

Conclusion

Respiratory training can improve pulmonary function for patients with Parkinson's disease, to further improve their activities of daily living. No synergistic effect is found on motor function.

Key words: Parkinson's disease, respiratory training, pulmonary function, motor function

中图分类号:

R742.5

厉坤鹏,周宗磊,张梓楠,施伯翰,陈浩,罗云,朱燕. 呼吸训练对帕金森病患者肺功能和运动功能的效果[J]. 《中国康复理论与实践》, 2021, 27(3): 320-324.

Kun-peng LI,Zong-lei ZHOU,Zi-nan ZHANG,Bo-han SHI,Hao CHEN,Yun LUO,Yan ZHU. Effects of Respiratory Training on Pulmonary Function and Motor Function for Patients with Parkinson's Disease[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(3): 320-324.

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组别	n	性别(n)		年龄(岁)	病程(年)	Hoehn-Yahr分期(n)
组别	n	男	女	年龄(岁)	病程(年)	Ⅱ期	Ⅲ期	Ⅳ期
对照组	30	17	13	63.17±5.78	8.29±2.19	12	12	6
观察组	30	16	14	65.53±9.43	8.11±2.23	10	13	7
χ²/t值		0.067		1.169	-0.315	0.299
P值		0.795		0.247	0.754	0.861

组别	n	治疗前	治疗后	t值	P值
对照组	30	3.05±0.28	3.11±0.21	-0.939	0.352
观察组	30	3.15±0.23	3.43±0.33	-3.813	< 0.001
t值		1.512	4.481
P值		0.136	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	2.29±0.38	2.32±0.36	-0.314	0.755
观察组	30	2.31±0.23	2.51±0.31	-2.838	0.006
t值		0.247	2.191
P值		0.806	0.033

组别	n	治疗前	治疗后	t值	P值
对照组	30	3.51±0.28	3.58±0.23	-1.058	0.294
观察组	30	3.44±0.31	3.75±0.26	-4.197	< 0.001
t值		-0.918	2.682
P值		0.363	0.010

组别	n	治疗前	治疗后	t值	P值
对照组	30	33.57±6.82	29.03±5.31	2.877	0.006
观察组	30	32.10±6.03	25.83±5.67	4.150	< 0.001
t值		-0.884	-2.256
P值		0.380	0.028

呼吸训练对帕金森病患者肺功能和运动功能的效果

Effects of Respiratory Training on Pulmonary Function and Motor Function for Patients with Parkinson's Disease

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组别	n	治疗前	治疗后	t值	P值
对照组	30	35.93±3.87	29.27±2.49	7.927	< 0.001
观察组	30	34.70±4.25	30.10±5.34	3.692	< 0.001
t值		0.734	0.772
P值		0.466	0.444

组别	n	治疗前	治疗后	t值	P值
对照组	30	68.83±6.18	72.77±5.78	-2.550	0.013
观察组	30	65.90±6.99	77.23±6.30	-6.595	< 0.001
t值		-1.720	2.857
P值		0.091	0.006

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