《中国康复理论与实践》

《中国康复理论与实践》

• 临床研究 • 上一篇    下一篇

心率变异性生物反馈改善卒中后抑郁压力反应的研究①

李欣1,2,3，桑德春1,2,3，邢春晓4，陈炘钧4,5，宋鲁平1,2,3   

  1. 1. 首都医科大学康复医学院，北京市100068；2. 中国康复研究中心北京博爱医院，北京市100068；3. 神经损伤与康复北京市重点实验室，北京市100068。4. 清华大学信息技术研究院计算机系，清华信息科学与技术国家实验室，北京市100084；5. 亚利桑那大学管理信息系统系人工智能实验室，美国图森。
  • 出版日期:2016-08-25 发布日期:2016-09-22

Effects of Heart Rate Variability Biofeedback Therapy on Stress Reaction in Patients with Post-stroke Depression

LI Xin1,2,3, SANG De-chun1,2,3, XING Chun-xiao4, CHEN Hsinchun4,5, SONG Lu-ping1,2,3   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China; 2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China; 3. Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing 100068, China; 4. Department of Computer Science and Technology, Research Institute of Information Technology, Tsinghua National Laboratory for Information Science and Technology, Tsinghua University, Beijing 100084, China; 5. Department of Management Information Systems, Artificial Intelligence Laboratory, University of Arizona, Tucson, AZ, USA
  • Published:2016-08-25 Online:2016-09-22

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摘要： 目的探讨认知压力刺激下，心率变异性生物反馈改善自主神经系统功能从而降低压力反应的机制。方法2013 年5月~2015 年12 月，将48 例脑卒中后抑郁患者随机分为反馈组(n=25)和对照组(n=23)。反馈组给予心率变异性生物反馈治疗，而对照组仅使用电脑开展放松治疗而没有反馈信号。以认知能力测试作为压力源，在治疗前后分别比较安静基线状态下、压力状态下及休息状态下心率变异性指标。结果压力刺激下，对照组低频段升高速度高于反馈组(P=0.02)，反馈组心率下降而对照组升高(P=0.05)；结束时反馈组心率下降且最终低于基线水平(P=0.02)。结论应对认知压力刺激时，心率变异性生物反馈通过降低交感神经敏感性，使个体的交感神经和副交感神经达到动态的平衡。

关键词: 脑卒中, 心率变异性, 生物反馈, 压力

Abstract: Objective To investigate the self-regulation of the autonomic nervous system following the cognitive stress tests after heart rate variability (HRV) biofeedback therapy in patients with post-stroke depression (PSD). Methods From May, 2013 to December, 2015, 48 patients with PSD were randomly divided into feedback group (n=25) and control group (n=23). The feedback group received HRV biofeedback therapy, while the control group only received relaxation therapy without feedback signal. HRV parameters were tracked during the cognitive stress test in quiet baseline state, cognitive stress state, and resting state before and after treatment. Results Under the stress condition, the low frequency of both groups increased during the first cognitive test, and the rate was higher in the control group than in the feedback group (P=0.02). The heart rates during the second cognitive test decreased in the feedback group, while increased in the control group (P=0.05). After rest, the heart rate of the feedback group decreased below the baseline (P=0.02). Conclusion During the cognitive stress test, HRV biofeedback therapy can achieve a dynamic balance between sympathetic and parasympathetic nerves by reducing sympathetic sensibility, which improved patients' adaptive capacity to cope with their internal physiological environment and external environmental pressures.

Key words: stroke, heart rate variability, biofeedback, stress test