基于数字健康模式下个性化帕金森病居家康复的效果

doi:10.3969/j.issn.1006-9771.2026.02.007

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (2): 181-190.doi: 10.3969/j.issn.1006-9771.2026.02.007

基于数字健康模式下个性化帕金森病居家康复的效果

夏岩, 徐思维, 祝岩岩, 王凤丽, 梁思捷, 李兢业, 梅光艳, 项洁()

徐州医科大学附属医院康复医学科，江苏徐州市 221000

收稿日期:2025-10-09 修回日期:2026-01-26 出版日期:2026-02-25 发布日期:2026-03-02
通讯作者: 项洁(1968-)，女，汉族，江苏徐州市人，博士，主任医师，博士研究生导师，主要研究方向：神经康复。E-mail： 18052268203@163.com E-mail:18052268203@163.com
作者简介:夏岩(1989-)，女，汉族，江苏徐州市人，硕士研究生，主治医师，主要研究方向：神经康复。
基金资助:
国家重点研发计划项目(2020YFC2006604)

Effect of personalized home-based rehabilitation under digital health model on Parkinson's disease

XIA Yan, XU Siwei, ZHU Yanyan, WANG Fengli, LIANG Sijie, LI Jingye, MEI Guangyan, XIANG Jie()

Department of Rehabilitation Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China

Received:2025-10-09 Revised:2026-01-26 Published:2026-02-25 Online:2026-03-02
Contact: XIANG Jie, E-mail: 18052268203@163.com E-mail:18052268203@163.com
Supported by:
National Key Research and Development Program(2020YFC2006604)

摘要/Abstract

摘要：

目的评价数字健康家庭服务模式下帕金森病患者个性化居家康复的效果。

方法 2022年1月至2023年12月，选取徐州医科大学附属医院参加数字健康模式项目的帕金森病患者100例，随机分为对照组(n= 50)和试验组(n = 50)。对照组接受常规治疗，试验组在常规治疗基础上增加个性化居家康复管理方案。干预前和干预后6个月，采用统一帕金森病评定量表第三部分(UPDRS-Ⅲ)和第四部分(UPDRS-Ⅳ)、Hoehn-Yahr (H-Y)分期、单日左旋多巴等效剂量(LEDD)、帕金森病生活质量问卷(PDQ-39)、患者健康问卷(PHQ-9)和广泛性焦虑障碍量表(GAD-7)进行评定，记录干预前后运动时间、收缩压和舒张压。

结果干预后，两组总体病情均有好转，试验组UPDRS-Ⅲ评分，UPDRS-Ⅳ总分，及PDQ-39总分和日常生活能力、精神健康、躯体不适维度分均优于对照组(|t| > 4.503, |Z| > 2.161, P < 0.05)，试验组运动时间、PHQ-9评分、GAD-7评分、收缩压和舒张压均优于对照组(|t| > 2.178, P < 0.05)。

结论个性化居家康复可更有效地改善帕金森症状，提高患者生活质量，改善一般健康水平。

关键词: 帕金森病, 数字健康模式, 居家康复, 慢性病管理

Abstract:

Objective To investigate the effect of personalized home-based rehabilitation under a digital health model on Parkinson's disease.

Methods From January, 2022 to December, 2023, 100 patients with Parkinson's disease who participated in the digital health model program at the Affiliated Hospital of Xuzhou Medical University were enrolled and randomly divided into control group (n = 50) and experimental group (n = 50). The control group received conventional treatment, while the experimental group additionally received a home-based rehabilitation management plan with personalized rehabilitation treatment. Before and six months after intervention, the Unified Parkinson's Disease Rating Scale Part Ⅲ (UPDRS-Ⅲ), Part Ⅳ (UPDRS-Ⅳ), Hoehn-Yahr (H-Y) stage, daily levodopa equivalent dose, Parkinson's Disease Questionnaire-39 (PDQ-39), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used for assessment. The time of exercise, systolic blood pressure and diastolic blood pressure were recorded before and after intervention.

Results After intervention, the most indices improved in both groups, and the total scores of UPDRS-Ⅲ, UPDRS-Ⅳ and PDQ-39, as well as the dimension scores of activities of daily living, mental health and physical discomfort of PDQ-39 were better in the experimental group than in the control group (|t| > 4.503, |Z| > 2.161, P < 0.05). The time of exercise, PHQ-9 score, GAD-7 score, systolic blood pressure and diastolic blood pressure improved more in the experimental group than in the control group (|t| > 2.178, P < 0.05).

Conclusion Personalized home-based rehabilitation is more effective on Parkinsonian symptoms, quality of life and general health conditions.

Key words: Parkinson's disease, digital health model, home-based rehabilitation, chronic disease management

中图分类号:

R742.5

夏岩, 徐思维, 祝岩岩, 王凤丽, 梁思捷, 李兢业, 梅光艳, 项洁. 基于数字健康模式下个性化帕金森病居家康复的效果[J]. 《中国康复理论与实践》, 2026, 32(2): 181-190.

XIA Yan, XU Siwei, ZHU Yanyan, WANG Fengli, LIANG Sijie, LI Jingye, MEI Guangyan, XIANG Jie. Effect of personalized home-based rehabilitation under digital health model on Parkinson's disease[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 181-190.

图/表 5

表1

表2

表3

两组干预前后PDQ-39评分比较"

变量	组别	n	测试	测量值	t/Z值	P值
身体活动	对照组	50	前测	22.4±11.2	8.843	< 0.001
			后测	21.9±11.9
	试验组	50	前测	22.1±10.8	21.202	< 0.001
			后测	21.8±11.1
	治疗前两组均值差			0.3±0.24	0.848	0.894
	治疗后两组均值差			0.1±0.18	1.127	0.262
日常生活能力	对照组	50	前测	12.0 (9.0)	2.504	0.037
日常生活能力			后测	11.0 (12.0)
	试验组	50	前测	12.0 (13.0)	6.146	< 0.001
			后测	10.0 (15.0)
	治疗前两组中值差			1.0 (1.5)	0.665	0.834
	治疗后两组中值差			2.0 (2.0)	2.410	0.018
精神健康	对照组	50	前测	4.0 (1.0)	4.092	0.007
精神健康			后测	3.0 (1.0)
	试验组	50	前测	4.0 (2.0)	6.147	< 0.001
			后测	2.0 (1.0)
	治疗前两组中值差			1.0 (1.0)	0.824	0.659
	治疗后两组中值差			1.0 (1.5)	4.973	< 0.001
耻辱感	对照组	50	前测	1.0 (2.5)	6.151	< 0.001
耻辱感			后测	0.0 (1.0)
	试验组	50	前测	1.0 (1.0)	2.203	0.028
			后测	0.0 (1.5)
	治疗前两组中值差			1.0 (1.5)	0.224	0.823
	治疗后两组中值差			1.0 (1.0)	0.138	0.857
社会支持	对照组	50	前测	1.0 (1.3)	2.008	0.051
			后测	0.0 (1.0)
	试验组	50	前测	1.0 (1.5)	1.866	0.067
			后测	0.0 (1.0)
	治疗前两组中值差			0.0 (1.8)	1.668	0.079
	治疗后两组中值差			1.0 (1.6)	1.028	0.159
认知	对照组	50	前测	3.0 (1.2)	-1.150	0.081
认知			后测	4.0 (1.8)
	试验组	50	前测	3.0 (1.6)	1.192	0.063
			后测	2.0 (1.5)
	治疗前两组中值差			1.0 (1.0)	-0.604	0.553
	治疗后两组中值差			2.0 (1.2)	3.017	0.003
交流	对照组	50	前测	0.0 (1.0)	-1.803	0.105
			后测	0.0 (1.0)
	试验组	50	前测	0.0 (1.0)	-1.410	0.164
			后测	0.0 (1.0)
	治疗前两组中值差			-1.0 (1.0)	-1.332	0.113
	治疗后两组中值差			-2.5 (1.3)	-2.945	0.004
躯体不适	对照组	50	前测	2.0 (1.0)	-2.802	0.010
躯体不适			后测	2.0 (1.0)
	试验组	50	前测	2.0 (1.0)	-6.034	< 0.001
			后测	1.0 (1.5)
	治疗前两组中值差			-1.5 (1.0)	-1.502	0.137
	治疗后两组中值差			-2.0 (1.0)	-3.337	0.001
总分	对照组	50	前测	49.3±26.2	17.004	< 0.001
			后测	46.6±27.0
	试验组	50	前测	48.8±26.0	18.302	< 0.001
			后测	39.5±21.2
	治疗前两组均值差			0.5±1.2	0.014	0.992
	治疗后两组均值差			7.1±2.2	4.503	< 0.001

表3

表4

表5

参考文献 44

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组别	n	性别(男/女)/n	年龄/岁	病程/年	有固定照护者/n	低教育水平/n
对照组	50	24/26	66.33±5.60	3.54±1.34	37	25
试验组	50	27/23	66.42±6.27	4.32±1.21	38	27
χ²/t值		0.207	-0.546	0.628	1.430	0.039
P值		0.649	0.586	0.487	0.232	0.844

基于数字健康模式下个性化帕金森病居家康复的效果

Effect of personalized home-based rehabilitation under digital health model on Parkinson's disease

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变量	组别	n	测试	测量值	t/Z值	P值
LEDD/mg	对照组	50	前测	534.5±172.3	2.172	0.098
LEDD/mg			后测	533.9±155.2
	试验组	50	前测	533.5±155.0	-1.810	0.610
			后测	536.5±145.5
	治疗前两组均值差			1.0±0.27	1.257	0.521
	治疗后两组均值差			-2.6±0.79	-1.684	0.095
UPDRS-Ⅲ评分	对照组	50	前测	28.0 (25.5)	-1.174	0.240
UPDRS-Ⅲ评分			后测	29.0 (23.5)
	试验组	50	前测	28.0 (20.5)	7.321	< 0.001
			后测	27.0 (20.0)
	治疗前两组中值差			1.0 (3.5)	0.393	0.695
	治疗后两组中值差			2.0 (1.0)	2.161	0.031
UPDRS-Ⅳ总分	对照组	50	前测	2.0 (4.0)	2.492	0.013
UPDRS-Ⅳ总分			后测	1.0 (3.5)
	试验组	50	前测	2.0 (3.0)	-2.951	0.009
			后测	1.0 (4.0)
	治疗前两组中值差			0.0 (2.0)	1.083	0.081
	治疗后两组中值差			0.0 (4.0)	3.871	< 0.001
UPDRS-Ⅳ异动症维度分	对照组	50	前测	0.0 (1.0)	1.040	0.170
UPDRS-Ⅳ异动症维度分			后测	0.0 (3.0)
	试验组	50	前测	0.0 (1.0)	-1.971	0.083
			后测	0.0 (2.0)
	治疗前两组中值差			0.0 (0.0)	0.022	0.843
	治疗后两组中值差			0.0 (0.0)	0.002	1.000
UPDRS-Ⅳ症状波动维度分	对照组	50	前测	1.0 (1.2)	-0.613	0.541
UPDRS-Ⅳ症状波动维度分			后测	0.0 (1.0)
	试验组	50	前测	1.0 (0.5)	-1.841	0.065
			后测	0.0 (1.0)
	治疗前两组中值差			0.0 (0.0)	0.001	1.000
	治疗后两组中值差			0.0 (1.0)	1.353	0.182
UPDRS- Ⅳ其他症状维度分	对照组	50	前测	0.0 (1.2)	-1.479	0.139
UPDRS- Ⅳ其他症状维度分			后测	0.0 (1.4)
	试验组	50	前测	0.0 (1.5)	1.928^a	0.022
			后测	0.0 (1.2)
	治疗前两组中值差			0.0 (0.4)	0.123	0.903
	治疗后两组中值差			1.0 (0.5)	1.391	0.168
H-Y分期	对照组	50	前测	2.0 (1.0)	0.704	0.484
			后测	1.5 (0.5)
	试验组	50	前测	2.0 (1.0)	0.409	0.685
			后测	1.5 (1.0)
	治疗前两组中值差			0.0 (0.0)	1.074	0.087
	治疗后两组中值差			1.0 (0.0)	1.164	0.063

变量	组别	n	测试	$\bar{x} \pm s$	t值	P值
收缩压/mmHg	对照组	50	前测	143.8±5.2	31.670	< 0.001
			后测	130.8±5.5
	试验组	50	前测	144.5±7.6	31.178	< 0.001
			后测	127.4±9.2
	治疗前两组均值差			-1.3±2.3	-0.809	0.420
	治疗后两组均值差			3.4±1.8	2.178	0.032
舒张压/mmHg	对照组	50	前测	94.3±2.2	12.170	< 0.001
			后测	86.8±7.4
	试验组	50	前测	93.1±3.5	29.483	< 0.001
			后测	80.5±2.7
	治疗前两组均值差			1.2±0.8	1.932	0.056
	治疗后两组均值差			6.3±1.2	5.276	< 0.001
运动时间/min	对照组	50	前测	18.44±4.13	25.630	< 0.001
			后测	35.31±2.24
	试验组	50	前测	17.18±2.44	39.724	< 0.001
			后测	39.74±2.85
	治疗前两组均值差			1.26±0.75	1.556	0.121
	治疗后两组均值差			-4.43±1.02	-8.369	< 0.001

变量	组别	n	测试	$\bar{x} \pm s$	t值	P值
GAD-7	对照组	50	前测	15.44±0.55	48.740	< 0.001
			后测	11.02±0.28
	试验组	50	前测	16.02±0.22	64.909	< 0.001
			后测	9.91±0.15
	治疗前两组均值差			-0.58±0.11	1.786	0.248
	治疗后两组均值差			1.11±0.15	14.264	< 0.001
PHQ-9	对照组	50	前测	18.05±1.74	25.806	< 0.001
			后测	14.94±1.75
	试验组	50	前测	18.01±1.22	28.937	< 0.001
			后测	13.46±0.35
	治疗前两组均值差			0.04±0.05	0.393	0.695
	治疗后两组均值差			1.48±0.67	5.770	< 0.001

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