不同呼吸训练对慢性非特异性腰痛患者躯干深层肌肉形态与功能的影响

doi:10.3969/j.issn.1006-9771.2026.04.009

摘要/Abstract

摘要：

目的对比膈式、腹式呼吸训练对慢性非特异性腰痛患者躯干深层肌肉形态与功能的影响。

方法 2025年3月至5月，纳入西安体育学院慢性非特异性腰痛患者37例，随机分为对照组(n = 12)、腹式呼吸组(n = 12)和膈式呼吸组(n = 13)。各组均接受经皮神经电刺激治疗和核心稳定训练，在此基础上，腹式呼吸组增加腹式呼吸训练，膈式呼吸组增加膈式呼吸训练，共6周。干预前后采用视觉模拟评分(VAS)评定其疼痛程度；采用表面肌电均方根值(RMS)评定多裂肌、腹横肌激活水平；采用肌骨超声评定多裂肌、腹横肌、膈肌厚度以及膈肌移动度。

结果干预后，除对照组膈肌厚度和移动度外，其余各组各项指标均显著改善(P < 0.001)。VAS评分的所有效应均显著(F > 4.634, P < 0.016)，膈式/腹式呼吸组均显著优于对照组(P < 0.01)；各肌肉形态和功能指标的组内效应(F > 64.869, P < 0.001)和交互效应(F > 12.379, P < 0.001)均显著，膈式呼吸组在多裂肌和腹横肌RMS、左侧多裂肌厚度、双侧腹横肌厚度、膈肌厚度和膈肌移动度方面，均优于对照组和腹式呼吸组(P < 0.05)；腹式呼吸组双侧腹横肌RMS、膈肌移动度和右侧多裂肌厚度方面优于对照组(P < 0.05)。

结论联合膈式/腹式呼吸训练可进一步改善慢性非特异性腰痛患者躯干深层肌肉的形态和功能，且膈式呼吸可能优于腹式呼吸。

关键词: 慢性非特异性腰痛, 膈式呼吸, 腹式呼吸

Abstract:

Objective To compare the effect of diaphragmatic and abdominal breathing training on the morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain.

Methods From March to May, 2025, a total of 37 patients with chronic nonspecific low back pain recruited at Xi 'an Physical Education University, were randomly divided into control group (n = 12), abdominal breathing group (n = 12) and diaphragmatic breathing group (n = 13). All groups received transcutaneous electrical nerve stimulation and core stability training. On this basis, the abdominal breathing group was added with abdominal breathing training, and the diaphragmatic breathing group was added with diaphragmatic breathing training, for six weeks. The degree of pain was evaluated with Visual Analogue Scale (VAS) before and after intervention, while the activation levels of multifidus and transversus abdominis were evaluated with the root mean square value (RMS) of surface electromyography, and the thickness of the multifidus muscle, transverse abdominis muscle, diaphragm and diaphragm mobility were evaluated with musculoskeletal ultrasound.

Results After intervention, all the indicators improved in all the groups (P< 0.001), except for the diaphragm thickness and mobility in the control group. All the effects (F> 4.634, P< 0.016) of VAS score were significant, and were better in the diaphragmatic/abdominal breathing groups than in the control group (P< 0.01). The intra-group effects (F> 64.869, P< 0.001) and interaction effects (F> 12.379, P< 0.001) of muscle morphology and function indexes were significant, and the RMS of multifidus and transversus abdominis, left multifidus thickness, bilateral transversus abdominis thickness, diaphragm thickness, and diaphragm excursion was better in the diaphragmatic breathing group than in the control group and the abdominal breathing group (P< 0.001), while bilateral transversus abdominis RMS, diaphragm excursion, and right multifidus thickness were better in the abdominal breathing group than in the control group (P< 0.037).

Conclusion The combination of diaphragmatic/abdominal breathing exercises can further improve the morphology and function of the deep muscles of trunk in patients with chronic nonspecific low back pain, and diaphragmatic breathing may be superior to abdominal breathing.

Key words: chronic nonspecific low back pain, diaphragmatic breathing, abdominal breathing

中图分类号:

R681.5

马竹一, 任超学. 不同呼吸训练对慢性非特异性腰痛患者躯干深层肌肉形态与功能的影响[J]. 《中国康复理论与实践》, 2026, 32(4): 453-462.

MA Zhuyi, REN Chaoxue. Effect of different breathing training on morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(4): 453-462.

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组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	病程/月	BMI/(kg·m^-2)
对照组	12	2/10	21.83±1.85	1.64±0.08	55.50±8.51	11.00±7.29	20.51±1.96
膈式呼吸组	13	2/11	23.15±2.04	1.64±0.08	57.58±10.75	11.54±6.42	20.95±3.31
腹式呼吸组	12	2/10	23.00±2.45	1.68±0.09	59.91±11.35	10.42±4.01	21.13±1.98
χ²/F值		0.239	1.413	0.693	0.553	0.106	0.191
P值		1.000	0.257	0.507	0.580	0.899	0.827

组别	n	治疗前	治疗后
对照组	12	3(3，3)	2(1.25，2)
膈式呼吸组	13	3(3，3)	1(0，1.5)
腹式呼吸组	12	3(3，3)	1(0.25，1)

效应	自由度	F值	P值
组内	1	163.774	< 0.001
组间	2	4.634	0.016
组内×组间	2	6.008	0.006

组别		平均值差	P值	95%CI
组别		平均值差	P值	下限	上限
对照组	膈式呼吸组	0.987	< 0.001	0.424	1.550
对照组	腹式呼吸组	0.833	0.002	0.259	1.408
膈式呼吸组	腹式呼吸组	-0.154	1.000	-0.717	0.409

变量	组别	n	治疗前		治疗后
变量	组别	n	均值	标准差	均值	标准差
左多裂肌RMS	对照组	12	51.50	19.34	61.17	26.16
左多裂肌RMS	膈式呼吸组	13	52.92	13.09	84.38	11.64
	腹式呼吸组	12	53.08	24.05	66.50	24.05
右多裂肌RMS	对照组	12	49.08	21.09	60.00	25.28
右多裂肌RMS	膈式呼吸组	13	50.23	17.84	85.38	11.32
	腹式呼吸组	12	51.83	26.25	65.58	24.93
左腹横肌RMS	对照组	12	61.42	20.00	72.25	19.27
	膈式呼吸组	13	62.00	15.88	106.34	16.40
	腹式呼吸组	12	63.00	18.83	89.42	25.49
右腹横肌RMS	对照组	12	62.08	17.86	73.50	15.86
	膈式呼吸组	13	64.85	15.40	104.63	14.83
	腹式呼吸组	12	61.83	21.75	89.33	23.31