慢速呼吸训练调整血压功能的系统综述

doi:10.3969/j.issn.1006-9771.2021.11.009

Abstract

Abstract:

Objective To evaluate the effects of slow breathing training on hypertension.Methods Articles about slow breathing training for hypertension were retrieved from CNKI, Wangfang Data, PubMed and Web of Science, until March, 2021. The authors, publishing time, subjects, interventions and courses, and outcome indexes and conclusion were extracted.Results There were 924 articles returned, and 35 included, which published mainly from 2009 to 2020. The subjects were patients with hypertension, and the outcome index was blood pressure.Conclusion Slow breathing training may work for hypertension, which associates to baroreflex sensitivity, heart rate variability, sympathetic nerve activity and cardiopulmonary diastolic receptors.

Key words: hypertension, slow breathing training, systematic review

HAO Wen-xue,ZHENG Jie,LI Rui-qing,FENG Hong-xia,LI Jie-ying,HU Yan-chao,FENG Xiao-dong. Slow Breathing Training for Hypertension: A Systematic Review[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1299-1306.

Figures/Tables 2

研究	出版年	研究对象	干预	主要结局指标	结果
瑜伽调息
Mourya等^[8]	2009	原发性高血压	交替鼻孔慢呼吸,3个月	血压、心率随呼吸变化,握力试验、冷压反应等自主神经功能测试	血压在3个月内下降,疗效优于快呼吸
Fetter等^[9]	2020	高血压绝经女性	瑜伽或伸展动作+慢呼吸,12周	血压、血管和内皮功能以及氧化应激状况	进一步改善血压、血管和内皮功能,以及氧化应激状况
Bhavanani等^[10]	2011	高血压	Sukha调息	干预前和干预后即刻心率和血压	心率、收缩压、脉压、平均动脉压、心率-压力乘积和倍数乘积降低
Thanalakshmi 等^[11]	2020	高血压	Sheetali调息,3个月	血压、HRV	血压降低,HRV改善
冥想
Hager等^[14]	1978	原发性高血压	冥想,4周	收缩压和舒张压	收缩压和舒张压降低
Manikonda等^[15]	2008	原发性高血压	冥想,8周	心率、收缩压和舒张压	心率、收缩压和舒张压降低
沈红五等^[16]	2013	轻、中度高血压	冥想,8周	血压,血浆肾上腺素、去甲肾上腺素水平	血压、肾上腺素与去甲肾上腺素水平降低
宋艳等^[17]	2013	轻、中度高血压	冥想,8周	血压、焦虑自评量表和抑郁自评量表评分,肾上腺素和去甲肾上腺素的水平	收缩压、舒张压、焦虑评分低于对照组;肾上腺素和去甲肾上腺素低于干预前
de Fatima等^[18]	2015	1级高血压	冥想,3个月	血压、简易精神状态检查、生活质量评估工具	降低收缩压,改善心理状况和生活质量
Venturelli等^[19]	2015	1级高血压	冥想,12周	静息血压、血糖和胆固醇水平、峰值摄氧量、机械效率和生活质量	改善血压和生活质量
Blackwell等^[22]	1976	高血压	超觉冥想,12周	血压、焦虑评分	降低血压和焦虑评分
Pollack等^[23]	1977	高血压	超觉冥想,6个月	收缩压、舒张压、脉率、血浆凝集素	收缩压和脉率小幅下降
Duraimani等^[55]	2015	1级高血压	超觉冥想,16周	端粒酶基因表达和血压	端粒酶基因表达增加,血压降低
负荷呼吸
Jones等^[24]	2010	1级或2级原发性高血压	慢速负荷(20 cmH₂O)呼吸,8周	静息血压和心率	血压下降更显著
Sangthong等^[25]	2016	单纯收缩期高血压	慢速负荷(18 cmH₂O)呼吸,8周	血压和心率	降低静息血压,疗效持续更久
Ubolsakka-Jones 等^[26]	2017	单纯收缩期高血压	慢速负荷(18 cmH₂O)呼吸,8周	静态握力运动血压	降低静息收缩压
Ublosakka-Jones 等^[27]	2018	单纯收缩期高血压	慢负荷呼吸(25%最大吸气压),8周	静息血压和心率;最大吸气压;肺活量;胸腹伸展;50%心率储备下手臂屈曲运动耐力	降低静息血压,增加吸气肌力、肺活量和手臂运动持续时间
Ubolsakka-Jones 等^[28]	2019	单纯收缩期高血压	慢负荷呼吸(25%最大吸气压),8周	家庭、实验室血压和心率对静态握力和动态手臂弯曲运动的反应	降低患者的静息血压及对静态和动态运动的反应
音乐引导
Modesti等^[31]	2010	高血压	音乐引导慢速呼吸,6个月	24 h动态血压	收缩压降低
Modesti等^[32]	2015	1级原发性高血压	音乐引导慢速呼吸,8周	办公室和动态血压监测、肾脏多普勒超声、序贯方法和频谱分析、高频和低频频谱功率	动态血压降低
Kow等^[33]	2018	1级原发性高血压	音乐引导慢速呼吸,8周	收缩压和舒张压	收缩压和舒张压降低
设备引导
Schein等^[34]	2001	高血压	互动音乐呼吸设备引导慢速呼吸,8周	收缩压、舒张压和平均动脉压	血压降低
Viskoper等^[35]	2003	高血压	RESPeRATE^®引导慢呼吸,8周	办公室和家庭血压	血压降低
Anderson等^[36]	2010	高血压前期或1级高血压	RESPeRATE^®引导慢呼吸,4周	24 h血压和呼吸模式	降低静息血压、午间动态收缩压(仅限女性)和静息呼吸频率,增加静息潮气量
Schein等^[38]	2009	高血压、2型糖尿病	RESPeRATE^®引导慢呼吸,8周	办公室血压	随着依从性增加,血压下降幅度更大
Howorka等^[39]	2013	高血压、糖尿病	RESPeRATE^®引导慢呼吸,8周	动态血压监测和标准化改良立位负荷时的短期HRV频谱	收缩压和脉压降低;HRV增加
Oneda等^[40]	2010	高血压	互动音乐呼吸设备引导的慢速呼吸	即时肌交感神经活动、血压、心率	降低血压和交感神经活动
Bertisch等^[41]	2011	高血压伴阻塞性睡眠呼吸暂停	BiPAP^®Pro2引导慢速呼吸,8周	办公室收缩压和舒张压	收缩压降低
Adams等^[42]	2018	高血压前期	呼吸意识冥想APP引导慢速呼吸,6个月	静息血压、心率	收缩压降低
Chandler等^[43]	2020	高血压	呼吸意识冥想APP引导慢速呼吸,12个月	静息收缩压	收缩压降低
Bachler等^[44]	2020	高血压	生物信号探测系统连接APP设备引导慢速呼吸	即时脉冲到达时间	脉冲到达时间增加,血压降低
de Barros等^[50]	2017	高血压	RESPeRATE^®引导慢呼吸,8周	动态血压监测、儿茶酚胺和肌交感神经活动	对血压、儿茶酚胺水平和肌交感神经活动无影响
Altena等^[57]	2009	高血压	RESPeRATE^®引导慢呼吸,9周	血压和生活质量	对血压或生活质量无影响
其他
Da Justa Pinheiro等^[47]	2007	原发性高血压	通过更大的胸部扩张进行慢速呼吸训练,1个月	HRV、收缩压、舒张压、平均动脉压、呼吸测量、胸部扩张测量	收缩压、舒张压和平均动脉压降低;HRV增加;呼吸频率下降;潮气量和胸廓扩张性增加
Kaushik等^[58]	2006	原发性高血压	自主调节慢速呼吸训练	即时收缩压、舒张压、心率、呼吸频率、肌电活动、外周皮温和皮肤电导率	心率、呼吸频率、收缩压和舒张压降低

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Slow Breathing Training for Hypertension: A Systematic Review

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