贾健,梁英姿,刘晓哲.吸气肌训练对慢性阻塞性肺疾病患者自主神经功能及运动能力的影响[J].中华物理医学与康复杂志,2025,47(6):519-523
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| 吸气肌训练对慢性阻塞性肺疾病患者自主神经功能及运动能力的影响 |
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| DOI：10.3760/cma.j.cn421666-20250118-00011 |
| 中文关键词: 吸气肌训练 慢性阻塞性肺疾病 自主神经系统 心率变异性 运动能力 |
| 英文关键词: Inspiratory muscle training Chronic obstructive pulmonary disease Autonomic nervous system Heart rate variability Exercise capacity |
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| 中文摘要: |
| 目的 观察吸气肌训练对慢性阻塞性肺疾病（COPD）患者自主神经功能、呼吸肌力量、肺功能及运动能力的影响。 方法 采用随机数字表法将60例COPD患者分为观察组及对照组。2组患者均给予常规康复干预（包括药物治疗、缩唇呼吸及腹式呼吸等），观察组患者在此基础上辅以训练强度为30%最大吸气压、每周3次、共持续12周的吸气肌训练。于干预前、干预12周后采用电子肺量计测定患者肺功能及呼吸肌力量，同时检测患者心率变异性（HRV），采用6 min步行试验（6MWT）评估患者功能性运动能力改善情况。 结果 与干预前比较，干预后对照组上述各项指标（除最大吸气压外）均无显著变化（P>0.05）。与干预前及同期对照组比较，干预后观察组最大吸气压［(97.0±12.8)cmH2O］、6MWT步行距离［(423.8±71.8)m］均显著增加（P<0.05），6MWT测试结束时心率［(111.0±3.8)次/min］明显降低（P<0.05），HRV的正常窦性心率间期标准差（SDNN）、相邻RR间期差值的均方根值（RMSSD）及高频（HF）功率［分别为(19.5±4.7)ms、(26.1±5.8)ms和（67.1±9.2）%］均明显增加（P<0.05），低频（LF）功率［ (32.1±5.4)%］及LF/HF比值(0.51±0.11)均显著降低（P<0.05）。 结论 持续12周的低强度吸气肌训练能显著改善稳定期COPD患者的心脏自主神经功能、呼吸肌力量及功能性运动能力，对纠正COPD患者自主神经功能紊乱及降低心血管疾病发生风险具有积极作用。 |
| 英文摘要: |
| Objective To evaluate the effect of inspiratory muscle training on autonomic nervous function, respiratory muscle strength, lung function and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Methods Sixty COPD patients were randomly divided into an observation group and a control group, each of 30. Both groups received routine rehabilitation management (pharmacotherapy, pursed-lip breathing exercises, and abdominal breathing training), but the observation group also received threshold-loaded inspiratory muscle training at 30% of their maximum inspiration pressure. The regimen was three sessions weekly over a 12-week period. Before and after the intervention, everyone′s lung function and respiratory muscle strength were measured with an electronic spirometer. The 6min walking test (6MWT) was also administered, with the subjects′ heart rate variability (HRV) recorded. Results After the intervention, no significant change was observed among the control group in any of the measurements except in their average maximum inspiratory pressure and 6MWT distance. In the observation group there was a significant increase in their average maximum inspiratory pressure (97.0±12.8cmH2O) and 6MWT distance, but a significant decrease in the average heart rate after the 6MWT. Conclusions Twelve weeks of low-intensity inspiratory muscle training can significantly improve the respiratory muscle strength, functional exercise capacity and cardiac function of stable COPD patients, relieving their risk of cardiovascular disease. |
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