戴允兰 孙鹏 龚心怡 吕倩 王元姣

[摘要] 目的 探究呼吸訓练对上交叉综合征患者膈肌运动及肺功能的影响。 方法 选取2017年2月至2019年2月浙江省人民医院康复医学科收治的40例上交叉综合征患者作为研究对象，采用随机数字表法分为观察组和对照组，每组各20例。对照组给予常规运动训练，观察组在对照组基础上给予全面呼吸功能训练。两组患者均于治疗前后行肺功能检测，在M型超声下观察平静呼吸、用力呼吸两组呼吸状态时的膈肌运动幅度。肺功能检测参数包括肺活量（VC）、用力肺活量（FVC）、最大通气量（MVV）实测值及实测值占预计值的百分比（实/预）。结果 治疗前，两组患者VC（实/预）、FVC（实/预）、MVV（实/预）比较，差异均无统计学意义（P>0.05）。观察组治疗后VC（实/预）、FVC（实/预）、MVV（实/预）均明显高于对照组，差异有统计学意义（P<0.05）。治疗前，两组患者两种呼吸状态时膈肌运动幅度比较，差异无统计学意义（P>0.05），观察组治疗后两种呼吸状态时的膈肌运动幅度均明显高于对照组，差异有统计学意义（P<0.05）。 结论 在常规运动疗法基础上进行呼吸功能训练能有效恢复上交叉综合征患者正常膈肌运动及肺功能，改善上交叉综合征患者呼吸功能。

[关键词] 呼吸训练;上交叉综合征;肺功能;膈肌运动

[中图分类号] R493          [文献标识码] A          [文章编号] 1673-9701（2021）06-0034-04

The impacts of respiratory training on diaphragmatic motion and pulmonary function in patients with upper cross syndrome

DAI Yunlan1， 2   SUN Peng2   GONG Xinyi2   LYU Qian2   WANG Yuanjiao1， 2

1.Zhejiang Chinese Medical University， Hangzhou   310053， China; 2.Department of Rehabilitation Medicine， Zhejiang Provincial People′s Hospital， People′s Hospital Affiliated to Hangzhou Medical College， Hangzhou   310014， China

[Abstract] Objective To investigate the impacts of respiratory training on diaphragmatic motion and pulmonary function in patients with upper cross syndrome. Methods A total of 40 patients with upper cross syndrome admitted to the Department of Rehabilitation Medicine of Zhejiang Provincial People′s Hospital from February 2017 to February 2019 were selected as the research objects. And they were divided into the observation group（n=20） and the control group（n=20） according to the random number table method. The control group was given conventional exercise training， while the observation group was given comprehensive respiratory function training on the basis of the control group. Before and after treatment， the pulmonary function was tested， and the diaphragmatic motion amplitude was observed under M-mode ultrasound in two breathing states， which were calm breathing and forced breathing. The parameters of pulmonary function test included the measured values of vital capacity（VC）， forced vital capacity（FVC）， maximal voluntary ventilation（MVV） and the percentage of the measured values to the predicted values（measured/predicted）. Results Before treatment， there was no significant difference in VC（measured/predicted）， FVC（measured/predicted） and MVV（measured/predicted） between the two groups（P>0.05）. After treatment， VC（measured/predicted）， FVC（measured/predicted） and MVV（measured/predicted） in the observation group were significantly higher than those in the control group（P<0.05）. Before treatment， there was no significant difference in diaphragm movement amplitude of two breathing states between the two groups（P>0.05）. After treatment， the diaphragm movement amplitude of two breathing states in the observation group was significantly higher than that in the control group（P<0.05）. Conclusion On the basis of conventional exercise therapy， respiratory function training can effectively restore the normal diaphragmatic motion and pulmonary function of patients with upper cross syndrome， improving the respiratory function of patients with upper cross syndrome.

[Key words] Respiratory training; Upper cross syndrome; Pulmonary function; Diaphragmatic motion

上交叉综合征（Upper cross syndrome，UCS）是由于肌肉失衡导致姿势不对称而引发的慢性运动系统疼痛综合征，其命名源于无力松弛和紧张的肌肉在上身形成交叉状连线，可引起肩带姿势与功能改变、颈肩臂疼痛麻木、头痛、头晕、消化与呼吸功能减弱等一系列症状[1-3]。患者最明显外观特征是其头部常常不自觉向前倾，背部胸椎位置弯曲，从身体的侧面看脊椎是呈“C”字型，肩胛骨上提或前倾[4]。近年来，国内外许多康复医学……