吸气肌训练对新冠病毒感染恢复后患者呼吸功能、心理和睡眠的影响

关键词：新型冠状病毒感染  吸气肌训练  呼吸功能  心理  睡眠

Keywords:corona virus disease 2019  inspiratory muscle training  respiratory function  psychology  sleep

摘要：

      摘要 目的：探究吸气肌训练（inspiratory muscle training， IMT）对新型冠状病毒感染恢复后患者呼吸功能、心理和睡眠的影响。 方法：选取2023年2月—6月中国人民解放军总医院第四医学中心康复医学科新型冠状病毒感染（corona virus disease 2019， COVID-19）恢复后，最大吸气压（maximal inspiratory pressure， MIP）<70%预测值的成年人76例，采用随机数字表法分为对照组 38例和试验组38例。对照组接受常规的康复训练指导；试验组在常规康复指导训练基础上，增加4周IMT。干预前、干预4周后，比较两组患者的呼吸功能指标，包括MIP、用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）、第1秒用力呼气容积/用力肺活量（FEV1/FVC）、呼气峰值流速（peak expiratory flow，PEF），并采用汉密尔顿抑郁量表（Hamilton depression scale， HAMD）、汉密尔顿焦虑量表（Hamilton anxiety scale， HAMA）和匹兹堡睡眠睡眠质量指数量表（Pittsburgh sleep quality index，PSQI）评估心理及睡眠的影响。 结果：干预4周后，对照组和试验组的MIP、FVC、FEV1、FEV1/FVC、HAMD、HAMA、PSQI均较干预前得到改善；试验组的MIP、PEF、PSQI明显优于干预前（P<0.05）；对照组MIP、FVC、FEV1、HAMA、PSQI明显优于干预前（P<0.05）。干预4周后，试验组的MIP、PEF明显优于对照组（P<0.05）；两组之间的FVC、FEV1、FEV1/FVC、HAMD、HAMA、PSQI相比，差异无显著性意义（P>0.05）。 结论：IMT可有效改善新型冠状病毒感染恢复后患者的呼吸功能、心理和睡眠，作为新型冠状病毒感染后患者的一种有效康复策略。

Abstract:

      Abstract Objective：To explore the effect of inspiratory muscle training （IMT） on respiratory function， psychological well-being, and sleep in patients recovered from corona virus disease 2019 （COVID-19） infection. Method：Seventy-six adults who had recovered from COVID-19 between February and June 2023 at the department of rehabilitation medicine of the fourth medical center of the PLA general hospital, with a massive inspiratory pressure （MIP） of less than 70% were selected for this study. The participants were randomly divided into the control group （n=38） and the experimental group （n=38）. The control group received conventional rehabilitation training, while the experimental group underwent an additional 4-week IMT program on top of conventional rehabilitation. Respiratory function including maximum massive inspiratory pressure （MIP），forced expiratory vital capacity （FVC）， forced expiratory volume in the first second （FEV1）， forced expiratory volume/forced vital capacity in the first second （FEV1/FVC）， and peak expiratory flow rate （PEF）, were measured before and after the 4-week intervention. Psychological status and sleep quality were assessed using the Hamilton depression scale （HAMD）， the Hamilton anxiety scale （HAMA） and Pittsburgh sleep quality index （PSQI）. Result：After 4 weeks of intervention， the MIP， FVC， FEV1， FEV1/FVC， HAMD， HAMA， and PSQI improved in both control and experimental group compared with pre-intervention. The MIP， PEF， and PSQI in the experimental group were significantly better than pre-intervention （P<0.05）； the control group showed significant improvement in MIP， FVC， FEV1， HAMA， and PSQI compared to pre-intervention （P<0.05）. After 4 weeks of intervention， the MIP and PEF in the experimental group were significantly better than those in the control group（P<0.05）； there was no significant difference in FVC， FEV1， FEV1/FVC， HAMD， HAMA， and PSQI between the two groups （P>0.05）. Conclusion： IMT can effectively improve the respiratory function， physical and mental health of patients recovered from COVID-19， making it an effective rehabilitation strategy for post-COVID-19 recovery.