呼吸训练对脑卒中患者睡眠、情绪变化的作用机制探讨

Mechanism of the effect of breathing training on sleep and mood changes in stroke patients

目的观察呼吸训练对脑卒中患者血浆儿茶酚胺浓度及睡眠、情绪的影响,进而探讨其作用机制。方法选取脑卒中患者50例,将其分为对照组(25例)与训练组(25例),2组均接受常规康复,训练组在此基础上接受呼吸训练,2组训练总时间均为6周。比较2组患者康复治疗前后的血浆儿茶酚胺浓度[去甲肾上腺素(NE)、肾上腺素(E)、多巴胺(DA)]的变化,并采用匹兹堡睡眠质量指数(PSQI)评估睡眠质量,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估焦虑、抑郁情况。结果治疗6周后,2组患者的NE、E、DA浓度及PSQI、SAS、SDS评分均较治疗前降低(P均<0.05)。训练组的NE、E、DA浓度均低于对照组,PSQI、SAS、SDS评分低于对照组(P均<0.05)。结论呼吸训练有助于提高脑卒中患者睡眠质量,并能改善焦虑抑郁情绪,其机制可能与其调节自主神经功能,降低交感神经活动从而降低儿茶酚胺浓度有关。

Objective To observe the effect of breathing training on plasma catecholamine concentration,sleep and mood in stroke patients,and unravel the underlying mechanism.Methods Fifty stroke patients were selected and randomly assigned into the control group(n=25)and training group(n=25).Patients in both groups received conventional rehabilitation.In the training group,breathing training was supplemented.The total training time was 6 weeks in two groups.The changes of plasma catecholamine concentration(norepinephrine(NE),epinephrine(E),dopamine(DA))between two groups were compared before and after corresponding interventions.The quality of sleep was assessed by the Pittsburgh Sleep Quality Index scale(PSQI).The anxiety and depression were assessed by the Self-Assessment Scale for Anxiety(SAS)and the Self-Assessment Scale for Depression(SDS).Results After 6 weeks of treatment,NE,E and DA concentrations and PSQI,SAS and SDS scores were significantly lower than those before treatment in two groups(all P<0.05).These parameters in the training group were significantly lower compared with those in the control group(all P<0.05).Conclusions Breathing training improves the quality of sleep and mitigates anxiety and depression in stroke patients,probably via the mechanism of regulating autonomic function and lowering sympathetic activity,thereby reducing catecholamine concentration.