体外膈肌起搏联合呼吸健肺功治疗脑卒中后肺功能障碍

External Diaphragmatic Pacing Combined with Hu Xi Jian Fei Gong in the Treatment of Pulmonary Dysfunction after Stroke

目的 探究体外膈肌起搏(EDP)联合呼吸健肺功治疗脑卒中患者肺功能障碍的临床疗效。方法 选取2020年6月—2022年6月在上海市同仁医院及上海中医药大学附属岳阳中西医结合医院治疗的162例脑卒中患者作为研究对象,分为观察组和对照组,每组各81例。两组均接受常规康复治疗及EDP,观察组同时接受呼吸健肺功。比较治疗前及治疗4周后两组用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PEF)、膈肌移动度、呼气末膈肌厚度、吸气末膈肌厚度。并在治疗前、治疗4周后及治疗结束12周后,比较上海中医药大学附属岳阳中西医结合医院收治的72例患者的日常生活活动能力(ADL)。结果 治疗后,两组患者FVC、FEV_(1)、PEF、呼气末膈肌厚度、吸气末膈肌厚度均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。治疗4周后及治疗结束12周后,72例患者ADL评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。结论 EDP联合呼吸健肺功,能更好地改善脑卒中后患者的肺功能。

Objective To investigate the clinical effect of external diaphragmatic pacing(EDP)combined with Hu Xi Jian Fei Gong in the treatment of pulmonary dysfunction in stroke patients.Methods From July 2020 to July 2022,162 stroke patients in Shanghai Tongren Hospital and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine were randomly divided into a control group and an observation group,with 81 patients in each group.Both group received conventional rehabilitation and EDP,and the observation group additionally received Hu Xi Jian Fei Gong.Forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),peak expiratory flow(PEF),diaphragmatic mobility,end-expiratory diaphragmatic thickness,and end-inspiratory diaphragmatic thickness were compared between the two groups before treatment and after 4 weeks of treatment.The activity of daily living(ADL)of 72 patients admitted to Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine were compared before treatment,after 4 weeks of treatment and 12 weeks after the end of treatment.Results After treatment,FVC,FEV_(1),PEF,end-expiratory diaphragmatic thickness and end-inspiratory diaphragmatic thickness in the two groups were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After 4 weeks of treatment and 12 weeks after the end of treatment,the ADL scores of 72 patients were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion EDP combined with Hu Xi Jian Fei Gong training can better improve the pulmonary function of patients after stroke.