调阴和阳针法联合Bobath疗法对中风后痉挛性瘫痪患者痉挛程度及运动功能的影响

:-
 
目的 探究调阴和阳针法联合Bobath疗法对中风后痉挛性瘫痪(spastic paralysis after stroke,SPAS)患者痉挛程度及运动功能的影响。方法 回顾性选取2024年2月至2026年2月就诊于我院的102例SPAS患者,按照治疗方案分为对照组、研究组,各51例。对照组采用Bobath疗法治疗,研究组采用调阴和阳针法联合Bobath疗法治疗,均治疗4周。比较两组临床疗效、治疗前后中医证候积分、肢体痉挛程度[改良Ashworth分级(MAS)]、相关量表[Fugl-Meyer运动功能量表(FMA)、功能独立性量表(FIM)、Berg平衡量表(BBS)、改良Barthel指数(MBI)]评分、不良反应发生情况。结果 研究组愈显率、总有效率均高于对照组(P<0.05);研究组治疗4周后半身不遂、头晕目眩、肢体麻木或手足拘急、舌强言謇、口舌歪斜积分低于对照组(P<0.05);研究组治疗4周后MAS评分低于对照组(P<0.05);研究组治疗4周后FMA、FIM、BBS、MBI评分高于对照组(P<0.05);两组均无严重不良反应发生。结论 采用调阴和阳针法联合Bobath疗法联合治疗SPAS患者可有效减轻临床症状及痉挛程度,提高疗效,且有利于促进患者运动功能、平衡能力及生活能力恢复,安全性良好。

运动干预对老年肌少性肥胖患者疗效的Meta分析

Effects of exercise intervention in elderly patients with Sarcopenia Obesity: a meta-analysis

:-
 
目的 评价不同运动干预对老年肌少性肥胖患者健康状况的干预效果。 方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库、维普数据库中关于运动干预老年肌少性肥胖患者的运动干预的随机对照试验,检索时限为建库至2025年8月。采用RevMan 5.4软件进行统计分析。 结果 共计纳入13篇文献,815名参与者。运动可显著改善患者身体质量指数 (P<0.0001)、体脂率 (P=0.001)、四肢骨骼肌质量(P<0.0001)、握力(P=0.007)、步速 (P=0.0003)、起立-行走计时测试用时(P<0.00001),提高患者IGF-1水平(P =0.0003);但IL-6(P =0.96)、血清总胆固醇(P=0.22)未见明显改变。 结论 运动可以有效降低肌少性肥胖患者的身体质量指数、体脂肪, 提高肌少性肥胖患者的身体机能、四肢骨骼肌质量和IGF-1水平,其中多组分运动和抗阻运动效果更加显著。
Objective To evaluate the effect of different exercise intervention on the health status of elderly patients with sarcopenia and obesity. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang database and VIP database were searched for randomized controlled trials on exercise intervention in elderly patients with sarcopenia and obesity until August 2025.Two researchers independently screened the literature, extracted the data, and evaluated the bias risk of the included studies, and then used RevMan 5. 3 software for statistical analysis. Results a total of 13 articles involving 815 participants were included.Exercise significantly reduced body mass index (P < 0.0001), body fat percentage (P = 0.001), and increased limb skeletal muscle mass (P < 0.0001).Exercise significantly improved the patient's grip strength (P = 0.007), pace (P = 0.0003), and decreased the time spent on the timed up-and-go test (P < 0. 00001).Exercise significantly increased serum IGF-1 levels (P = 0.0003), but did not significantly change serum IL-6 (P = 0.96) and serum total cholesterol (P = 0.22). Conclusion Exercise can effectively reduce the body mass index and body fat, and improve the body function, limb skeletal muscle mass and IGF-1 level in patients with sarcopenia obesity, and the effects of multi-component exercise and resistance exercise are more significant.

基于圆运动和五脏相关理论探讨2型糖尿病的病因病机与治疗

:-
 
2型糖尿病(T2DM)作为临床常见代谢性疾病,其病机阐释多从“阴虚燥热”立论,然临证所见,单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴,四维如轮,轴运轮行,轮运轴灵”为核心框架,结合五脏相关、气机升降、气化失常理论,重新阐释T2DM的病因病机:认为脾胃中气亏虚、枢机失运是发病之本,肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标,痰、湿、瘀、热为病理产物,共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲,提出“运轴复轮、轴轮并调、标本同治”的核心治法,分阶段、分脏腑辨证施治,兼顾气机升降与气化功能,为T2DM的中医诊疗提供新的理论视角与临床思路。

基于圆运动和五脏相关理论探讨2型糖尿病的病因病机与治疗

:-
 
2型糖尿病(T2DM)作为临床常见代谢性疾病,其病机阐释多从“阴虚燥热”立论,然临证所见,单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴,四维如轮,轴运轮行,轮运轴灵”为核心框架,结合五脏相关、气机升降、气化失常理论,重新阐释T2DM的病因病机:认为脾胃中气亏虚、枢机失运是发病之本,肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标,痰、湿、瘀、热为病理产物,共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲,提出“运轴复轮、轴轮并调、标本同治”的核心治法,分阶段、分脏腑辨证施治,兼顾气机升降与气化功能,为T2DM的中医诊疗提供新的理论视角与临床思路。
论著

个性化营养干预联合分级步行运动方案对肺癌化疗患者癌因性疲乏及生活质量的影响

Effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy

:367-372
 
       目的  分析对肺癌化学治疗(化疗)患者采取个性化营养干预联合分级步行运动方案的应用价值。   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象,通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案,观察组则联合分级步行运动方案,两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏[Piper疲乏修订量表(PFS-R)]、营养状况、睡眠质量[匹茨堡睡眠质量指数(PSQI)]、生活质量[生活质量评估量表(SF-36)]水平予以比较。结果  相较于对照组,干预后观察组PFS-R、PSQI评分较低,白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高(P<0.05)。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案,有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。
       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy.Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects.They were divided into an observation group and a control group,with 99 cases in each group,by the random number table method.The control group only received individualized nutritional intervention,while the observation group received graded walking exercise additionally.Both groups of patients were enrolled at the same time and received continuous intervention for three months.Cancer-related fatigue(Piper’s Fatigue Scale-Revised[PFS-R]),nutritional status,sleep quality(Pittsburgh Sleep Quality Index[PSQI]),and quality of life(Quality of Life Scale[SF-36]) before and after the intervention were compared between the two groups.Results  Compared with the control group,the observation group had lower PFS-R and PSQI scores and higher albumin,prealbumin,hemoglobin,transferrin levels and SF-36 scores after the intervention(P<0.05).Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status,sleep quality and quality of life.
论著

多组分运动训练对老年 COPD 稳定期病人骨骼肌功能的影响

The effect of multi-component exercise training on skeletal muscle function in elderly patients with stable COPD

:345-351
 
       目的  探讨多组分运动训练对老年慢性阻塞性肺疾病(COPD)稳定期病人骨骼肌功能的影响。方法 瞻性选择2022年10月—2024年10月90例COPD稳定期患者,采用抽签法随机分为观察组与对照组,对照组45例采取常规运动干预,观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量,四肢肌群力量,运动耐力与肺功能,生活质量。结果 干预后,两组上肢、下肢骨骼肌含量均略增加,观察组高于对照组(P<0.05);干预后,两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加,观察组高于对照组(P<0.05);干预后,两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高,观察组高于对照组(P<0.05);干预后,两组圣乔治呼吸问卷各维度分数及总分均降低,观察组低于对照组(P<0.05)。结论  针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量,改善患者运动耐力与肺功能,减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
        Objective  To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods  From October 2022 to October 2024,90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method.The control group consisted of 45 patients who received routine exercise care,while the observation group  consisted of 45 patients who received multi-component exercise training in addition to the routine care.Skeletal muscle content,muscle group strength,exercise endurance,lung function,and quality of life between two groups of patients were compared before and three months after intervention.Results  After intervention,the skeletal muscle content of both upper and lower extremities slightly increased in both groups,with the observation group  being higher than the control group(P<0.05).After intervention,the strength of the knee extensor,knee flexor,elbow extensor,and elbow flexor muscle groups increased in both groups,with the observation group  had better results than the control group(P<0.05).After intervention,both groups showed an increase in six-minute walking test,forced vital capacity,and forced expiratory volume in first second,with the observation group  had better  results than the control group(P<0.05).After intervention,the scores of each dimension and total score of the SGRQ in both groups decreased,and the observation group had lower scores than the control group(P<0.05).Conclusions  Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities,enhance exercise endurance and lung function,and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life.
论著

多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭并发衰弱患者的效果

The effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure and frailty

:202-208
 
       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭(CHF)并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低(P<0.05)。与对照组相比,观察组干预后左室射血分数(LVEF)水平明显更高,超敏心肌肌钙蛋白T(hs-cTnT)、N末端B型利钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)水平更低(P<0.05)。与对照组相比, 观察组干预后主观整体营养状况评价表(PG-SGA)评分明显更低,血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)水平更高(P<0.05)。与对照组相比,观察组干预后症状、身体、情感及总分更低(P<0.05)。观察组不良事件发生率(1.96%)低于对照组(15.69%)(P<0.05)。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure(CHF)and frailty.Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included. According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention.The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups.Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention(P<0.05).Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention(P<0.05).Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention(P<0.05).Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention(P<0.05).The incidence of adverse events in the observation group(1.96%)was lower than that in the control group(15.69%)(P<0.05).Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events.
专家述评

运动捕捉技术在步态分析中的研究进展

Research progress of motion capture technology in gait analysis

:826-835
 
运动捕捉技术已经广泛应用于步态分析、运动康复、动作对比、技战术分析、生物运动力学分析、损伤防护、运动装备设计研发等领域,实现了人机交互的全新体验。而步行是人类运动中最基础的动作,在生物力学研究上对异常步态进行分析能够有效改善患者治疗和康复的效果。本文总结了运动捕捉技术在各种异常步态分析中的应用,并对其优缺点进行了总结与展望。检索PubMed、Embase、EBSCO、Web of Science、中国知网,收集2018年1月至2023年12月公开发表的有关有标记运动捕捉及无标记运动捕捉在异常步态的相关研究,进行系统综述。最终纳入了22篇英文文献,这些文献主要集中在神经科学、生物医学工程和临床医学等领域,特别是在步态分析、运动捕捉技术、神经病理学和康复医学等方面的应用。这些研究为我们理解和改善各种神经系统疾病,如帕金森病、多发性硬化症和脑卒中以及骨关节炎等疾病的步态提供了宝贵的见解。利用运动捕捉来进行异常步态分析能有效地给患者提供准确的康复治疗,将结果用于临床诊断、康复规划或研究目的。异常步态分析在评估肌肉骨骼状况、神经系统疾病或干预措施的有效性方面具有重要价值。
Motion capture technology has been widely used in the fields of gait analysis,sports rehabilitation,action comparison,technical and tactical analysis,biomotor mechanics analysis,injury protection,sports equipment design and development,etc.,which realizes a brand-new experience of human-computer interaction.While walking is the most basic action in human movement,the analysis of abnormal gait on biomechanical research can effectively improve the effect of patient treatment and rehabilitation.This paper summarizes the application of motion capture technology in the analysis of various abnormal gaits,and summarizes and prospects its advantages and disadvantages.PubMed,Embase,EBSCO,Web of Science and China Knowledge Network were searched to collect related studies,openly published from January 2018 to December 2023,about labeled motion capture and unlabeled motion capture in abnormal gait for systematic review.Twenty-two English-language papers were finally included,which focused on the fields of neuroscience,biomedical engineering and clinical medicine,especially in the applications of gait analysis,motion capture technology,neuropathology and rehabilitation medicine.These studies provide valuable insights into understanding and improving gait in various neurological disorders such as Parkinson’s disease,multiple sclerosis and stroke and osteoarthritis.The use of motion capture for abnormal gait analysis can be effective in providing accurate rehabilitation to patients,using the results for clinical diagnosis,rehabilitation planning,or research purposes.Abnormal gait analysis is valuable in assessing musculoskeletal conditions,neurological disorders,or the effectiveness of interventions.
论著

真武汤联合八段锦对老年冠心病患者心肺运动功能及生存质量的影响

Clinical effects of Zhenwu Decoction combined with Baduanjin Qigong on the cardiopulmonary function and quality of life in older adults with coronary heart disease

:1470-1475
 
目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病(冠心病)患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效(P=0.023)和中医证候积分(P<0.001)均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量(Peak VO2,P=0.005)、最大摄氧量(VO2max,P=0.001)、氧脉搏(VO2/HR,P=0.002)和无氧阈值时最大代谢当量(MET,P=0.001),以及降低无氧阈值(AT,P<0.001)和二氧化碳通气当量(VE/VCO2,P=0.020)方面比对照组更明显。两组患者在36项简明健康状态调查表(SF-36)评分的8个维度中评分均有所升高,其中在生理机能(P=0.001)、生理职能(P<0.001)、一般健康状况(P=0.018)、精力(P=0.007)、社会职能(P=0.010)、精神健康(P=0.004)方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义(P>0.05)。两组患者的匹兹堡睡眠质量指数(PSQI)均有所改善,且干预组效果优于对照组(P<0.001)。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO2、VO2max、VO2/HR、MET、AT、VE/VCO2等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。
Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease(CHD).Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group.Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment.Results After treatment,both groups showed improvement in the traditional Chinese medicine(TCM)clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index(PSQI)scores;increase in Peak VO2,VO2max,VO2/HR,and metabolic equivalent(MET);and decrease in AT and VE/VCO2.However,the treatment group had a more pronounced improvement in the TCM clinical efficacy(P=0.023),TCM syndrome(P<0.001),PSQI scores(P<0.001),and cardiopulmonary exercise testing(CPET)indicators including Peak VO2(P=0.005),VO2max(P=0.001),VO2/HR(P=0.002),MET(P=0.001),AT(P<0.001)and VE/VCO2(P=0.020),compared to their control counterparts. For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning(P=0.001),role limitations due to physical health(P<0.001),general health(P=0.018),vitality(P=0.007),social functioning(P=0.010)and mental health(P=0.004),but not in pain or role limitations due to emotional problems.Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO2、VO2max、VO2/HR、MET、AT and VE/VCO2,and elevate both quality of life and sleep quality among older adults with CHD.
论著

炎症性肠病患者运动锻炼的证据总结

Summary of the best evidence for exercise in patients with inflammatory bowel disease

:1397-1406
 
目的 建立针对炎症性肠病患者的运动锻炼方案。方法 通过系统检索Web of Science、Embase、Cochrane Library等数据库,综合相关文献并由两名研究者独立提取信息,制定出指导患者运动锻炼的方案。检索时间从建库截至2023年9月1日。结果 共筛选出12篇文献,包括指南、专家共识、Meta分析以及RCT试验。最终总结出运动的必要性、作用、适合人群、评估及筛选、运动方式选择、监测以及限制因素等7个方面,共计37条证据。结论 这些证据为轻中度炎症性肠病患者提供了有氧运动联合抗阻运动的最佳实践依据,可指导临床实践,规范运动训练,从而延缓疾病进展。
Objective To establish an exercise program for patients with inflammatory bowel disease(IBD).Methods A systematic search was conducted in databases such as Web of Science,Cochrane Library,and Embase,with relevant literature being comprehensively reviewed.Information was independently extracted by two researchers to develop a program guiding patients' exercise.Searching terms included both Chinese and English keywords,with the searching period covering from the inception of the databases to September 1,2023.Results A total of 12 articles were screened,including guidelines,expert consensuses,Meta-analyses,and randomized controlled trials.Ultimately,37 pieces of evidence were summarized across seven aspects:the importance of exercise,suitable populations,assessment and screening,choice of exercise modes,monitoring and limiting factors.Conclusions These evidences provide the best practice basis for aerobic and resistance exercises in patients with mild to moderate IBD,guiding clinical practice,standardizing exercise training,and thus delaying disease progression.
出版者信息








《广州医药》公众号