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.
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.
医学教育

BOPPPS模式下模块化教学结合模拟演练在创伤急救培训中的应用

Application of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model

:422-428
 
目的 探讨BOPPPS[(导引(B),目标(O),课前测试(P),参与式学习(P),课后测试(P),总结(S)]模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法 选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士,随机分为对照组和干预组,每组45名护士。对照组采用传统授课模式进行教学培训;干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果 干预组的综合理论成绩为(80.74±6.87)分、单项技能成绩为(92.13±2.26)分,相较于对照组均提高(P<0.05)。干预组对创伤急救课程的总体满意度:非常同意23例、同意20例,比例均高于对照组(P<0.05)。干预组的创伤急救救护综合能力如病情评估预判能力,优秀26例、良好15例;护理计划分析实施能力,优秀25例、良好13例;团队协作与资源管理能力,优秀27例、良好15例;情景感知与应变能力,优秀30例、良好11例;综合救护能力,优秀36例、良好5例。显著优于对照组(P<0.05)。结论 BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力,且取得了较高的满意度,值得进一步推广应用。
Objective To explore the application effect of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model.Methods A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group(n=45) and intervention group(n=45).The control group was trained by traditional teaching mode.The intervention group was trained by BOPPPS modular teaching combined with simulation exercise.After the training,the comprehensive theory of trauma first aid,individual skills,comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed.Results The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group(P<0.05).The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group(P<0.05).The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group(P<0.05).Conclusions The combination of modular teaching and simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergency department,and has obtained a high degree of satisfaction,which is worthy of further popularization and application.
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.
论著

悬吊运动疗法配合推拿治疗神经根型颈椎病临床价值

Clinical value of sling exercise therapy combined with massage in the treatment of cervical spondylotic radiculopathy

:64-67
 
目的 探究对神经根型颈椎病(CSR)患者开展悬吊运动疗法+推拿的临床价值。方法 选择2020年1月—2021年7月100例神经根型颈椎病患者,参考“数字双盲法”,分为对照组和观察组(均n=50);对照组患者为推拿治疗,观察组基于对照组基础+悬吊运动疗法;对比治疗结果。结果 观察组临床总有效率94.00%较对照组80.00%高(P<0.05)。2组治疗后VAS疼痛评分较治疗前均下降,且观察组较对照组更低(P<0.05)。治疗前120°/s的等速度运动状态下2组峰力距(PT)、平均功率(AP)、屈肌峰力距/伸肌峰力距(F/E)比较(P>0.05),经治疗后2组均显著改善,且观察组PT、AP、F/E指标较对照组均更优(P<0.05)。2组治疗后颈椎功能障碍指数(NDI)评分、颈椎病临床评价量表(CASCS)评分较同组治疗前均改善,且观察组较对照组NDI评分更低,CASCS评分更高。结论 针对CSR患者开展悬吊运动疗法+推拿治疗,有利于调节患者颈部肌群协调能力,减轻疼痛感,改善临床症状,促进颈椎功能恢复,实现理想的治疗效果。
Objective To explore the clinical value of sling exercise therapy (SET) and massage in patients with cervical spondylotic radiculopathy (CSR). Methods From January 2020 to July 2021, 100 patients with CSR were selected and divided into control group and observation group (both n=50). The patients in the control group were treated with massage, and the observation group was treated with massage+SET, the treatment results were compared. Results The total clinical effective rate of 94.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05). The VAS pain scores of the two groups after treatment were lower than those before treatment, and the VAS pain score of the observation group was lower than that of the control group (P<0.05). The peak torque (PT), average power (AP) and flexor peak force distance/extensor peak force distance (F/E) of the two groups were significantly improved after treatment, and the PT, AP and F/E indexes of the observation group were better than those of the control group (P<0.05). After treatment, the neck disability index (NDI) score and clinical assessment scale of cervical spondylosis (CASCS) score of the two groups were significantly improved compared with those before treatment, and the NDI score of the observation group was lower and the CASCS score was higher in the observation group. Conclusions SET+massage therapy for patients with CSR is helpful to adjust the coordination ability of cervical muscle group, reduce pain, improve clinical symptoms, promote the recovery of cervical function and achieve ideal therapeutic effect.
论著

伴OP的KOA患者TKA术前整体针联合运动处方临床应用的前瞻性研究及其对Wnt/β-catenin通路的影响

Evidence-based evaluation of the clinical application of preoperative combined holistic acupuncture with exercise prescription in KOA patients with OP and its effect on the Wnt/β-catenin pathway

:19-25
 
目的 探索整体针联合运动处方应用于伴骨质疏松症(OP)的膝骨关节炎(KOA)患者全膝关节置换术(TKA)术前预康复的可行性、有效性及其对Wnt/β-catenin通路的影响。方法 2021年5月—2022年4月在广州市第一人民医院南沙医院骨科住院治疗的伴OP的KOA患者随机入组,分3组:A组予常规术前宣教和准备;B组在A组基础上,术前应用标准化运动处方3周;C组在A组基础上,术前联合应用整体针和运动处方3周。比较术前3周、术前1天、术后8周视觉模拟疼痛评分(VAS)、关节活动度(ROM)、膝关节功能评分(HSS)的组间差异,并比较术中关节液β连环蛋白(β-catenin)、基质金属蛋白酶-13(MMP-13)、重组人Dickkopf相关蛋白-1(DKK-1)含量的组间差异。结果 共纳入50例受试者,A组15例,B组18例,C组17例。术前1天组间方差分析显示:B、C组VAS均低于A组(P<0.05),C组VAS低于B组(P<0.05);B、C组ROM均高于A组(P<0.05),B、C组ROM比较差异无统计学意义(P>0.05);B、C组HSS均高于A组(P<0.05),C组HSS高于B组(P<0.05)。术后8周组间方差分析显示:B、C组VAS均低于A组(P<0.05),C组VAS低于B组(P<0.05);B、C组ROM均高于A组(P<0.05),B、C组ROM比较差异无统计学意义(P>0.05);B、C组HSS均高于A组(P<0.05),C组HSS高于B组(P<0.05)。术中关节液标志物含量组间方差分析显示:B、C组β-catenin、MMP-13含量均低于A组(P<0.05),C组β-catenin、MMP-13含量均低于B组(均P<0.05);B、C组DKK-1含量均高于A组(均P<0.05),C组DKK-1含量高于B组(P<0.05)。结论 整体针联合运动处方在OP患者TKA术前应用切实可行,可有效缓解疼痛、改善功能。整体针可增强运动处方的正向预康复作用,其作用机制可能与Wnt/β-catenin通路调节有关。
Objective To explore the feasibility,effectiveness and impact on the Wnt/β-catenin pathway of combined holistic acupuncture and exercise prescription for preoperative rehabilitation in knee osteoarthritis(KOA)patients with osteoporosis(OP)undergoing total knee arthroplasty(TKA).Methods KOA patients with OP were divided into three groups randomly:Group A received conventional preoperative education and preparation,Group B received standardized exercise prescription for three weeks additionally,Group C received combined holistic acupuncture and exercise prescription for three weeks additionally.Between-group differences in visual analogue scale(VAS)pain scores,range of motion(ROM)and knee joint function scores(HSS)were compared at 3 weeks preoperatively,1 day preoperatively and 8 weeks postoperatively.Differences in intraoperative joint fluid levels of β-catenin,MMP-13 and DKK-1 were also compared.Results A total of 50 participants were included,with 15 in Group A,18 in Group B and 17 in Group C.Baseline conditions were comparable among the three groups.One-day preoperative analysis showed that VAS scores were lower in both Groups B and C compared to Group A(P<0.05),and VAS score was lower in Group C compared to Group B(P<0.05).ROM was higher in Groups B and C compared to Group A(P<0.05),with no statistically significant between-group difference between Groups B and C.HSS scores were higher in Groups B and C compared to Group A(P<0.05),and HSS score was higher in Group C compared to Group B(P<0.05).Eight-week postoperative analysis revealed that VAS scores were lower in both Groups B and C compared to Group A(P<0.05),and VAS score was lower in Group C compared to Group B(P<0.05).ROM were higher in Groups B and C compared to Group A(P<0.05),with no statistically significant between-group difference between Group B and C.HSS scores were higher in Groups B and C compared to Group A(P<0.05),and HSS score was higher in Group C compared to Group B(P<0.05).Intraoperative joint fluid biomarker analysis showed that β-catenin and MMP-13 levels were lower in Groups B and C compared to Group A(P<0.05),and β-catenin and MMP-13 levels were lower in Group C compared to Group B(P<0.05).DKK-1 levels were higher in Groups B and C compared to Group A(P<0.05),and DKK-1 level was higher in Group C compared to Group B(P<0.05).Conclusions Combined holistic acupuncture and exercise prescription is feasible and effective for preoperative rehabilitation in TKA for KOA patients with OP.Holistic acupuncture enhances the positive pre-rehabilitation effect of exercise prescription,and its mechanism may be related to the regulation of the Wnt/β-catenin pathway.
论著

孕期盆底肌锻炼联合产后盆底功能康复治疗对产后女性盆底功能障碍的防治效果

The prevention and treatment effect of pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy on postpartum pelvic floor dysfunction in women

:91-95
 
目的 探讨孕期盆底肌锻炼联合产后盆底功能康复治疗对产后女性盆底功能障碍的防治效果。方法 选取2019年1月—2020年6月在我院产科门诊定期产检,B超确认为单胎足月顺产,剔除妊娠合并症及并发症,符合入组标准病例共316例,随机分成观察组和对照组,观察组131例,对照组185例,观察组在孕12周开始宣教孕期定期行盆底肌Kegel运动,并在产后42天开始行盆底康复治疗仪治疗6周,统计临床疗效,2组均在产后42天、3个月、6个月统计2组盆底功能检测、盆底器官脱垂(pelvic organ prolapse,POP)和压力性尿失禁(stress urinary incorrtinence,SUI)发生情况。结果 观察组和对照组一般资料,2组在年龄、分娩孕周、新生儿平均体重无统计学差异(P>0.05),2组盆底功能进行检测比较,产后42天观察组阴道收缩持续时间、Ⅱ类肌纤维强度(85.24±22.19 cmH2O)高于对照组(74.14±19.94 cmH2O),差异具有统计学意义(P<0.05),产后3月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(76.41±16.42 cmH2O;4.35±1.78 s;94.15±18.25 cmH2O)高于对照组(62.45±17.55 cmH2O;3.89±1.52 s;88.55±18.36 cmH2O),差异具有统计学意义(P<0.05),产后6月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(79.56±15.78 cmH2O;5.46±2.01 s;99.78±23.47 cmH2O)明显高于对照组(67.63±14.45 cmH2O;4.13±1.45 s;90.16±18.75 cmH2O),差异具有统计学意义(P<0.05)。对比2组POP和SUI发生率情况,产后42天观察组SUI发生率(28.24%)低于对照组(35.14%),差异具有统计学意义(P<0.05);产后3月观察组POP和SUI发生率(18.32%;13.74%)低于对照组(22.70%;17.83%),差异具有统计学意义(P<0.05),产后6月观察组POP和SUI发生率(0.00%;0.07%)明显低于对照组(8.10%;11.89%),差异具有统计学意义(P<0.05)。 结论 孕期行盆底肌锻炼联合产后盆底功能康复治疗能明显改善产后盆底功能状态,显著降低产后盆底功能障碍性疾病的发生率。
Objective To explore the prevention and treatment effect of pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy on postpartum pelvic floor dysfunction in women. Methods From January 2019 to June 2020, women in our hospital's obstetrics outpatient department for regular obstetric checkups were selected, which ultrasound confirmed it was a singleton full-term delivery. The cases of stillbirth, fetal malformation and placenta previa were excluded. A total of 316 cases met the inclusion criteria and were randomly divided into the observation group and the control group, with 131 cases in the observation group and 185 cases in the control group. Observation group started regular pelvic floor muscle Kegel exercises from 12 weeks of gestation,and accepted pelvic floor rehabilitation therapeutic treatment from 42 days to six weeks postpartum. We summerized the pelvic floor function tests results, pelvic organ prolapse (POP) and stress urinary incontinence (SUI) situation of both groups in 42 days, 3 months and 6 months postpartum. Results The general information of the observation group and the control group showed that there were no statistical differences in age, gestational age of delivery and average weight of newborn (P>0.05). The pelvic floor function 42 days after delivery of the two groups was tested and compared, duration of vaginal contraction and class Ⅱ muscle fiber strength of the observation group [(85.24±22.19) cmH2O] was significantly higher than that of the control group [(74.14±19.94) cmH2O], and the difference was statistically significant (P<0.05). Class I muscle fiber strength, duration of vaginal contraction and class Ⅱ muscle fiber strength were observed at 3 months postpartum, those of observation group[(76.41±16.42) cmH2O; (4.35±1.78) s; (94.15±18.25) cmH2O] were significantly higher than that in the control group [(62.45± 17.55) cmH2O; (3.89±1.52) s; (88.55±18.36) cmH2O], and the difference were statistically significant (P<0.05). At 6 months postpartum, class I muscle fiber strength, vaginal contraction duration and class Ⅱ muscle fiber strength in observation group [(79.56±15.78) cmH2O; (5.46±2.01) s; (99.78±23.47) cmH2O] were significantly higher than that of the control group [(67.63±14.45) cmH2O; (4.13± 1.45) s; (90.16±18.75) cmH2O], and the difference were statistically significant (P<0.05). Comparison of the incidence of POP and SUI between the two groups showed that the incidence of SUI in the observation group at 42 days postpartum (28.24%) was significantly lower than that in the control group (35.14%), the difference was statistically significant (P<0.05). The incidences of POP and SUI in the observation group at 3 months postpartum (18.32%; 13.74%) were significantly lower than that of the control group (22.70%; 17.83%), the difference were statistically significant (P<0.05). The incidences of POP and SUI in the observation group at 6 months postpartum (0.00%; 0.07%) were significantly lower than that of the control group (8.10%; 11.89%), the difference were statistically significant (P<0.05). Conclusion Pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy can significantly improve postpartum pelvic floor function and significantly reduce the incidence of postpartum pelvic floor dysfunction diseases.
论著

中等强度有氧运动联合力量训练的运动干预对老年高尿酸血症患者尿酸、身体机能及生活质量的影响

Effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia

:83-86
 
目的 观察中等强度有氧运动联合力量训练对老年高尿酸血症(HUA)尿酸、身体机能及生活质量影响分析。方法 2019年1月—2019年12月在我社区收治的老年HUA患者60例纳入研究,随机数字表法进行分组,选取其中的30例患者实施常规饮食、运动指导为对照组,另30例患者配合中等强度有氧运动联合力量训练为研究组。比较2组患者对干预的依从性,干预前、后的血尿酸水平,身体机能及生活质量评分(WHOQOL-100评分)。结果 2组患者均在干预期内完成训练,依从性优良率比较,差异无统计学意义(P>0.05)。干预前2组患者的血尿酸水平、身体机能比较,差异无统计学意义(P>0.05)。干预后2组患者的血尿酸水平、安静心率较干预前降低,研究组低于对照组,而肺活量则较干预前提升,研究组高于对照组,差异有统计学意义(P<0.05)。干预前2组患者的WHOQOL-100评分比较,差异无统计学意义(P>0.05),干预后2组WHOQOL-100各项评分较干预前提升,研究组高于对照组,差异有统计学意义(P<0.05)。结论 在老年HUA患者的相关指导中,运用中等强度有氧运动联合力量训练的运动干预,可较为明显的降低血清血尿酸水平,降低并平稳安静心率,提升肺活量,提升生活质量,效果理想。
Objective To observe the effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia (HUA). Methods Sixty elderly patients with HUA were treated in our center from January 2019 to December 2019. They were randomly divided into two groups, 30 cases in each group. Among them, 30 cases given routine diet and exercise guidance were included in control group, and the other 30 cases given moderate intensity aerobic exercise combined with strength training on the basis of the control group were included in study group. The compliance, blood uric acid level, physical function and quality of life (WHOQOL-100 scores) before and after the intervention were compared between the two groups. Results Two groups of patients completed the training within the expected time, and there was no significant difference in compliance (P>0.05). Before the intervention, there were no significant differences in blood uric acid level and physical function between the two groups (P>0.05). After the intervention, the serum uric acid level and resting heart rate of the two groups were lower than those before the intervention, and those of the research group were even lower than the control group, while the vital capacity was higher than that before the intervention, and the research group was higher than the control group, those differences were significant (P<0.05). Before the intervention, there was no significant difference in WHOQOL-100 score between the two groups (P>0.05). After the intervention, the scores of WHOQOL-100 in the two groups were higher than those before the intervention, and that in the study group was higher than the control group (P<0.05). Conclusions In the relevant guidance of elderly patients with hyperuricemia (HUA), the application of moderate intensity aerobic exercise combined with strength training can significantly lower the serum uric acid level, reduce and stabilize the resting heart rate, improve the vital capacity and quality of life, with ideal effect.
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