腹式呼吸训练联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、肺功能及腰部姿势控制能力的影响

摘要 目的：观察腰部核心肌力训练、腹式呼吸训练联合干预对腰椎间盘突出症（LDH）患者肺功能、腰椎功能及腰部姿势控制能力的影响。方法：选取自2020年10月至2022年10月期间在湖南中医药大学第一附属医院就诊的98例LDH患者。按照随机数字表法将患者分为对照组（腰部核心肌力训练，n=49）和研究组（对照组基础上接受腹式呼吸训练，n=49）。对比两组视觉模拟评分法（VAS）、世界卫生组织生存质量测定量表简表（WHOQOL-BREF）评分、腰椎功能、肺功能和腰部姿势控制能力变化情况。结果：研究组干预3个月后VAS评分低于对照组（P<0.05）。研究组干预3个月后日本骨科学会（JOA）评分高于对照组；Oswestry功能障碍指数（ODI）评分低于对照组（P<0.05）。研究组干预3个月后最大通气量（MVV）、用力肺活量（FVC）、第1秒最大呼气率（FEV1）高于对照组（P<0.05）。研究组干预3个月后左右侧多裂肌肌电信号图均方根值（RMS）、左右侧腹横肌RMS高于对照组；压力中心转移距离小于对照组（P<0.05）。研究组干预3个月后生理、心理、社会、环境各维度评分高于对照组（P<0.05）。结论：腹式呼吸训练联合腰部核心肌力训练用于LDH患者，可有效改善患者的腰椎功能、肺功能及腰部姿势控制能力。

Effects of Abdominal Breathing Training Combined with Lumbar Core Muscle Strength Training on Lumbar Function, Lung Function and Lumbar Posture Control Ability in Patients with Lumbar Disc Herniation

ABSTRACT Objective: To observe the effects of combined intervention of lumbar core muscle strength training and abdominal breathing training on lung function, lumbar function and lumbar posture control ability of patients with lumbar disc herniation (LDH). Methods: LDH 98 patients who were treated in the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from October 2020 to October 2022 were selected. Patients were divided into control group (waist core muscle strength training, n=49) and study group (abdominal breathing training on the basis of the control group, n=49) according to the random number table method. The changes of visual analogue scale (VAS), World Health Organization Quality of Life-BREF (WHOQOL-BREF) score, lumbar function, lung function and lumbar posture control ability were compared between two groups. Results: The VAS score in study group was lower than that in control group 3 months after intervention (P<0.05). The Japanese Orthopaedic Association (JOA) score in study group was higher than that in control group 3 months after intervention. The Oswestry disability index (ODI) score was lower than that in control group (P<0.05). 3 months after intervention, the maximum ventilation volume (MVV), forced vital capacity (FVC) and maximum expiratory rate in the first second (FEV1) in study group were higher than those in control group (P<0.05). 3 months after intervention, the root mean square (RMS) of left and right multifidus electromyography and RMS of left and right transverse abdominal muscles in study group were higher than those in control group. The transfer distance of pressure center was less than that in control group(P<0.05). The scores of physiological, psychological, social and environmental dimensions in study group were higher than those in control group 3 months after intervention (P<0.05). Conclusion: Abdominal breathing training combine with lumbar core muscle strength training for LDH patients can effectively improve the lumbar function, lung function and lumbar posture control ability of patients.