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中华老年病研究电子杂志

中华老年病研究电子杂志 ›› 2021, Vol. 08 ›› Issue (01) : 14 -19. doi: 10.3877/cma.j.issn.2095-8757.2021.01.004

所属专题： 文献；

帕金森病

运动康复护理对帕金森病患者日间嗜睡的改善作用
刘丹丹1, 陈岩2,†(), 李娟3, 申潇竹1, 龚晨1, 李敏4, 白学玲1, 刘后芹1, 张茜5   
  1. 1. 222006　江苏省连云港市第二人民医院老年医学科
    2. 222006　江苏省连云港市第二人民医院神经外科
    3. 222006　江苏省连云港市第二人民医院护理部
    4. 222006　江苏省连云港市第二人民医院康复科
    5. 222006　江苏省连云港市第二人民医院药学部
  • 收稿日期:2020-08-31 出版日期:2021-02-28
  • 通信作者: 陈岩
  • 基金资助:
    江苏省科技厅公益类项目(BM2018033); 江苏省"科教强卫工程"青年医学重点人才培养项目(QNRC2016496)

Effect of sports rehabilitation nursing on improving daytime sleepiness of patients with Parkinson's disease

Dandan Liu1, Yan Chen2,†(), Juan LI3, Xiaozhu Shen1, Chen Gong1, Min Li4, Xueling Bai1, Houqin Liu1, Qian Zhang5   

  1. 1. Department of Geriatrics. The Second People's Hospital of Lianyungang, Lianyungang 222023, China
    2. Department of Neurosurgery. The Second People's Hospital of Lianyungang, Lianyungang 222023, China
    3. Nursing Department. The Second People's Hospital of Lianyungang, Lianyungang 222023, China
    4. Rehabilitation Division. The Second People's Hospital of Lianyungang, Lianyungang 222023, China
    5. Department of Pharmacy. The Second People's Hospital of Lianyungang, Lianyungang 222023, China
  • Received:2020-08-31 Published:2021-02-28
  • Corresponding author: Yan Chen
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引用本文：

刘丹丹, 陈岩, 李娟, 申潇竹, 龚晨, 李敏, 白学玲, 刘后芹, 张茜. 运动康复护理对帕金森病患者日间嗜睡的改善作用[J/OL]. 中华老年病研究电子杂志, 2021, 08(01): 14-19.

Dandan Liu, Yan Chen, Juan LI, Xiaozhu Shen, Chen Gong, Min Li, Xueling Bai, Houqin Liu, Qian Zhang. Effect of sports rehabilitation nursing on improving daytime sleepiness of patients with Parkinson's disease[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(01): 14-19.

目的

观察运动康复护理对帕金森病（Parkinson's disease，PD）日间嗜睡的临床疗效。

方法

选取2017年2月至2019年11月连云港市第二人民医院收治的PD伴日间嗜睡患者51例，其中24例（干预组）在PD常规治疗基础上接受为期6周的运动康复护理，27例（对照组）仅给予PD常规治疗及护理。治疗前后均完成爱普沃斯嗜睡量表（Epworth sleepiness scale，ESS）、PD睡眠量表（PD sleep scale，PDSS）、衰弱量表、焦虑自评量表、抑郁自评量表、日常生活能力量表的评估，并比较两组患者睡眠日志中的睡眠时间、睡眠潜伏期、入睡后睡眠中断次数、夜间睡眠觉醒时间和4项睡眠指标（睡眠质量、醒后清醒感指数、易醒、做梦）评分。计量资料的组间比较采用独立样本t检验，计数资料的比较采用χ2检验。两组患者连续性时点指标的比较采用重复测量方差分析。

结果

治疗后，两组患者ESS、PDSS评分以及睡眠潜伏期、睡眠中断次数、睡眠质量的比较呈现显著分组效应，即干预组ESS及PDSS评分均显著优于对照组（F=17.780、23.400，均P<0.01），干预组潜伏期显著短于对照组、睡眠中断次数显著少于对照组、睡眠质量显著优于对照组（F=12.390、15.290、50.730，均P<0.01）；衰弱、焦虑、抑郁、日常生活能力的评分以及睡眠时间、夜间睡眠觉醒时间、醒后清醒感指数、易醒及做梦评分的比较均无分组效应（F=18.460、19.800、13.730、19.670、0.890、25.640、16.870、19.860、16.480，均P>0.05）。

结论

运动康复护理可以改善PD患者日间嗜睡状况，同时能缩短夜间睡眠潜伏期、减少夜间睡眠中断次数、改善夜间睡眠质量。

关键词: 帕金森病, 运动康复护理, 日间嗜睡, 非运动症状
Objective

To observe the clinical efficacy of exercise rehabilitation nursing on daytime sleepiness in Parkinson's disease.

Methods

51 patients with Parkinson's disease with daytime sleepiness admitted to the Second People's Hospital of Lianyungang City from February 2017 to November 2019 were selected. Among them, 24 patients (intervention group) received 6 weeks of exercise rehabilitation nursing on the basis of routine standardized treatment for Parkinson's disease, and 27 patients (control group) received routine standardized treatment and nursing for Parkinson's disease. Before and after treatment, Epworth Sleepiness Scale (ESS), PD Sleep Scale (PDSS), Faintness Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Daily Living Ability Scale were evaluated. The sleep time, sleep latency, times of sleep interruption after sleep, nocturnal sleep-wake time and four sleep indexes (sleep quality, wakefulness index after waking, easy waking and dreaming) scores of two groups were compared. The independent sample t test was used to compare the measurement data between groups, and the χ2 test was used to compare the enumeration data. Repeated measure analysis of variance was used to compare continuous time point indicators between the two groups.

Results

After treatment, the ESS, PDSS scores, latency period, number of sleep interruptions and night sleep quality in the sleep log showed a significant grouping effect. The ESS and PDSS scores in the intervention group were significantly better than those in the control group (F=17.780, 23.400, P < 0.01). The incubation period of the intervention group was significantly shorter than that of the control group, the frequency of sleep interruption was significantly less than that of the control group, and the sleep quality of the intervention group was significantly better than that of the control group (F=12.390, 15.290, 50.730, P < 0.01). The FRAIL, SAS, SDS, ADL score, and sleep time, night sleep-wake time, wakefulness index after wakefulness, wakefulness and dream score had no grouping effect (F=18.460, 19.800, 13.730, 19.670, 0.890, 25.640, 16.870, 19.860, 16.480, P > 0.05).

Conclusion

Exercise rehabilitation nursing interventions can improve daytime sleepiness in Parkinson's disease, as well as shorten nocturnal sleep latency, reduce the number of nocturnal sleep interruptions, and improve nocturnal sleep quality.

Key words: Parkinson's disease, Exercise rehabilitation nursing, Excessive daytime sleepiness, Non-motor symptoms
表1 两组患者一般资料的比较
组别 例数 年龄（岁） 性别（男/女） 病程（年） Hoehn-Yahr分期[例（%）] ESS
2期 2.5期 3期 4期
干预组 24 80.7±7.0 14/10 7.94±3.61 16（69.6） 4（17.4） 2（8.7） 1（4.3） 15.16±3.15
对照组 27 81.7±7.7 16/11 8.62±4.04 14（56.0） 7（28.0） 2（8.0） 2（8.0） 14.95±2.61
检验值   t=0.374 χ2=0.004 t=0.827 χ2=1.204 t=0.572
P值   >0.05 >0.05 >0.05 >0.05 >0.05
组别 例数 PDSS PSQI FRAIL SAS SDS ADL
干预组 24 75.74±22.34 8.12±4.12 3.27±0.76 41.06±6.11 39.83±3.40 50.92±15.03
对照组 27 77.65±21.04 7.56±2.81 3.12±1.07 36.34±7.83 35.09±8.42 45.47±13.28
检验值   t=0.873 t=0.293 t=0.473 t=0.829 t=0.958 t=0.374
P值   >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
表2 两组患者治疗前后各量表评分情况（±s，分）
组别 例数 ESS PDSS
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 15.16±3.15 11.86±4.22 11.65±2.14 75.74±22.34 88.24±18.55 108.4.37±20.62
对照组 27 14.95±2.61 14.31±3.08 14.88±3.29 77.65±21.04 78.23±25.85 76.54±18.73
组别 例数 FRAIL SAS
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 3.27±0.76 3.84±1.28 2.97±1.33 41.06±6.11 42.00±4.60 41.70±6.12
对照组 27 3.12±1.07 3.02±0.54 3.09±1.34 36.34±7.83 39.00±7.81 38.00±10.31
组别 例数 SDS ADL
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 39.83±3.40 36.02±6.00 37.40±4.89 50.92±15.03 49.25±20.03 48.28±17.73
对照组 27 35.09±8.42 34.80±8.21 35.84±5.96 45.47±13.28 50.23±17.26 51.82±10.37
表3 两组患者治疗前后的睡眠日志情况（±s）
组别 例数 睡眠时间（h） 潜伏期（min）
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 7.0±1.0 7.3±1.0 7.3±0.9 37±21 28±10 20±12
对照组 27 7.0±1.3 7.4±1.3 7.3±1.3 34±16 32±16 33±21
组别 例数 睡眠中断次数 夜间睡眠觉醒时间（min）
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 3.5±1.0 2.9±1.0 1.8±1.1 40.2±28.5 39.7±30.0 45.2±30.6
对照组 27 3.2±1.1 3.1±1.1 3.2±1.0 39.5±19.6 31.8±23.3 38.6±31.7
组别 例数 夜间睡眠质量评分 醒后清醒感指数
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 2.86±1.02 3.61±0.75 3.79±0.82 3.03±0.84 3.65±1.07 3.44±0.94
对照组 27 3.08±0.83 3.03±0.91 3.07±0.43 3.14±0.12 3.03±1.22 3.26±0.86
组别 例数 易醒评分 做梦评分
干预前 干预4周 干预6周 干预前 干预4周 干预6周
干预组 24 2.42±0.67 2.26±0.67 2.23±0.78 1.79±0.65 1.81±0.80 1.71±0.65
对照组 27 2.33±0.54 2.41±0.52 2.37±0.67 1.74±0.70 1.63±0.62 1.73±0.74
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