中文摘要：

目的观察骨膜压揉加抗阻力运动对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的影响及作用机制。方法选取OSAHS中度患者32例，按随机数字表法分为训练组和药物组，每组16例。训练组采用骨膜压揉加抗阻力运动处方训练，药物组采用常规药物口服治疗，治疗前、后分别采用睡眠呼吸监测系统（PSG）、Thera—Band弹力带及PWS型角度测量仪对2组患者的PSG参数、颈部周围肌肉力量及颈椎活动度进行评估。结果治疗后，训练组与治疗前比较，PSG指标[包括呼吸事件（AHI）、睡眠结构（SS）、觉醒次数（AN）、非快速动眼期（NREM）、快速动眼期（REM）、平均血氧饱和度（MSaO2）、最低血氧饱和度（LSaO2）、氧减饱和度指数（ODD]均较前改善，差异有统计学意义（P〈0．05）；药物组最低血氧饱和度（LSaO2）及氧减饱和度指数（ODI）与治疗前相比有所改善，差异有统计学意义（P〈0．05），剩余PSG指标与治疗前比较，差异无统计学意义（P〉0．05）；训练组PSG指标改善程度优于药物组，差异有统计学意义（P〈0．05）。治疗后，训练组在颈部负荷下牵拉平均停留时间较前延长，差异有统计学意义（P〈0．05）；药物组平均停留时间较前无明显变化，差异无统计学意义（P〉0．05）；训练组较药物组平均停留时间长，组间差异有统计学意义（P〈0．05）。治疗后训练组颈椎平均活动度较前增加，差异有统计学意义（P〈0．05）；药物组颈椎平均活动度与治疗前比较，差异无统计学意义（P〉0．05）；训练组颈椎平均活动度与药物组相比明显改善，差异有统计学意义（P〈0．05）。结论气道周围骨骼肌病变可能是导致OSAHS形成的重要原因，骨膜压揉加抗阻力运动对OSAHS患者具有显著疗效。

英文摘要：

Objective To observe the effect and mechanism of periosteal pressure kneading plus resistance exercise in improving obstructive sleep apnea/hypopnea syndrome （OSAHS）. Methods Thirty-two patients with moderate OSAHS were divided randomly into a kneading plus resistance training group and a conventional drug group, each group with 16 patients. The training group was given periosteal pressure kneading plus resistance exercise while the drug group received only conventional oral treatment with drugs. Before and after treatment, polysomnography （PSG） , Thera-Band elastic bands and a PWS angle measuring instrument were used to observe PSG parameters a- round the neck plus the muscle strength and cervical activity of both groups. Results In the training group the fol- lowing components of the PSG index had improved significantly compared with before treatment： respiratory events （AHI） , sleep structure （SS） , awakening number （AN） , non-rapid eye movement （NREM） , rapid eye movement （REM） , mean oxyhemoglobin saturation （ MSaO2 ） events, lowest oxyhemoglobin saturation （ LSaO2 ） , and the index of oxyhemoglobin saturation decrease （ ODI）. In the drug group only the LSaO2 and ODI had improved significantly compared with before treatment. In terms of the PSG parameters, the training group demonstrated significantly greater improvement than the drug group. After treatment, the training group＇s average residence time in neck load pulling was extended significantly while that of the drug group showed no significant change. The difference between the groups was statistically significant. After the treatment the training group＇s average activity of the cervical spine was also significantly increased, and again the drug group showed no significant improvement. Conclusion Skeletal le- sions in peripheral airways may be an important factor in the formation of OSAHS. Periosteum kneading with resist- ance exercise has an obvious curative effect on OSAHS.