以腹式呼吸法對脊髓肌肉萎縮症病患之肺功能及生理指標之影響

本研究的目的旨在探討以腹式呼吸法對脊髓肌肉萎縮症病患之肺功能及生理指標之影響，並進一步探討腹式呼吸介入後，肺功能及生理指標的前後得分比較。本研究採重覆測量設計(repeated measures design)。選取南部醫學中心門診小兒神經科就醫之脊髓肌肉萎縮症Type II及Type III為對象，探討兩組共同接受腹式呼吸法後一、二、三個月之肺功能，包括：包括用力吐氣肺活量（FVC）、用力呼氣第一秒容積（FEV1）、尖峰吐氣流速（PEFR）及生理指標，包括：血壓、血氧飽和濃度、呼吸、心跳速率的變化。　　研究結果顯示：（一）比較在腹式呼吸介入後，脊髄肌肉萎縮症Type II及Type III兩組之間，於用力吐氣肺活量(FVC)、用力呼氣第一秒容積(FEV1)，尖峰呼氣流速(PEFR)、FEV1/FVC %，在統計上皆有顯著性差異。結論為腹式呼吸不僅簡單又不具侵入性，更能提升橫膈肌力、增加換氣量，故本研究認為腹式呼吸對於脊髄肌肉萎縮症病人在肺功能有改善及保健的效果。（二）比較在腹式呼吸介入後，脊髄肌肉萎縮症Type II及Type III兩組之間，於收縮壓（systolic pressure）、舒張壓（diastolic pressure）、血氧飽和濃度（SpO2）、心跳（HR）、呼吸（RR），皆未有統計上的顯著性差異。本研究推論除非改善肺部呼吸功能，才能更進一步使生理指標改善。藉本研究得知腹式呼吸訓練可以改善脊髓肌肉萎縮症Type II及Type III病患肺功能。以上這些發現可進一步建議改善腹式呼吸介入的技巧是必需的。

關鍵字

脊髓肌肉萎縮症；腹式呼吸；肺功能；生理指標

並列摘要

The purpose of this study was to explore the abdominal breathing in patients with spinal muscular atrophy and physiological effects of lung function, and further intervention of abdominal breathing, lung function and physiological scores before and after comparison. In this study, repeated measures design was applied, and selected outpatients from medical center in southern Taiwan for medical treatment of pediatric neurology spinal muscular atrophy Type II and Type III as the object of two commonly accepted abdominal breathing after one, two, three months lung function, including: including the forced expiratory vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and physiological indicators, including: blood pressure, serum oxygen saturation, respiration rate, heart rate changes. The results showed: 1. lung function: comparison in SMA Type II and Type III groups in the forced expiratory vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and FEV1/FVC% of the scores statistically showed significant difference. Meanwhile the two groups in forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) the role of time factors vary with the grouping. 2. physiological indicators: comparison in SMA Type II and Type III in systolic blood pressure, diastolic blood pressure, serum oxygen saturation (SPO2), respiratory rate (RR), heart rate (HR) due to the time factor does not change as the groups differ. Comparing these two groups in systolic blood pressure, diastolic blood pressure, heart rate (HR) the scores it statistically showed a significant difference. Comparing these two groups in oxygen saturation (SPO2), respiratory rate (RR) scores it statistically showed no significant difference. Through this study, abdominal breathing training that can improve the spinal muscular atrophy Type II and Type III patients with pulmonary function. These findings further suggested that the involvement of improved abdominal breathing techniques is required.