中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (32): 5215-5221.doi: 10.12307/2021.227

• 组织构建综述 tissue construction review • 上一篇    下一篇

不同模式下血流限制治疗老年性肌肉减少症的效果与安全因素

陈  蓉1,曾  庆1,巩  泽1,黄国志1,2   

  1. 1南方医科大学珠江医院康复医学科,广东省广州市   510280;2南方医科大学康复医学院,广东省广州市    510280

  • 收稿日期:2020-09-15 修回日期:2020-09-18 接受日期:2020-10-30 出版日期:2021-11-18 发布日期:2021-07-26
  • 通讯作者: 黄国志,博士,主任医师,南方医科大学珠江医院康复医学科,广东省广州市 510280;南方医科大学康复医学院,广东省广州市 510280
  • 作者简介:陈蓉,女,1995年生,四川省凉山彝族自治州人,汉族,南方医科大学康复医学与理疗学在读硕士,主要从事运动康复、神经康复研究
  • 基金资助:
    国家自然科学基金面上项目(81874032,82072528),项目负责人:黄国志;国家自然科学青年科学基金项目(82002380),项目负责人:曾庆;广东省医学科学技术研究基金项目(A2017610),项目负责人:曾庆

Different modes of blood flow restriction in the treatment of senile sarcopenia: therapeutic effects and safety factors 

Chen Rong1, Zeng Qing1, Gong Ze1, Huang Guozhi1, 2#br#

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  1. 1Department of Rehabilitation, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China; 2Medical College of Rehabilitation, Southern Medical University, Guangzhou 510280, Guangdong Province, China

  • Received:2020-09-15 Revised:2020-09-18 Accepted:2020-10-30 Online:2021-11-18 Published:2021-07-26
  • Contact: huang Guozhi, MD, Chief physician, Department of Rehabilitation, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China; Medical College of Rehabilitation, Southern Medical University, Guangzhou 510280, Guangdong Province, China
  • About author:chen rong, master candidate, Department of Rehabilitation, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China
  • Supported by:
    the National Natural Science Foundation of China (General Program), No. 81874032 and 82072528 (to HGZ); the National Natural Science Foundation of China (Youth Program), No. 82002380 (to ZQ); Guangdong Provincial Medical Science and Technology Research Project, No. A2017610 (to ZQ)

摘要:

文题释义:
血流限制疗法 (blood flow restriction therapy,BFRT):又称加压训练,是一项在低负荷运动强度下增加肌肉力量和肌容积的方式,具体实施办法是在肢体近心端使用绑带对骨骼肌施加压力,阻断组织的静脉回流,且不阻断组织动脉血流的条件下进行运动。
老年性肌肉减少症:是一种随年龄增长出现的骨骼肌容积和力量的迅速衰减、骨与关节系统的稳定性和协调性降低的骨骼肌疾病。患者主要表现为行动缓慢、步履蹒跚、平衡功能障碍,发生跌倒、骨折和心血管系统意外不良事件大幅增加。

背景:有研究报道了血流限制疗法对中老年肌肉适能的影响与优势,基本肯定了血流限制疗法应用的科学性和其改善中老年人肌力及肌肉量的有效性,但关于不同运动模式下的血流限制疗法在老年性肌肉减少症中的应用以及相关作用机制的综述国内外还未见报道。
目的:综述不同运动模式下的血流限制疗法应用于老年性肌肉减少症的应用效果、安全性及不良反应,为此类患者选择科学有效的治疗方式提供新的思路。
方法:在PubMed、ScienceDirect 、Web of Science、万方、维普、CNKI数据库检索2005年1月至2020年7月收录的相关文献,英文检索词为“blood flow restriction or exercise or therapy ;KAATSU training ;sarcopenia;motor function;mechanism”;中文检索词为“血流限制疗法;血流限制训练;血流限制;加压血流阻滞训练;加压训练;老年性肌肉减少症;肌少症;少肌症;肌肉力量;运动功能;机制”,经筛选后对50篇文献进行归纳总结。
结果与结论:①在老年性肌肉减少症患者中使用血流限制疗法可增加肌肉力量和肌容积,尤其是与中低强度抗阻运动结合的效果最佳且不良反应少;②血流限制疗法可能通过增加肌肉组织蛋白合成与降解速率、提高线粒体能量代谢水平及改善组织微循环水平发挥作用,但目前血流限制疗法发挥作用的机制仍存在争议,需进一步研究加以论证;③在老年性肌肉减少症患者中使用血流限制疗法尚无明确的安全性结论,使用中需重点关注血流闭塞压力和运动负荷情况。


https://orcid.org/0000-0001-5811-7883 (陈蓉) 

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程

关键词: 血流限制疗法, 老年肌肉减少症, 运动训练, 肌力, 综述

Abstract: BACKGROUND: Geriatric muscular dystrophy increases the incidence of falls, fractures, and cardiovascular adverse events. The blood flow restriction therapy combine with exercise is appropriate for preventing and treating sarcopenia.
Studies have reported merits and demerits of blood flow restriction therapy in the middle-aged and elderly with regard to muscular fitness, in which blood flow restriction therapy has been basically affirmed to be scientific and effective for improving muscle strength and mass in the middle-aged and elderly people. However, there is yet no report to review the application and mechanism of different modes of blood flow restriction therapy in senile sarcopenia.
OBJECTIVE: To review the efficacy, safety and adverse reactions of blood flow restriction therapy in sarcopenia, and to provide new ideas for such patients about how to choose scientific and effective treatment methods.
METHODS: Related literatures were searched in PubMed, Science Direct, Web of Science, WanFang, VIP and CNKI from January 2005 to July 2020, with the key words of “blood flow restriction or exercise or therapy; KAATSU training; sarcopenia; senile sarcopenia; motor function; mechanism; muscular strength’’ in English and Chinese, respectively. Eventually, 50 articles that met the criteria were included.
RESULTS AND CONCLUSION: The blood flow restriction therapy, especially in combination with exercise, can increase muscle strength and muscle volume in sarcopenia patients suffering few less adverse reactions. Blood flow restriction therapy may play a role by increasing the rate of protein synthesis and degradation in muscle tissues, elevating the level of mitochondrial energy metabolism and improving the level of tissue microcirculation. However, the mechanism of blood flow restriction therapy is still controversial and needs further verification. For senile sarcopenia patients, doctors should focus on blood flow occlusion pressure and exercise load, because there is no clear exact safety conclusion.


Key words: blood flow restriction therapy, senile sarcopenia, sports exercise, muscle strength, review

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