【摘要】目的探讨尿毒症患者血液透析中进行脚踏车运动对不安腿综合征(restless legs syndrome, RLS)的治疗效果。方法选择2018 年10 月～2019 年6 月中国人民解放军联勤保障部队第983医院进行维持性血液透析治疗的尿毒症患者60 例，随机分为对照组和运动组，对照组进行常规透析护理，运动不加干预，运动组进行为期12 周的透析中脚踏车运动疗法，每次透析前2h 进行3 组20min 的卧位脚踏车运动。治疗前后通过国际不安腿综合征评估量表(international restless legs syndrome study group rating scale，IRLS)评估不安腿综合征(restless legs syndrome，RLS)症状，5 次起坐耗时试验(5 times sit- to- stand test,ST- 5)评估下肢肌力，匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评估睡眠质量。结果对照组前后ST- 5 评分增加(16.46±0.25 比17.80 ± 0.33, t=3.338, P=0.002)，IRLS(18.77±1.12 比20.73 ± 1.00, t=1.314, P=0.194) 和PSQI (14.57±0.39 15.50± 0.31, t=1.878, P=0.065)评分无显著变化，运动组治疗前后IRLS(19.27±0.96比14.87 ± 0.79, t=3.530,P=0.001)、ST- 5(16.61 ± 0.27 比14.21 ± 0.28,t=6.093,P=0.000)、PSQI(14.13±0.50 比9.93±0.43, t=6.377, P=0.014)评分较治疗前均显著降低。结论尿毒症患者透析中进行脚踏车运动疗法，可减轻不安腿综合征症状，增强下肢肌力，改善睡眠质量。
【Abstract】Objective To investigate the preventive and therapeutic efficacy of intradialytic bicycle exercise on restless legs syndrome (RLS) among uremic patients. Methods A total of 60 maintenance hemodialysis patients treated in the period from October 2018 to June 2019 were randomly divided into control(n=30) and exercise groups (n=30). Patients in control group treated with the basic dialysis management without any exercise intervention, while those in exercise group underwent an intradialytic bicycle exercise program of 12 weeks. Within the first 2 hours of hemodialysis sessions, the patients exercised supinely on a bicycle each for 20 minutes and 3 times together. The IRLS international restless legs syndrome study group rating scale (IRLS), 5 times sit-to-stand test(ST-5) and Pittsburgh sleep quality index (PSQI) were used to evaluate symptom of RLS, muscle force of lower limbs and sleeping quality before and after the intervention in both groups. Results In control group, the scores of ST-5 (16.46±0.25 vs. 17.80±0.33, t=3.338, P=0.002) was significantly increased, and the scores of IRLS (18.77± 1.12 vs. 20.73±1.00, t=1.314, P=0.194) and PSQI (14.57±0.39 vs. 15.50±0.31, t=1.878, P=0.065) had no differences compared to the basal levels. In exercise group after the intradialytic exercise intervention, the scores of IRLS (19.27 ± 0.96 vs. 14.87 ± 0.79,t=3.530,P=0.001),ST- 5 (16.61 ± 0.27 vs. 14.21 ± 0.28,t=6.093,P=0.000) and PSQI(14.13 ± 0.50 vs. 9.93 ± 0.43,t=6.377,P=0.014) decreased significantly. Conclusion The exercise program relieves the symptom of RLS, enhances the muscle force of lower limbs, improves the sleeping quality, and prevents RLS development. Therefore, this method can be used clinically.
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