本文選題：高原 + 耐力�。� 參考：《第三軍醫(yī)大學(xué)》2006年碩士論文

【摘要】： 目的探討不同強(qiáng)度耐力訓(xùn)練對(duì)自主神經(jīng)系統(tǒng)(ANS)功能的影響及預(yù)防急性高原反應(yīng)(AMS)的作用,為平原擔(dān)負(fù)高原作戰(zhàn)任務(wù)部隊(duì)提供科學(xué)、合理的訓(xùn)練方案及理論依據(jù)。 方法 (一)平原急進(jìn)西藏高原現(xiàn)場(chǎng)研究 遂行某部99名男性新兵由四川雙流(海拔560m)空運(yùn)至西藏拉薩(3675m)。在平原和急進(jìn)高原后第4天檢測(cè)受試新兵握力、4×10m折返跑、臺(tái)階指數(shù)及臺(tái)階運(yùn)動(dòng)后血乳酸濃度;在平原和急進(jìn)高原后第2至4日內(nèi)檢測(cè)5min短程心率變異性(HRV)、冷加壓試驗(yàn)(CPT);于急進(jìn)高原后第1至5日根據(jù)軍用標(biāo)準(zhǔn)GJB1098-91《急性高原反應(yīng)的診斷和處理原則》進(jìn)行AMS癥狀學(xué)評(píng)分,并按急進(jìn)高原后第1日AMS癥狀評(píng)分將受試新兵分為中重度組、輕度組、基本無反應(yīng)組及無反應(yīng)組。 (二)平原不同強(qiáng)度耐力訓(xùn)練對(duì)ANS功能影響的研究 平原某部72名男性新兵被隨機(jī)分為現(xiàn)行軍體訓(xùn)練組(n=24)、有氧耐力組(n=24)、無氧耐力組(n=24),均進(jìn)行連續(xù)8周訓(xùn)練。訓(xùn)練前、訓(xùn)練第4周末及第8周末,檢測(cè)受試新兵臺(tái)階指數(shù)、最大耗氧量(VO_2max)、體力活動(dòng)能力(PWC_(150))、5000m、50m跑成績(jī)、HRV、CPT及直立傾斜試驗(yàn)(HUTT)。訓(xùn)練前及訓(xùn)練第8周末檢測(cè)血漿腎上腺素(EPI)、去甲腎上腺素(NE)、腎素活性(PRA)及神經(jīng)肽Y(NPY)。 (三)訓(xùn)練后模擬急進(jìn)高原研究 不同強(qiáng)度耐力訓(xùn)練結(jié)束后第5至8日,隨機(jī)確定上述三個(gè)試驗(yàn)組中43名受試新兵,分三批在我校低壓、低氧艙模擬急進(jìn)海拔4500m高原一日,檢測(cè)模擬高原后第2h、10h、20h HRV、模擬高原4h后CPT,采集模擬高原24h時(shí)血液樣本檢測(cè)血漿NE、EPI、PRA、NPY等。根據(jù)《急性高原反應(yīng)的診斷和處理原則》對(duì)受試新兵進(jìn)行AMS癥狀學(xué)評(píng)分,同步進(jìn)行心理量化評(píng)分。 結(jié)果 (一)平原急進(jìn)西藏高原現(xiàn)場(chǎng)研究 1.體能改變和AMS發(fā)生率 ①與平原時(shí)比較,急進(jìn)高原后第4天折返跑速度、運(yùn)動(dòng)后血乳酸濃度均顯著降低(P均＜0.01)。 ②AMS以急進(jìn)高原后第1天為重,其中,中重度反應(yīng)者9名,輕度反應(yīng)者33名,基本無反應(yīng)者50名,無反應(yīng)者7名。 2.ANS功能變化 ①與平原時(shí)比較,急進(jìn)高原后SDNN、RMSSD、PNN50、HF、HFn均顯著降低,LFn、LF/HF、HR均顯著增加(P均＜0.01);TP顯著下降(P＜0.05)。急進(jìn)高原CPT中BP、HR的增高幅度均顯著降低(P均＜0.01)。 ②AMS癥狀評(píng)分由高至低均伴隨平原或高原LFn、LF/HF下降及HFn上升趨勢(shì);發(fā)生AMS的三組其平原靜息SBP均顯著高于無反應(yīng)組(P均＜0.05),其高原靜息HR均高于無反應(yīng)組;平原CPT中,HR的增高幅度越大其AMS癥狀評(píng)分越小,中重度組HR的增高幅度顯著低于基本無反應(yīng)組(P＜0.05);高原CPT中,發(fā)生AMS的三組SBP、HR增高幅度均顯著低于無反應(yīng)組(P均＜0.05),DBP增高幅度均低于無反應(yīng)組,其中輕度組與無反應(yīng)組間有顯著差異(P＜0.05)。 3.相關(guān)性分析AMS癥狀評(píng)分與平原時(shí)臺(tái)階運(yùn)動(dòng)后血乳酸濃度負(fù)相關(guān)(r=0.469,P=0.001);與平原時(shí)LF/HF正相關(guān)(r=0.437,P=0.00);與平原時(shí)CPT中心率增高幅度負(fù)相關(guān)(r=-0.35,P=0.01)。平原時(shí)運(yùn)動(dòng)后血乳酸濃度與平原時(shí)CPT中HR增高幅度弱相關(guān)(r=0.31,P=0.051)。 (二)平原不同強(qiáng)度耐力訓(xùn)練對(duì)ANS影響的研究 1.耐力變化 有氧耐力組運(yùn)動(dòng)中實(shí)際心率為145～160bpm,無氧耐力組為170～180bpm,現(xiàn)行軍體訓(xùn)練組最大心率則在180bpm以上。與訓(xùn)練前比較,三個(gè)試驗(yàn)組50m、3000m跑成績(jī)以及VO_2max、臺(tái)階指數(shù)、PWC_(150)均隨時(shí)間顯著提高,且至訓(xùn)練第8周末有氧耐力組臺(tái)階指數(shù)、VO_2max、3000m成績(jī)顯著優(yōu)于現(xiàn)行訓(xùn)練組(P＜0.05或0.01);無氧耐力組臺(tái)階指數(shù)、50m跑成績(jī)顯著優(yōu)于現(xiàn)行訓(xùn)練組(P＜0.05);PWC_(150)無顯著組間差異。 2.ANS功能 ①HRV 1)與訓(xùn)練前比較,訓(xùn)練第4周末僅有氧耐力組PNN_(50)、LF顯著增高(P＜0.05),HR顯著下降(P＜0.01)。至訓(xùn)練第8周末,三個(gè)試驗(yàn)組心率均顯著下降(P均＜0.01)有氧耐力組RMSSD、PNN_(50)、HF、SDNN均顯著增加、LF顯著增高(P均＜0.01),HFn呈增高趨勢(shì),而LFn、LF/HF呈下降趨勢(shì);現(xiàn)行訓(xùn)練組HFn顯著降低、LF、LFn、LF/HF顯著增加(P均＜0.05):無氧耐力組上述各指標(biāo)均無顯著變化。 2)訓(xùn)練第8周末,有氧耐力組RMSSD、PNN_(50)、HF、LF、SDNN顯著高于另外兩組(P＜0.01或0.05);現(xiàn)行訓(xùn)練組HFn顯著低于有氧耐力組(P＜0.05),LFn、LF/HF顯著高于有氧耐力組(P＜0.05);無氧耐力組LF/HF顯著高于有氧耐力組(P＜0.05)。 ②CPT和HUTT 1)與訓(xùn)練前比較,訓(xùn)練第4、8周末三個(gè)試驗(yàn)組心率均呈下降趨勢(shì)、SBP均無顯著變化,現(xiàn)行訓(xùn)練組、無氧耐力組DBP呈下降趨勢(shì),有氧耐力組DBP顯著降低(P＜0.01);CPT中各組SBP、DBP增高幅度無顯著變化,但HR增高幅度在現(xiàn)行訓(xùn)練組顯著增加(P＜0.05),有氧耐力組微弱增加,無氧耐力組則顯著降低(P＜0.05)。訓(xùn)練第8周末無氧耐力組CPT中HR增高幅度顯著低于現(xiàn)行訓(xùn)練組和有氧耐力組(P均＜0.05)。 2)訓(xùn)練第8周末現(xiàn)行訓(xùn)練組HUTT陽(yáng)性例數(shù)較訓(xùn)練前增多,但無統(tǒng)計(jì)學(xué)意義。 3.血液生化指標(biāo) 訓(xùn)練第8周末,與訓(xùn)練前比較,三個(gè)試驗(yàn)組血漿NE、NPY濃度均顯著下降(P＜0.05或0.01);現(xiàn)行訓(xùn)練組PRA呈增加趨勢(shì),有氧耐力組顯著下降(P0.05)、無氧耐力組呈下降趨勢(shì)。有氧、無氧耐力組NE、PRA顯著低于現(xiàn)行訓(xùn)練組(P＜0.01); (三)訓(xùn)練后模擬急進(jìn)高原研究 1.ANS功能 ①HRV模擬急進(jìn)4500m高原24h內(nèi),現(xiàn)行訓(xùn)練組、有氧耐力組RMSSD、PNN50均顯著下降,無氧耐力組呈先下降后升高曲線;各組HFn、LFn均呈先下降后升高曲線,其中無氧耐力組HFn自10h丌始升高,另兩組則自20h方出現(xiàn);有氧耐力組LF/HF先下降后增高,無氧耐力組、現(xiàn)行訓(xùn)練組LF/HF則均呈先增高后下降曲線,其中無氧耐力組在10h時(shí)即開始回落,20h時(shí)基本恢復(fù)至模擬高原前狀態(tài),而現(xiàn)行訓(xùn)練組LF/HF于20h仍增高;現(xiàn)行訓(xùn)練組、有氧耐力組SDNN、TP顯著下降或呈下降趨勢(shì),而無氧耐力組則無顯著變化。 ②CPT與模擬高原前比較,急進(jìn)4500m高原4h前述三個(gè)試驗(yàn)組靜息HR均顯著增加(P＜0.01);各組靜息SBP無顯著變化;無氧耐力組靜息DBP顯著增加(P＜0.05),現(xiàn)行訓(xùn)練組和有氧耐力組靜息DBP呈增加趨勢(shì);CPT中現(xiàn)行訓(xùn)練組和有氧耐力組SBP、DBP、HR增高幅度均呈下降趨勢(shì),而無氧耐力組SBP、DBP、HR增高幅度則呈相對(duì)穩(wěn)定或增高趨勢(shì)。 2.血液生化指標(biāo)與模擬高原前比較,模擬急進(jìn)4500m高原24h三個(gè)試驗(yàn)組血漿NE濃度均顯著下降(P＜0.01或0.05),有氧、無氧耐力組血漿NE濃度下降幅度顯著小于現(xiàn)行訓(xùn)練組(P＜0.05);與模擬高原前比較,現(xiàn)行訓(xùn)練組、有氧耐力組血漿EPI濃度均顯著增加(P均＜0.01),無氧耐力組則無顯著變化�，F(xiàn)行訓(xùn)練組、無氧耐力組PRA均顯著下降(P＜0.01),有氧耐力組呈下降趨勢(shì),現(xiàn)行訓(xùn)練組下降幅度顯著大于有氧、無氧耐力組(P＜0.01)�，F(xiàn)行訓(xùn)練組、有氧耐力組NPY呈下降趨勢(shì),而無氧耐力組呈增高趨勢(shì)。 3.AMS與心理量化評(píng)分AMS發(fā)病率為100%,AMS癥狀評(píng)分由高到低依次為現(xiàn)行訓(xùn)練組、有氧耐力組、無氧耐力組,且現(xiàn)行訓(xùn)練組顯著高于無氧耐力組(P＜0.05);各組間心理量化評(píng)分無顯著差異,但現(xiàn)行訓(xùn)練組、有氧耐力組AMS癥狀評(píng)分與心理量化評(píng)分呈正相關(guān)關(guān)系(r分別為0.77、0.68,P＜0.01)。 4.相關(guān)性分析AMS癥狀評(píng)分與模擬急進(jìn)高原前NE、PRA、NPY濃度及模擬急進(jìn)高原前后NE、PRA變化幅度均顯著正相關(guān)(P＜0.05);與模擬急進(jìn)高原后10h、20h時(shí)LF/HF顯著正相關(guān)(P＜0.05);與模擬急進(jìn)高原后10h、20h時(shí)SDNN、RMSSD、PNN_(50)、HFn均顯著負(fù)相關(guān)(P＜0.01或0.05)。 結(jié)論 1.ANS功能在AMS發(fā)生、發(fā)展中具有重要作用。平原時(shí)交感神經(jīng)活動(dòng)相對(duì)過高者,其對(duì)AMS較易感;急進(jìn)高原1日內(nèi)交感神經(jīng)和副交感神經(jīng)活動(dòng)受抑制程度較重且交感神經(jīng)優(yōu)勢(shì)持續(xù)增高者其AMS癥狀重。平原或急進(jìn)高原檢測(cè)ANS功能有助于預(yù)測(cè)或診斷AMS。 2.現(xiàn)行軍體訓(xùn)練實(shí)施中強(qiáng)度接近極限,其相對(duì)于規(guī)范的有氧、無氧耐力訓(xùn)練對(duì)提高訓(xùn)練成績(jī)和耐力素質(zhì)作用有限,部隊(duì)軍體訓(xùn)練應(yīng)進(jìn)行科學(xué)、規(guī)范、合理的有氧耐力和無氧耐力訓(xùn)練。 3.現(xiàn)行軍體訓(xùn)練和有氧耐力訓(xùn)練分別相對(duì)增強(qiáng)交感神經(jīng)活動(dòng)和副交感神經(jīng)活動(dòng),均降低ANS調(diào)節(jié)能力,不利于對(duì)急進(jìn)高原環(huán)境的習(xí)服;無氧耐力訓(xùn)練使交感和副交感神經(jīng)活動(dòng)維持相對(duì)穩(wěn)定狀態(tài),增強(qiáng)ANS的調(diào)節(jié)能力,有助于提高急進(jìn)高原的適應(yīng)能力。
[Abstract]:Objective to explore the effect of different strength endurance training on the function of autonomic nervous system (ANS) and the effect of preventing acute plateau response (AMS), and to provide scientific, reasonable training scheme and theoretical basis for plateau combat task force.
Method
(1) a field study of the plain in Tibet Plateau
99 male recruits were airlifted from Sichuan double flow (elevation 560m) to Lhasa (3675m) in Tibet. Test recruits' grip strength, 4 x 10m reentry, step index and blood lactate concentration after step movement were tested fourth days after the plain and high altitude, and 5min short range heart rate variability (HRV) was detected and cold compression test was tested within second to 4 days after the plain and steep plateau. (CPT): first to 5 days after the rapid progress of the plateau, according to the diagnostic and treatment principles of the military standard GJB1098-91< acute plateau response, the AMS symptom score was scored, and the recruits were divided into moderate and severe group, mild group, basic non reaction group and no reaction group according to the first days of AMS symptom score of first days after urgent high altitude.
(two) effect of different intensity endurance training in plain on ANS function
72 male recruits in the plain were randomly divided into current military training group (n=24), aerobic endurance group (n=24) and anaerobic endurance group (n=24) for 8 weeks of training. Before training, training fourth weekend and 8 weekend, test recruits step index, maximum oxygen consumption (VO_2max), physical activity ability (PWC_ (150)), 5000m, 50m running results, HRV, CPT and Head up tilt table test (HUTT). Plasma adrenaline (EPI), norepinephrine (NE), renin activity (PRA) and neuropeptide Y (NPY) were measured before training and eighth weeks after training.
(three) the study of simulated emergency plateau after training
Fifth to 8 days after the end of different strength endurance training, 43 recruits were randomly selected from the three test groups, three batches in our low pressure, low oxygen cabin simulated high altitude 4500m plateau one day, 2h, 10h, 20h HRV after Simulated Plateau, CPT after Simulated Plateau 4h, and blood samples were collected to detect the plasma NE, EPI, PRA, NPY and so on when the Simulated Plateau 24h was collected. According to the principles of diagnosis and treatment of acute altitude sickness, the AMS symptom scores of the recruits were recruits, and the psychological quantification was scored simultaneously.
Result
(1) a field study of the plain in Tibet Plateau
1. changes in physical energy and the incidence of AMS
(1) compared with plain time, the speed of running back and forth after fourth days of rapid entering the plateau decreased significantly after exercise (P < 0.01).
(2) AMS was the most important factor in first days after rushing into the plateau. Among them, 9 cases were moderately severe, 33 were mild reactions, 50 were basically non responders, and 7 were non responders.
2.ANS function change
(1) compared with the plain, SDNN, RMSSD, PNN50, HF, HFn were significantly decreased, LFn, LF/HF, HR were significantly increased (P < 0.01), and TP significantly decreased (P < 0.05).
(2) the AMS symptom score from high to low was accompanied by LFn, LF/HF and HFn rising in plain or plateau, and in the three groups of AMS, the resting SBP was significantly higher than that in the non reactive group (P < 0.05), and the resting HR in the plateau was higher than that in the non reactive group; in plain CPT, the higher the increase of HR, the smaller the AMS symptom score was, and the increased amplitude of the HR in the moderate and severe group. It was lower than the basic non reactive group (P < 0.05); in the plateau CPT, the increase of HR in three groups of SBP in AMS was significantly lower than that in the non reactive group (P < 0.05). The increase of DBP was lower than that in the non reactive group, and there was a significant difference between the mild group and the non reaction group (P < 0.05).
In 3. correlation analysis, the AMS symptom score was negatively correlated with the concentration of blood lactic acid (r=0.469, P=0.001) after the step exercise in the plain. LF/HF was positively correlated with the plain (r=0.437, P=0.00), and was negatively correlated with the increase of CPT center rate (r=-0.35, P=0.01) at the plain (r=-0.35, P=0.01). The concentration of blood lactic acid after the plain movement was weakly correlated with the HR increase of CPT in the plain (r=0.31,).
(two) the effect of different intensity endurance training on ANS in plain
1. change of endurance
The actual heart rate of the aerobic endurance group was 145 ~ 160bpm, the anaerobic endurance group was 170 ~ 180bpm, the maximum heart rate of the current military training group was above 180bpm. Compared with the training before the training, the three test groups, 50m, 3000m run, VO_2max, step index, PWC_ (150) were all improved with time, and the aerobic endurance group step index, V at the training eighth weekend. O_2max, 3000m scores were significantly better than those in the current training group (P < 0.05 or 0.01); the stair index of anaerobic endurance group was significantly better than the current training group (P < 0.05), and PWC_ (150) had no significant differences.
2.ANS function
(1) HRV
1) compared with pre training, the only oxygen endurance group was PNN_ (50), LF significantly increased (P < 0.05), and HR decreased significantly (P < 0.01). To the weekend of training, the heart rate of the three experimental groups decreased significantly (P < 0.01) in the aerobic endurance group RMSSD, PNN_ (50), HF and SDNN increased significantly (P < 0.01). In the current training group, HFn decreased significantly, while LF, LFn and LF/HF increased significantly (P < 0.05): there was no significant change in the above indexes of anaerobic endurance group.
2) in the eighth week of training, the aerobic endurance group RMSSD, PNN_ (50), HF, LF, SDNN were significantly higher than the other two groups (P < 0.01 or 0.05); the current training group was significantly lower than the aerobic endurance group (P < 0.05), LFn, LF/HF significantly higher than the aerobic endurance group (P < 0.05), and the LF/HF significantly higher than the aerobic endurance group (0.05).
(2) CPT and HUTT
1) compared with before training, the heart rate of the three experimental groups in the 4,8 weekend showed a decline trend, and there was no significant change in SBP. In the current training group, the DBP of the anaerobic endurance group decreased and the DBP in the aerobic endurance group decreased significantly (P < 0.01), and the SBP in each group of CPT was not significantly changed, but the increase of HR was significantly increased in the current training group (P < 0.05). The aerobic endurance group was slightly increased, and the anaerobic endurance group decreased significantly (P < 0.05). The increase of HR in the CPT free endurance group was significantly lower than that of the current training group and the aerobic endurance group (P < 0.05).
2) training for eighth weeks, the number of HUTT positive cases in the current training group increased more than before training, but there was no statistical significance.
3. biochemical indexes of blood
After eighth weeks of training, compared with pre training, the plasma concentration of NE and NPY decreased significantly in the three experimental groups (P < 0.05 or 0.01). The current training group increased the PRA trend, the aerobic endurance group decreased significantly (P0.05), the anaerobic endurance group decreased, and the aerobic and anaerobic endurance group was NE, and PRA was significantly lower than the existing training group (P < 0.01).
(three) the study of simulated emergency plateau after training
1.ANS function
(1) HRV simulated acute 4500m plateau 24h, the current training group, the aerobic endurance group RMSSD, PNN50 decreased significantly, the anaerobic endurance group was first descended and then increased curve, LFn in each group HFn, LFn decreased first and then increased curve, and the anaerobic endurance group HFn from 10h started to rise, the other two groups appeared from 20h, and the aerobic endurance group decreased first and then increased, and oxygen free. In the endurance group, the LF/HF of the current training group increased first and then descended, in which the anaerobic endurance group began to fall down at 10h, and the 20h was basically restored to the state before the Simulated Plateau, while the current training group was still higher in 20h; the current training group was SDNN in the aerobic endurance group, and the TP decreased significantly or decreased, while the anaerobic endurance group had no significant change.
(2) compared with before the Simulated Plateau, the resting HR in the three experimental groups before the 4500m plateau 4H increased significantly (P < 0.01), and there was no significant change in resting SBP in each group; the resting DBP in the anaerobic endurance group increased significantly (P < 0.05), and the resting DBP in the current training group and the aerobic endurance group increased. The present training group and the aerobic endurance group were SBP, DBP, and increased amplitude in the current training group and the aerobic endurance group. All of them showed a decreasing trend, while the SBP, DBP and HR increased in the anaerobic endurance group.
2. compared with the Simulated Plateau before the Simulated Plateau, the plasma NE concentration of the three experimental groups in the simulated 4500m plateau 24h was significantly decreased (P < 0.01 or 0.05). The decrease of plasma NE concentration in the oxygen free endurance group was significantly lower than that of the current training group (P < 0.05). Compared with the Simulated Plateau, the plasma EPI concentration in the aerobic endurance group was significantly higher than that before the Simulated Plateau. The increase (P < 0.01) and anaerobic endurance group had no significant changes. The PRA in the aerobic endurance group decreased significantly (P < 0.01) in the current training group (P < 0.01), and the aerobic endurance group showed a downward trend. The current training group was significantly lower than the aerobic and anaerobic endurance group (P < 0.01). The current training group had a decreasing trend in the aerobic endurance group, while the anaerobic endurance group showed an increasing trend. Potential.
The incidence of 3.AMS and AMS was 100%. The AMS symptom score from high to low was in the order of the current training group, the aerobic endurance group and the anaerobic endurance group, and the current training group was significantly higher than the anaerobic endurance group (P < 0.05). There was no significant difference in the psychological quantitative scores among the groups, but the present training group, the AMS symptom score and the psychological quantitative score in the aerobic endurance group. The positive correlation (r was 0.77,0.68, P < 0.01).
4. correlation analysis AMS symptom score was significantly positively correlated with the NE, PRA, NPY concentration and NE and PRA changes before and after the simulated high altitude plateau (P < 0.05), and significantly positive correlation with 10h and 20h (P < 0.05) after the simulated rapid altitude of plateau (P < 0.05). .05).
conclusion
The function of 1.ANS plays an important role in the development of AMS. When the sympathetic nerve activity is relatively high in the plain, it is more susceptible to AMS; the sympathetic and parasympathetic nervous activity in the plateau is heavier and the sympathetic nerve is increasing in 1 days, and the AMS symptoms are heavy. The detection of ANS function in the plain or the plateau is helpful to the prediction or diagnosis. Break AMS.
2. the strength near the current military body training is close to the limit, its relative to the standard oxygen, the anaerobic endurance training is limited to improve the training performance and endurance quality, and the army body training should carry out scientific, standardized and rational aerobic endurance and anaerobic endurance training.
3. the current military training and aerobic endurance training, respectively, enhance the sympathetic and parasympathetic activity of the sympathetic nerve and reduce the ANS regulation ability, which is not conducive to the acclimatization to the plateau environment, and the anaerobic endurance training makes the sympathetic and parasympathetic nervous activities relatively stable, and strengthens the regulation ability of ANS, and helps to improve the rapid plateau. Adaptability.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R82

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