目的：本研究旨在探讨有氧运动对不同年龄帕金森病（Parkinson’s disease，PD）患者临床 症状及肠道菌群的影响。

方法：本研究纳入21例PD患者，按照年龄分为＜60岁和≥60岁组，进行为期8周的中等强 度有氧运动干预。在干预前后对患者进行相关量表评估，并采集患者粪便进行肠道微生物 16S核糖体RNA测序及统计分析。

结果：有氧运动干预后，年龄＜60 岁组 PD 患者仅有统一 PD 综合评价量表（Unified PD Rating Scale，UPDRS）-Ⅲ开期和UPDRS总分有所改善（P值分别为0.042和0.021）；年龄≥60 岁组 PD 患者的 UPDRS-Ⅱ、UPDRS-Ⅲ开期、UPDRS-Ⅲ关期、UPDRS 总分、Berg 平衡量表 （Berg Balance Scale，BBS）和 Tinetti 平 衡 与 步 态 量 表（Tinetti Performance Oriented Mobility Assessment，Tinetti POMA）都有所改善（P 值分别为 0.029、＜0.001、0.025、＜ 0.001、0.008和0.023）。此外，有氧运动干预后，年龄≥60岁PD患者的简易精神状态检查量 表（Mini-mental State Examination，MMSE）、蒙 特 利 尔 认 知 评 估（Montreal Cognitive Assessment，MoCA）、PD日常生活质量问卷调查（PD Questionnaire-39，PDQ-39）、快速眼动 睡 眠 行 为 障 碍 问 卷（Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire，RBDSQ）、自 主 神 经 症 状 量 表（Scales for Outcomes in PD-Autonomic， SCOPA-AUT）、胃肠道功能障碍评分（Gastrointestinal Dysfunction Score，GIDS）、汉密尔顿 焦 虑 量 表（Hamilton Anxiety Rating Scale，HAMA）、汉 密 尔 顿 抑 郁 量 表（Hamilton Depression Rating Scale，HAMD）和非运动症状量表（Non-Motor Symptoms Scale，NMSS） 评分均有所改善（P 值分别为 0.002、0.006、0.002、0.016、0.007、0.029、0.002、0.008 和 0.003）；＜60岁组的PD患者NMSS评分有改善且差异具有统计学意义（P＝0.044）。与有氧 运动干预前比较，年龄＜60岁组PD患者肠道内的梭形杆菌属（Fusicatenibacter）和丹毒丝菌 属（Erysipelotrichaceae_UCG-003）在干预后的相对丰度均有提高，且差异有统计学意义（Z值 分别为－2.201和－2.207，P值分别为0.028和0.027）。

结论：中等强度有氧运动可以改善改善不同年龄PD患者的运动症状，也可以改善认知、生 活质量、睡眠、自主神经功能、焦虑和抑郁等非运动症状。中等强度有氧运动可以提高不同 年龄PD患者，特别是年龄＜60岁PD患者肠道内有益菌的相对丰度。

Objective: To investigate the effects of aerobic exercise on clinical symptoms and gut microbiota in Parkinson’s disease (PD) patients of different age groups.

Methods: This study included 21 PD patients, divided into age groups of <60 years and ≥60 years, and underwent an 8-week moderate intensity aerobic exercise intervention. Assess patients with relevant scales before and after intervention, and collect their feces for 16S ribosomal RNA amplicon sequencing and statistical analysis.

Results: Only UPDRS-III on-off and total scores showed statistically significant improvement in <60 years old PD patients after aerobic exercise intervention (P＝0.042, P＝ 0.021); UPDRS-II, UPDRS-III on, UPDRS-III off, UPDRS total scores, Berg Balance Scale (BBS) and Tinetti Performance Oriented Mobility Assessment (Tinetti POMA) improved in ≥60 years old PD patients (the P values were 0.029, <0.001, 0.025, <0.001, 0.008 and 0.023 respectively). In addition, after aerobic exercise intervention, the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), PD Questionnaire 39 (PDQ- 39), Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Scales for Outcomes in PD Autonomous (SCOPA-AUT), Gastrointestinal Dysfunction Score (Gastrointestinal Dysfunction Score), Gastrointestinal Dysfunction Score (GIDS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Non Motor Symptoms Scale (NMSS) scores were improved in ≥60 years old PD patients (P values were 0.002, 0.006, 0.002, 0.016, 0.007, 0.029, 0.002, 0.008, and 0.003, respectively). The NMSS score of PD patients in the <60 age group improved and the difference was statistically significant (P＝0.044) after intervention. Gut microbiota analysis revealed the relative abundance of Fusicatenibacter and Erysipelotrichaceae_UCG-003 were increased in the PD group aged <60 years after aerobic exercise intervention, and the difference was statistically significant compared with the pre-intervention period (Z values were －2.201 and －2.207, and P values were 0.028 and 0.027, respectively).

Conclusion: Moderate-intensity aerobic exercise can improve motor symptoms as well as non-motor symptoms such as cognition, quality of life, sleep, autonomic function, anxiety and depression in PD patients of different age groups. Notably, moderate-intensity aerobic exercise can improve the relative abundance of beneficial gut microbiota, particularly in <60 years old patients .