1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.北京中医药大学
wangshihan91@126.com,13910838435
收稿:2021-03-24,
修回:2021-07-30,
纸质出版:2021-11-02
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吕乾瑜,李俊佳,唐菁菁等.太极拳康复训练对稳定型心绞痛患者心绞痛发作、生活质量及心肺储备功能的影响[J].中医杂志,2021,62(21):1895-1900.
LYU Qianyu,LI Junjia,TANG Jingjing,et al.The Effect of Taichi Rehabilitation Excercises on Angina Pectoris Attack, Quality of Life and Cardiorespiratory Reserve in Stable Angina Pectoris[J].Journal of Traditional Chinese Medicine,2021,62(21):1895-1900.
吕乾瑜,李俊佳,唐菁菁等.太极拳康复训练对稳定型心绞痛患者心绞痛发作、生活质量及心肺储备功能的影响[J].中医杂志,2021,62(21):1895-1900. DOI: 10.13288/j.11-2166/r.2021.21.010.
LYU Qianyu,LI Junjia,TANG Jingjing,et al.The Effect of Taichi Rehabilitation Excercises on Angina Pectoris Attack, Quality of Life and Cardiorespiratory Reserve in Stable Angina Pectoris[J].Journal of Traditional Chinese Medicine,2021,62(21):1895-1900. DOI: 10.13288/j.11-2166/r.2021.21.010.
目的
2
探讨太极拳康复训练治疗稳定型心绞痛(SAP)患者的临床疗效及安全性。
方法
2
72例SAP患者随机分为康复组和对照组各36例,对照组接受常规治疗,康复组在常规治疗基础上接受3个月的太极拳康复方案治疗,治疗结束后随访6个月。两组干预前后及随访时采用西雅图心绞痛量表总积分评价心绞痛发作情况,采用生活质量指数(SF-36)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评价生活质量,干预前后检测血清分子生物学指标[包括血糖(GLU)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)、C反应蛋白(CRP)、血清同型半胱氨酸(HCY)和尿酸(UA)]及心肺储备功能指标[包括最大摄氧量(VO
2
max)和6分钟步行距离(6MWD)],记录干预期间主要心血管不良事件(MACE)发生情况及不良事件。
结果
2
最终康复组32例及对照组33例纳入统计分析。干预后及随访时,康复组西雅图心绞痛量表总积分、SF-36评分较干预前明显提高,而SAS评分、SDS评分明显降低(
P
<0.01),且康复组西雅图心绞痛量表总积分、SF-36评分均明显高于对照组,而SAS评分、SDS评分明显低于对照组(
P
<0.01)。干预后康复组GLU、LDL-C、TG、TC、CRP、HCY、UA较干预前下降,VO
2
max及6MWD较干预前明显提升(
P
<0.05或
P
<0.01),且干预后康复组GLU、TG、CRP、CHO、Hcy水平较对照组下降,而VO
2
max及6MWT干预后均较对照组明显上升(
P
<0.05或
P
<0.01)。康复过程中,两组患者均无MACE事件发生,康复组无运动损伤出现,两组均未见肝功能、肾功能异常。
结论
2
太极拳康复训练治疗SAP患者可改善患者生活质量,提高心肺功能,可能与降低血脂有关,且安全性好。
Objective
2
To investigate the effectiveness and safety of the rehabilitation training of Taichi for treatment of stable angina pectoris (SAP).
Methods
2
Seventy-two SAP patients were randomly divided into rehabilitation group (36 cases) and control group (36 cases). The control group received conventional treatment, and the rehabilitation group received Taichi training program for 3 months in addition to the conventional treatment. The frequency of angina attacks assessed through Seattle Angina Questionnaire (SAQ) and the quality of life evaluated by the MOS 36-item short-form healty survey (SF-36), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected before treatment, after treatment and after follow-up of six months; the serum molecular biological indexes including blood glucose (GLU), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC), C-reactive protein (CRP), serum homocysteine (HCY) and uric acid (UA)) and the cardiopulmonary reserve function indexes including maximum oxygen uptake (VO
2
max) and 6-minute walking distance (6MWD)) were assessed before and after treatment, and were compared between groups; the major adverse cardiovascular events (MACE) and adverse events were recorded.
Results
2
Totally, 32 subjects in the rehabilitation group and 33 in the control group were included for statistical analysis. The total score of SAQ and SF-36 in both groups were significantly increased after treatment and at follow-up of six months, while SAS and SDS scores decreased (
P
<0.001); and more changes were seen in rehabilitation group than in the control group (
P
<0.01). After treatment, GLU, LDL-C, TG, TC, CRP, HCY and UA in the rehabilitation group decreased compared to those before treatment, while VO
2
max and 6MWD were significantly increased (
P
<0.05 or
P
<0.01); the levels of GLU, TG, CRP, CHO and Hcy in the rehabilitation group were lower than those in the control group, while VO
2
max and 6MWD significantly increased (
P
<0.05 or
P
<0.001). During rehabilitation, no MACE occurred; there was no sports injuries in the rehabilitation group, and no abnormalities of liver or kidney function in both two groups.
Conclusions
2
Taichi exercises can improve cardiopulmonary function and the quality of life of SAP patients, which may relate to the decrease of blood lipid level, and is considered to be safe.
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