生物反馈放松训练对冠状动脉粥样硬化性心脏病患者心率变异性的影响  

Influence of the biofeedback relaxation training on the heart rate variability of patients with coronary heart disease

作　　者：王兰爽[1] 张芳[2] 刘红艳[3] 吕新湖[2] 

机构地区：[1]河北师范大学教育科学学院心理研究所,河北省石家庄市050091 [2]石家庄第一人民医院心血管内科,河北省石家庄市050016 [3]河北科技大学学生处,河北省石家庄市050011

出　　处：《中国临床康复》2006年第6期13-15,共3页Chinese Journal of Clinical Rehabilitation

基　　金：河北师范大学青年基金(W2003Q11)~~

摘　　要：目的:观察冠状动脉粥样硬化性心脏病(冠心病)患者经生物反馈放松训练后心脏植物神经活性的定量检测指标心率变异性的变化情况。方法:选择2004-04/2005-04在石家庄第一人民医院心血管内科进行24h动态心电图检查的冠心病患者34例,均自愿参加观察。将患者分为两组,观察组17例,对照组17例。①两组患者均佩带24h连续动态心电图记录仪,在安静状态下休息15min后记录5min的心率变异性时域指标,即第一阶段(基线)时域指标。②观察组进行生物反馈训练结合放松训练,先听10min的自我松弛训练磁带,然后进行额肌生物反馈训练,每次训练约30min。对照组不进行生物反馈放松训练,而是静卧30min。记录观察组患者生物反馈放松训练最后5min的心率变异性时域指标,即第二阶段时域指标;同时记录对照组患者30min静卧过程中最后5min(第二阶段)的心率变异性时域指标。③在两组患者均休息5min后,分别记录其在接下来5min内的心率变异性时域指标,即第三阶段时域指标。分析指标包括全部正常窦性心动间期标准差、相邻正常窦性心动间期差的均方根、相邻心动间期之差大于50ms的心搏数占总正常窦性心动间期数的百分率及三角形指数,以上指标降低,心率变异性就降低,而且心率变异性降低程度与冠状动脉损伤的程度有关,病情越严重,心率变异性就越低。结果:进入结果分析观察组保持为17例;对照组中有些患者不配合,有效人数只有11例。①两组患者相应阶段的时域指标比较:观察组患者在实验第二阶段的全部正常窦性心动间期标准差、相邻正常窦性心动间期差的均方根、相邻心动间期之差大于50ms的心搏数占总正常窦性心动间期数的百分率均显著高于对照组(t=2.33～2.48,P<0.05)。在实验第三阶段,观察组患者相邻心动间期之差大于50ms的心搏数占总正常窦性心动间期数的百分率显�AIM： To observe the changes of heart rate variability （HRV）, the quantitative measurement index of activity of heart vegetative nerve, in patients with coronary heart disease after biofeedback relaxation training. METHODS： Thirty-four patients, who were diagnosed to have coronary heart disease with 24-hour ambulatory electrocardiogram in the Department of Cardiology, Shijiazhuang First People＇s Hospital between April 2004 and April 2005, all voluntarily participated in the study. The patients were divided into observational group （n=17） and control group （n=17）. ① All the patients in both groups took the 24-hour ambulatory electrocardiogram recorder with them, The HRV time-domain indexes for 5 minutes at rest were recorded at 15 minutes after rest [time-domain indexes of the first period （baseline）]. ② The patients in the observational group took part in the bio-feedback relaxation training： They listened to the tape of selfrelaxation training for 10 minutes at first, and then underwent the biofeedback relaxation of frontal muscle, 30 minutes for each time. The patients in the control group only lay for 30 minutes without bio-feedback relaxation training. The HRV time-domain indexes within the last 5 minutes of bio-feedback relaxation training （time-domain indexes of the second period） in the observational group. ③ After 5-minute rest, the HRV time-domain indexes in the next 5 minutes were recorded in both groups （time-domain indexes of the third period）. The indexes included standard deviation of all sinus rhythm RR intervals （SDNN）, mean square of successive RR-differences （RMSSD）, the percentage of consecutive RRinterval differences greater than 50 ms （pNNs0） and triangular index. The HRV would decrease with the decreases of the above indexes, and the decreased degree was associated with the severity of coronary arterial injury, the severer the disease, the lower the HRV. RESULTS： Finally 17 cases in the observational group and 11 cases in the control group e

关 键 词：冠状动脉疾病 生物反馈(心理学) 心率 

分 类 号：R541.4[医药卫生—心血管疾病]