穴位按摩结合肢体功能锻炼对冠心病患者踝臂指数和脉搏波传导速度的影响  

Influence of acupuncture point massage combined with limb function exercise on ABI and PWV of patients with CHD

作　　者：黄春雨[1] 谢幸尔[1] 耿桂灵[2] 王美兰[1] 钱湘云[1] 丁磊[1] 周果[1] 李刚[1] 吴建明[1] 

机构地区：[1]江苏省南通市第三人民医院,江苏南通226001 [2]南通大学护理学院,江苏南通226006

出　　处：《现代临床护理》2016年第4期18-23,共6页Modern Clinical Nursing

基　　金：2013年度南通市市级科技计划(指导性)立项项目;项目编号为HS13968;2014年度教育部人文社会科学研究一般项目;项目编号为14YJAZH022

摘　　要：目的探讨穴位按摩结合肢体功能锻炼对冠心病患者踝臂指数(ankle brachial index,ABI)和脉搏波传导速度(pulse wave velocity,PWV)的影响。方法将180例冠心病患者按Grace评分分为低危组(58例)、中危组(68例)和高危组(54例)3组。每组内再运用随机数字表法分为实验组与对照组,低危组分别为29例,中危组分别为34例,高危组分别为27例。对照组接受常规治疗护理及肢体功能锻炼训练,实验组在对照组基础给予穴位按摩。在干预前、干预7 d、干预30 d及干预90 d测量各组患者ABI与PWV的数值。结果方差分析结果表明:两组在干预前、干预7 d、干预30 d及干预90 d时ABI、PWV在低危、中危、高危组中,处理与时间交互效应比较,均P>0.05,说明时间和处理无交互作用,即时间因素(1 d、7 d、30 d、90 d)不随分组(实验组和对照组)的不同而不同;在低危组中,时间主效应比较,均P>0.05,差异无统计学意义;在中危、高危组中时间主效应比较,均P<0.05,差异具有统计学意义,说明不同时间点(1 d、7 d、30 d、90 d)两组主效应是有区别的;在低危组中处理主效应比较,均P>0.05,差异无统计学意义;在中危组、高危组中主效应比较,均P<0.05,差异具有统计学意义,进一步两两比较表明,实验组中危组、高危组患者在干预7 d、干预30 d时ABI较对照组高,而PWV较对照组低,组间比较,差异具有统计学意义(均P<0.01),但在干预前及干预90 d时两组患者PWV、ABI比较,差异无统计学意义(均P>0.05)。结论穴位按摩结合肢体功能锻炼能有效改善冠心病患者外周动脉的血运情况,提升ABI、降低PWV。Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index（ABI） and pulse wave velocity（PWV） in patients with coronary heart disease（CHD）. Methods According to scores by grace score scale, 180 CHD patients were divided into three groups ： low risk group（n = 58）, moderate risk group（n = 68） and high risk group（n = 54）. Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention, while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time： before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention.Results Repeated measurement data analysis of the experiment group and control group suggested that ： in the moderate and high risk groups, there was statistically significant difference（P〈 0.05） in the data at the four time points. There was no statistically significant difference（P 〉 0.05） in time and group interaction effect. The difference between the experiment group and control group was statistically significant（P 〈 0.05）. Repeated measurement data analysis showed that there was no statistically significant difference（P〉 0.05） in ABI PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant（all P 0.05）. In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group（P 〉 0.05）, And it suggested that time and group interaction, namely effect of time factor（1 d, 7 d, 30 d, 90 d）, was not decided by the division of groups. In comparison of main effect,the difference was stati

关 键 词：冠心病 穴位按摩 肢体功能锻炼 踝臂指数 脉搏波传导速度 

分 类 号：R473.5[医药卫生—护理学]