有氧联合抗阻运动对冠心病合并2型糖尿病患者影响的观察  

Effects of combined aerobic and resistant exercise on coronary heart disease patients with type 2 diabetes millitus

作　　者：毛立伟[1] 余萍[2] 季鹏[2] 胡树罡[2] 王萍[2] 汤瑶[2] 王磊[1] 

机构地区：[1]南京中医药大学第二临床医学院康复医学系,210023 [2]江苏省省级机关医院心脏康复门诊,南京210024

出　　处：《中国心血管杂志》2016年第6期442-446,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的：探索个体化有氧联合抗阻运动较单纯有氧运动对冠心病合并2型糖尿病患者在血糖、血脂及整体运动能力等方面的影响，并分析可能机制。方法招募冠心病合并2型糖尿病患者60例纳入研究，并按随机数表法分为对照组（20例）、有氧运动组（20例）和联合运动组（20例）。3组均进行常规药物治疗、健康宣教及饮食指导，而对照组不增加其他干预；有氧运动组根据心肺运动试验测试评估结果，进行强度为60％～85％目标心率的个体化有氧训练，联合运动组在此基础上增加等速肌力训练，通过角速度的调节，根据自主感觉劳累分级表，使受试者训练强度控制在11～13。每次运动时间30～60 min，每周3次，共12周。治疗前后所有患者测定空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、脂肪重、瘦体重、最大摄氧量，同时评估下肢肌群的峰力矩及平衡能力。结果3组患者治疗前各项指标差异无统计学意义（均为P＞0．05），治疗后两运动组患者血糖、血脂、脂肪重、最大摄氧量等指标较对照组均显著改善（均为P＜0．05）；两运动组最大摄氧量差异无统计学意义（P＞0．05），其他各项联合运动组均优于有氧运动组（均为P＜0．05）；联合运动组在瘦体重、肌力及平衡能力等方面均优于其他两组（均为P＜0．05）。结论个体化有氧联合抗阻运动较单纯有氧训练能更好地改善冠心病合并2型糖尿病患者的血糖、血脂，同时能够增强肌力，改善平衡能力。Objective To explore the effects of individual aerobic combined with resistance training on the blood glucose , blood lipid and total exercise capacity compared with simple aerobic training in the coronary artery disease（CAD）patients with type 2 diabetes mellitus（T2DM）and the possible mechanisms. Methods The total 60 patients of CAD and T2DM were randomly assigned to control group （ n =20）, aerobic training group（n=20）and combined training group （n=20）.Three groups all adopted the routine medication management ,health education and diet guide .The control group had no other intervention .The aerobic training group had some 60%-85% of target heart rate （ HR ） aerobic exercises which was set according to the cardiopulmonary exercise test （ CPET ） .The combined training group adopted isokinetic muscle strength training based on the aerobic training group which set intensity in 11-13 according the RPE.All patients were evaluated with fasting blood-glucose（FBG）,glycosylated hemoglobin（HBA1c）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL）,fat mass（FM）,lean body mass（LBM）, 〈br〉 VO2 max,lower limbs peak torque （ PT） and balance ability before and after training .Each exercise time 30-60 min,3 times a week, a total of 12 weeks. Results There was no significant difference among the physiology index in three groups before training （ P〉0.05 ） .Aerobic training group and combined training group significantly improved compared with control group in blood glucose ,blood lipid,FM,VO2max after training（P〈0.05）.Meanwhile,all index were better in combined training group than aerobic training group （P〈0.05）except VO2max（P〉0.05）.Combined training group had great improvement in lower limbs peak torque and balance ability than the other two groups （ P〈0.05 ） . Conclusions Individualized aerobic combined with resistance training can give better control of coronary risk factors in CAD-T2DM patients,and improve the muscle str

关 键 词：冠状动脉疾病 糖尿病 有氧运动 抗阻训练 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]