太极拳对社区冠心病患者心功能和6分钟步行距离的影响  

Effects of Practicing Tai Chi on Cardiac Function and 6-minute Walk Distance in Community Patients with Coronary Heart Disease

作　　者：马纯洁 洪怡 施晨 张雯 刘向云[1] Ma Chunjie;Hong Yi;Shi Chen;Zhang Wen;Liu Xiangyun(Key Laboratory of Sports and Fitness Science and Technology,Ministry of Education,Shanghai University of Sports,Shanghai 200438,China;Shanghai No.1 Rehabilitation Hospital,Shanghai 200438,China)

机构地区：[1]上海体育学院运动健身科技省部共建教育部重点实验室,上海200438 [2]上海市第一康复医院,上海200438

出　　处：《中国运动医学杂志》2020年第1期26-32,共7页Chinese Journal of Sports Medicine

基　　金：上海市中医传统运动推广试点项目(B5-8001-16-0070)。

摘　　要：目的:观察太极拳对社区冠心病患者心功能和6分钟步行距离(6MWD)的影响。方法:在社区招募冠心病患者30例,随机分为太极拳组和对照组,每组各15例。太极拳组在常规药物治疗基础上进行连续12周、每周3次、每次1小时的杨氏24式太极拳运动,对照组接受常规药物治疗。观察干预前后两组6MWD、QT离散度(QTd)以及校正QT离散度(QTcd)、心电图疗效、心功能分级疗效、生活质量量表(SF-36)等指标的变化。结果:12周后,太极拳组6MWD(510.40±78.52 m)相比对照组(373.09±104.91 m)显著提高(P=0.001)。太极拳组6MWD干预前(393.67±98.42 m)与干预后(510.40±78.52 m)差值为116.73 m,具有显著性差异(P<0.001)。干预后,太极拳组QTd(50.53±12.27 ms)和QTcd(53.47±13.67 ms)相比对照组(68.47±19.29 ms和72.40±20.13 ms)显著下降(P=0.005;P=0.005)。太极拳组干预后的QTd(P=0.004)和QTcd(P=0.006)相比干预前显著下降。太极拳组心电图疗效(P=0.049)和心功能分级疗效(P=0.041)的总有效率显著高于对照组。干预后,太极拳组SF-36量表除了躯体疼痛和精神健康,其他各个维度均显著高于对照组(P<0.05);太极拳组除了生理机能,其他各个维度的评分相比于干预前均显著提高(P<0.05)。结论:12周的杨氏24式太极拳运动改善了社区冠心病患者的心功能,增加了6分钟步行距离,并有助于提高患者的生活质量。Objective To explore the effect of practicing Tai Chi on the cardiac function and 6-minute walk distance(6 MWD) of community patients with coronary heart disease(CHD). Methods Thirty CHD patients were randomly divided into a control group or a Tai Chi group, each of 15. Both groups were given routine medications,while the Tai Chi group additionally performed one-hour Yang Tai Chi 24-Form 3 times a week for 12 weeks. Then both groups were evaluated the 6 MWD,ST segment and QT dispersion(QTd),corrected QT dispersion(QTcd),cardiac function grading efficacy and life quality using the quality of life scale(SF-36). Results After the intervention,compared with control group(373.09 ± 104.91 m),the average 6 MWD of the tai chi group increased significantly from393.67 ± 98.42 m to 510.40 ± 78.52 m(P=0.001),with an increase of 116.73 meters(P<0.001). After the intervention,the average QTd(50.53 ± 12.27 ms) and QTcd(53.47 ± 13.67 ms) of the Tai Chi group reduced significantly compared with those before the intervention(P=0.004, P=0.006), as well as the control group[QTd(68.47 ± 19.29 ms,P=0.005),QTcd(72.40 ± 20.13 ms,P=0.005)] at the same time point. There were significant differences in the effective rate of ECG and cardiac function classification between the two groups(P=0.049, P=0.041). After the intervention, the average scores of all dimensions of the SF-36 scale of the Tai Chi group were significantly higher than the control group except the bodily pain and mental health(P<0.05). Moreover, after the intervention,there was significant improvement in all dimensions except the physiological function in the Tai Chi group(P<0.05). Conclusion Practicing the 12-week Yang Tai Chi 24-Form can improve the cardiac function,six-minute walk distance,and life quality of community patients with coronary heart disease.

关 键 词：太极拳 社区康复 冠心病 6分钟步行试验 

分 类 号：R541.4[医药卫生—心血管疾病]