八段锦对急性心肌梗死患者心肺功能影响的随机对照研究  

Effect of Baduanjin Exercise on Cardiopulmonary Function in Patients with Acute Myocardial Infarction:A Randomized Controlled Trial

作　　者：史璐斯 苏立硕 赵林丹 王贤良[1,2] 王帅 苏全[1,2] 李晨钰 赵志强[1,2] 毛静远 SHI Lu-si;SU Li-shuo;ZHAO Lin-dan;WANG Xian-liang;WANG Shuai;SU Quan;LI Chen-yu;ZHAO Zhi-qiang;and MAO Jing-yuan(Department of Cardiovascular,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin,300381;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,300381)

机构地区：[1]天津中医药大学第一附属医院心血管科,天津300381 [2]国家中医针灸临床医学研究中心,天津300381

出　　处：《中国中西医结合杂志》2023年第8期922-929,共8页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局中医临床研究基地业务建设科研专项(No.JDZX2015005,No.JDZX2015003);中医药防治心血管疾病传承创新团队项目(No.ZYYCXTD-C-202203)。

摘　　要：目的观察八段锦对急性心肌梗死患者心肺功能的影响。方法将64例AMI患者按照1:1比例随机分为试验组和对照组,每组32例。在西医规范治疗的基础上,试验组采取坐式-立式八段锦序贯疗法,对照组进行常规运动锻炼,干预3个月,分别在入组时、出院时、出院1个月、出院3个月对患者进行访视。采用心肺运动试验峰值耗氧量(Peak VO_(2))为主要疗效指标,代谢当量(MET)、峰值运动负荷、运动时间、峰值分钟通气量(Peak VE)和峰值呼吸储备(Peak BR)、B型利钠肽(BNP)、左室射血分数(LVEF)、左室质量指数(LVMI)、西雅图心绞痛量表评分(SAQ)、匹兹堡睡眠质量指数量表评分(PSQI)、症状积分为次要疗效指标,血压、心率、不良事件等为安全性指标。结果试验组脱落1例,最终纳入分析63例,其中试验组31例,对照组32例。与本组入组时比较,试验组和对照组出院时及出院1、3个月BNP、症状积分降低,LVEF升高(P<0.05);对照组出院1、3个月LVMI降低(P<0.05)。与本组出院时比较,试验组出院1、3个月Peak VO_(2)、峰值运动负荷、运动时间、Peak VE、LVEF、SAQ评分中躯体活动受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)、疾病认知程度(DP)升高,BNP、Peak BR、PSQI评分、症状积分降低(P<0.05);试验组出院1个月MET升高(P<0.05);试验组出院3个月LVMI降低(P<0.05);对照组出院1、3个月BNP、LVMI降低,LVEF、SAQ评分中PL、AS、AF、DP升高(P<0.05);对照组出院3个月Peak VO_(2)升高(P<0.05)。与对照组同期比较,试验组出院时症状积分升高,出院1、3个月Peak VO_(2)、SQA评分中PL升高,出院1个月峰值运动负荷升高,出院3个月症状积分降低(P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论在西医规范治疗的基础上,八段锦可进一步提高急性心肌梗死患者的运动耐量、生活质量,改善症状,且安全性良好。(No.CObjective To investigate the effect of Baduanjin exercise on cardiopulmonary function in acute myocardial infarction(AMI)patients.Methods A total of 64 AMI patients were randomly assigned to the experimental group and control group in a 1:1 ratio,with 32 patients in each group.Based on standard Western medicine treatment,the experimental group performed sitting and standing Baduanjin sequential therapy,while the control group performed conventional exercise,the treatment course was 3 months.Patients were followed up at enrollment,discharge,1 month and 3 months after discharge.The primary outcome was the peak oxygen consumption(Peak VO_(2))in the cardiopulmonary exercise test.The secondary outcomes included the metabolic equivalent of task value(MET),peak exercise load,exercise time,peak minute ventilation(Peak VE)and peak breathe reserve(Peak BR),B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI),Seattle Angina Qectoris Scale(SAQ),Pittsburgh Sleep Quality Index(PSQI)and symptom score.The safety outcomes comprised blood pressure,heart rate and adverse events.Results One patient dropped out in the experimental group,and 63 patients were included in the analysis,including 31 patients in the experimental group and 32 patients in the control group.Compared with enrollment,BNP and symptom scores decreased,LVEF increased at discharge,1 month and 3 months after discharge in experimental and control group(P<0.05).LVMI decreased at 1 month and 3 months after discharge in control group(P<0.05).Compared with discharge in the same group,Peak VO_(2),peak exercise load,exercise time,Peak VE,LVEF,SAQ-physical limitation(PL),SAQ-angina stability(AS),SAQ-angina frequency(AF),SAQ-treatment satisfaction(TS),and SAQ-disease perception(DP)increased,BNP,Peak BR,PSQI,and symptom scores decreased at 1 month and 3 months after discharge in experimental group(P<0.05).MET increased at 1 month after discharge,LVMI decreased at 3 months after discharge in experimental group(P<0.05).BNP a

关 键 词：八段锦 急性心肌梗死 运动耐量 心肺功能运动试验 

分 类 号：R542.22[医药卫生—心血管疾病]