基于心肺功能监测的个体化运动配合针刺夹脊穴对PCI术后患者氧化应激相关指标的影响  

Impact of individualized exercise based on cardiopulmonary monitoring combined with acupuncture at Jiaji points on oxidative stress-related indicators in patients after PCI

作　　者：邵明璐 任敏[1] 庄燕[1] 瞿昱[1] 蒋琳玲[1] 马光慧 甘梦洁 孟宪忠[1] Shao Minglu;Ren Min;Zhuang Yan;Qu Yu;Jiang Linling;Ma Guanghui;Gan Mengjie;Meng Xianzhong(Department of Rehabilitation Medicine,Pudong New Area People's Hospital,Shanghai 201299,China)

机构地区：[1]上海市浦东新区人民医院康复医学科,上海201299

出　　处：《保健医学研究与实践》2024年第7期83-89,共7页Health Medicine Research and Practice

基　　金：上海市卫生健康委员会科研课题青年项目(20204Y0178);上海市浦东新区卫生健康委员会优秀青年医学人才培养计划(PWRq2021-01)。

摘　　要：目的研究基于心肺运动试验的个体化运动配合针刺夹脊穴治疗,对冠心病经皮冠状动脉介入治疗(PCI)术后患者心肺功能及其氧化应激相关指标的影响,以期为临床决策的制定提供参考。方法选取2021年1月—2023年12月于上海市浦东新区人民医院康复医学科、心血管内科门诊就诊的120例PCI术后患者作为研究对象,采用随机数字表法将患者随机分为针刺组、康复组、联合组、对照组,每组30例。各组患者均于治疗前后行心肺运动试验。对照组患者采用规范化药物治疗;其余3组患者在对照组的基础上进行治疗,针刺组接受针刺夹脊穴治疗,康复组基于心肺运动试验进行个体化运动治疗,联合组采用针刺夹脊穴联合个体化运动治疗,4组患者均观察8周。以治疗后峰值公斤摄氧量(VO_(2)/kg)作为主要结局指标,并比较治疗前后各组峰值代谢当量(MET)、氧脉搏(VO_(2)/HR),以及二氧化碳通气当量(VE/VCO_(2))斜率,测定治疗前后患者血浆超氧化物歧化酶(SOD)、丙二醛(MDA)、血红素加氧酶1(HO-1)、谷胱甘肽过氧化物酶4(GPX4)水平并比较。结果共有107例患者完成观察,治疗前各组患者基础资料具有可比性(P>0.05)。组内比较,针刺组患者治疗后峰值MET、VO_(2)/HR提高,VE/VCO_(2)斜率降低(P<0.05);康复组及联合组患者治疗后峰值VO_(2)/kg、MET、VO_(2)/HR提高,VE/VCO_(2)斜率降低(P<0.05);组间比较,治疗后联合组患者峰值VO_(2)/kg及VE/VCO_(2)斜率均优于其他3组(P<0.05);针刺组与康复组患者治疗后以上指标的差异均无统计学意义(P>0.05)。组内比较,针刺组、康复组、联合组患者的SOD、HO-1、GPX4水平均升高,MDA水平均降低(P<0.05);治疗后组间比较,联合组患者以上指标的改善情况优于其余3组(P<0.05)。结论基于心肺运动试验制定个体化运动处方联合针刺夹脊穴对冠心病PCI术后患者心肺功能具有良好改善作用,优于单用针刺或康复�Objective To investigate the impact of individualized exercise based on cardiopulmonary exercise testing combined with acupuncture at Jiaji points on the cardiopulmonary function and oxidative stress-related indicators in patients after percutaneous coronary intervention(PCI)for coronary heart disease,to provide a reference for clinical decision-making.Methods A total of 120 patients who underwent PCI and visited the Department of Rehabilitation Medicine and the outpatient service of Department of Cardiology at Pudong New Area People's Hospital from January 2021 to December 2023 were selected as the study participants and randomly assigned to four groups:acupuncture group,rehabilitation group,combined group,and control group,with 30 cases in each group.All groups underwent cardiopulmonary exercise testing before and after treatment.The control group received standardized drug treatment.The other three groups received treatment based on the control group,with the acupuncture group receiving acupuncture at Jiaji points,the rehabilitation group receiving individualized exercise treatment based on cardiopulmonary exercise testing,and the combined group receiving both acupuncture at Jiaji points and individualized exercise treatment,with an observation period of 8 weeks for all groups.The primary outcome measure was the peak oxygen uptake(VO_(2)/kg)after treatment,and the peak metabolic equivalent(MET)value,oxygen pulse(VO_(2)/HR),and the slope of the carbon dioxide ventilatory equivalent(VE/VCO_(2))were compared among the groups before and after treatment.The levels of plasma superoxide dismutase(SOD),malondialdehyde(MDA),heme oxygenase-1(HO-1),and glutathione peroxidase 4(GPX4)were measured and compared before and after treatment.Results A total of 107 patients completed the observation,and the baseline data of all groups were comparable(P>0.05).Within-group comparisons showed that the peak MET and VO_(2)/HR increased significantly,and the VE/VCO_(2) slope decreased significantly in the acupuncture group after treat

关 键 词：针刺 夹脊穴 经皮冠状动脉介入治疗 心肺运动试验 氧化应激 

分 类 号：R541.4[医药卫生—心血管疾病]