华佗五禽戏中医运动处方治疗血瘀型无症状性心肌缺血的临床观察  

Clinical observation on the treatment of blood-stasis-type silent myocardial ischemia by doing Huatuo five-animal play

作　　者：甘向永 杨宇[2] 林润东 叶政宏 曾雨涵 叶志铭 洪炜博 刁天霞 梁怡 Gan Xiangyong;Yang Yu;Lin Rundong;Ye Zhenghong;Zeng Yuhan;Ye Zhiming;Hong Weibo;Diao Tianxia;Liang Yi(The First Clinical Faculty School of Guangxi University of Chinese Medicine,Nanning 530000,China;Tuina Department of the First Afiliated Hospital of Guangxi University of Chinese Medicine,Nanning530000,China)

机构地区：[1]广西中医药大学第一临床医学院,广西南宁530000 [2]广西中医药大学第一附属医院推拿科,广西南宁530000

出　　处：《中国运动医学杂志》2025年第2期113-118,共6页Chinese Journal of Sports Medicine

基　　金：广西中医药适宜技术开发与推广项目(GZSY22-30);国家自然科学基金-地区科研基金项目(82060889)。

摘　　要：目的:探究华佗五禽戏中医运动处方治疗血瘀型无症状性心肌缺血(silent myocardial ischemia,SMI)患者的临床疗效及其对冠状动脉血流动力学的影响。方法:将诊断为无症状性心肌缺血的90例患者按照随机数字法分为五禽戏组(n=45,年龄:51.56±11.00岁,男/女:24/21)和常规运动组(n=45,年龄:52.44±7.19岁,男/女:24/21),五禽戏组采用华佗五禽戏中医运动处方指导锻炼,每日按处方量锻炼;常规运动组采用中等强度踏车有氧运动进行锻炼,每日锻炼时长为30分钟;两组每周均锻炼5天,疗程为4周。观察两组患者干预前后24小时动态心电图ST-T段异常发生阵次、心肌耗氧量(consumption myocardium oxygen,CMO)、冠脉缺血阈值(coronary ischemia threshold,CMR)、血流平滑度(blood smoothness index,BSD)的变化情况,并评价两组干预后的疗效及血流动力学特征。结果:运动干预后4周,常规运动组和五禽戏组的24小时动态心电图ST-T段异常发生阵次较干预前降低(P<0.001),五禽戏组较常规运动组改善明显(P<0.001);常规运动组和五禽戏组心肌耗氧量(CMO)均较干预前降低(P<0.05),冠脉缺血阈值(CMR)、血流平滑度(BSD)均较干预前升高(P<0.05);干预后组间对比,五禽戏组心肌耗氧量较常规运动组更低,冠脉缺血阈值、血流平滑度均较常规运动组更高,组间差异有统计学意义(P<0.05)。五禽戏组的总有效率高于常规运动组,差异有统计学意义(P<0.01)。结论:华佗五禽戏中医运动处方及中等强度有氧运动对血瘀型无症状性心肌缺血均有一定临床疗效,其中,华佗五禽戏中医运动处方的疗效优于中等强度有氧运动,并且能一定程度改善心肌耗氧量和冠脉的缺血阈值、血流平滑度。Objective To observe the clinical effect of doing Huatuo five-animal play treating bloodstasis-type silent myocardial ischemia(SMI)and its influence on coronary hemodynamics.Methods Ninety patients diagnosed as silent myocardial ischemia were randomly divided into a five-animal play group(n=45,age:51.56±11.00 years,24 males and 21 females)and a regular exercise group(n=45,age:52.44±7.19 years old,24 males and 21 females)according to a random number table.The five-animal play group practised the traditional five-animal play,while the regular exercise group conducted daily 30-minute moderate-intensity treadmill aerobic exercise,five times a week,for 4 weeks.The changes in the number of abnormal ST-T segment occurrences,myocardial oxygen consumption(CMO),coronary ischemia threshold(CIT),and blood smoothness index(BSD)within 24-hour ambulatory electrocardiogram before and after the intervention were observed in both groups,with the therapeutic effect and hemodynamic characteristics of both groups evaluated.Results The average number of ST-T segment abnormalities decreased after intervention in both groups(P<0.001),with significantly greater improvement in the five-animal play group than the regular exercise group(P<0.001).Moreover,the average CMO decreased significantly,while the average CMR and BSD increased significantly in both groups after intervention(P<0.05),with significantly greater improvement in the five-animal play group than the other group.Meanwhile,the total effective rate in the five-animal play group was significantly higher than the regular exercise group(P<0.01).Conclusion Undergoing the five-animal play and moderate intensity treadmill aerobic exercise both are effective in treating silent myocardial ischemia.However,the former therapy is superior to the latter in bettering CMO,CIT and BSD.

关 键 词：华佗五禽戏 五禽戏中医运动处方 无症状性心肌缺血 五行藏象 中医导引术 中医运动疗法 

分 类 号：R259[医药卫生—中西医结合]