| 毛立伟,季 鹏,余 萍,王 萍,汤 瑶,胡树罡,王 磊.运动训练结合揿针治疗对中老年冠心病患者PCI术后运动能力、心肺功能及生存质量的影响[J].中国康复医学杂志,2019,(8):920~925 |
| 运动训练结合揿针治疗对中老年冠心病患者PCI术后运动能力、心肺功能及生存质量的影响 点此下载全文 |
| 毛立伟 季 鹏 余 萍 王 萍 汤 瑶 胡树罡 王 磊 |
| 南京中医药大学第二临床医学院，南京，210023 |
| 基金项目： |
| DOI： |
| 摘要点击次数: 1234 |
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| 摘要： |
| 摘要
目的：通过对中老年冠心病患者经皮冠脉介入术（PCI）术后制定科学、个体化，以运动训练为核心的心脏康复，结合揿针疗法，观察患者运动能力、心肺功能以及生存质量改善情况。
方法：60例中老年冠心病PCI术后患者按随机数表法分为三组各20例，三组患者均接受常规药物治疗。A组患者于心脏康复门诊接受每周3次，共12周的运动训练，包括有氧运动和抗阻运动；B组患者采用揿针，选择双侧内关、郄门、足三里、心俞、肺俞、膈俞、三阴交留针后进行运动训练。C组患者接受常规药物治疗和健康宣教。12周前后评估患者的心肺功能包括：1秒用力呼气量（FEV1），用力呼气量占用力肺活量比值（FEV1/FVC%），最大通气量（MVV），左心室射血分数（LVEF），心肺运动试验1min后心率恢复（HRR1）；相关运动能力包括最大摄氧量（VO2max），无氧阈（AT），最大运动负荷（MWL）；生存质量评估采用健康调查简表（SF-36），对患者生理机能、躯体疼痛等8个维度进行评估。
结果：①C组12周后心肺功能、运动能力及生存质量均出现不同程度下降。②A组患者心肺功能、运动能力指标均有显著改善（P＜0.01）；SF-36量表评估中，生理机制、社会功能、生理职能、一般健康状况四个方面有所改善（P＜0.01），其余四项无明显改善（P＞0.05）。③B组患者心肺功能、运动能力指标均有显著改善（P＜0.01），且HRR1、LVEF、VO2max、AT优于A组（P＜0.05）。SF-36量表评估8个维度均显著改善（P＜0.01），其中躯体疼痛、精力、情感职能、精神健康优于A组（P＜0.05）。
结论：①中老年冠心病PCI术后患者仅给予常规药物治疗，其心肺功能、运动能力及生存质量将会不同程度下降，不利于预后；②揿针治疗结合运动训练相比于单纯运动训练，能够更好地改善中老年冠心病PCI术后患者的心肺功能和运动能力，对患者躯体疼痛、精力、情感职能、精神健康等方面的改善也优于单纯运动训练。 |
| 关键词：冠心病 运动训练 揿针 |
| Effects of combined exercise training and press-needle on exercise performance, cardiopulmonary function and living quality of middle aged and elderly PCI postoperative CHD patients Download Fulltext |
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| The Second Clinical Medical College of Nanjing University of Chinese Medicine, 210023 |
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| Abstract: |
| Abstract
Objective: To observe effects of exercise training and press-needle on exercise performance, cardiopulmonary function and living quality of middle aged and elderly PCI postoperative CHD patients
Method: Sixty middle aged and elderly PCI postoperative CHD patients were randomly assigned to exercise training group A (n=20), exercise training and press-needle group B (n=20) and control group C (n=20) by random number table. All the patients adopted the routine medication management and health education. Group A adopted the exercise training including aerobic training and resistance training 3 times a week for 12 weeks. Group B firstly adopted the press-needle treatment on double Nei Guan (PC6), Xi Men (PC4), Zu Sanli (ST36), Xin Shu (BL15), Fei Shu (BL13), Ge Shu (BL17), San Yinjiao (SP6) and then had the same exercise training with group A. Group C has regular medicine treatment and health education. All patients were evaluated with cardiopulmonary function including FEV1, FEV1/FVC%, MVV, LVEF, HRR1 and exercise performance including VO2max, AT, MWL. The living quality is assessed by SF-36 questionnaire from 8 aspects before and after 12 weeks.
Result: ①Varying degrees of decline in exercise performance, cardiopulmonary function and living quality existed in group C. ②Group A had significant improvements in FEV1, FEV1/FVC%, MVV, LVEF, HRR1, VO2max, AT, MWL (P＜0.01). Group A also had improvement in Physical Functioning (PF), Role-Physical (RP), Social Functioning (SF), General Health (GH) among SF-36 (P＜0.01) and the last 4 aspects had no significant change (P＞0.05). ③Group B had significant improvements in FEV1, FEV1/FVC%, MVV, LVEF, HRR1, VO2max, AT, MWL (P＜0.01) and better than group A in HRR1, LVEF, VO2max, AT (P＜0.05). All the 8 aspects of SF-36 had remarkable improvements in group B (P＜0.01) which were better than group A in Body Pain (BP), Vitality (VT), Role-Emotional (RE) and Mental Health (MH) (P＜0.05).
Conclusion: ①Middle aged and elderly PCI postoperative CHD patients’ exercise performance, cardiopulmonary function and living quality have varying degrees of decline if they accept conventional drug treatment only and will have a bad for prognosis; ②Exercise training combined with press-needle treatment have better improvements than single exercise training in exercise performance, cardiopulmonary function and living quality. |
| Keywords:coronary heart disease exercise training press-needle |
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