形意八段锦训练对冠心病经皮冠状动脉介入术后患者心肺功能与生存质量的影响

关键词：冠心病  经皮冠状动脉介入术  心脏康复  形意八段锦

Keywords:coronary heart disease  percutaneous coronary intervention  cardiac rehabilitation  Xingyi Baduanjin

摘要：

      摘要 目的：探讨形意八段锦训练对冠心病经皮冠状动脉介入（percutaneous coronary intervention，PCI）术后患者心肺功能与生存质量的康复效果。 方法：选取2017年9月—2021年1月就诊于解放军总医院第一医学中心心血管内科确诊冠心病且行PCI术的患者总计119例，并将其随机分为试验组（59例）和对照组（60例）。其中对照组采用常规心脏康复治疗方案，而试验组在此基础上联合应用了形意八段锦训练在内的康复治疗方案，治疗时间均为6周。分别在治疗前及治疗6周后，采用心肺运动试验对两组患者的运动耐力情况进行测评，主要观察运动试验期间两组患者的峰值功率、峰值氧耗、峰值代谢当量、峰值氧脉搏及峰值呼吸交换率的变化，并采用生存质量测定简表（quality of life scale brief version， QQL-BREF）与健康调查简表（the MOS item short from health survey，SF-36）对两组患者的生存质量与健康状况进行评估。 结果：运动耐力指标比较，治疗前，两组患者的峰值功率、峰值氧耗、峰值代谢当量、峰值氧脉搏及峰值呼吸交换率均无显著性差异（P＞0.05）。治疗6周后，两组患者的峰值功率、峰值氧耗、峰值代谢当量均较治疗前显著提高（t＞3.141，P＜0.05），且试验组显著高于对照组（t＞2.017，P＜0.05）；试验组的峰值氧脉搏较治疗前显著提高（t=7.459，P＜0.05），且显著高于对照组（t=5.866，P＜0.05），呼吸交换率较治疗前显著降低（t=6.281，P＜0.05），且显著低于对照组（t=2.686，P＜0.05）。生存质量评分比较，治疗前，两组患者的QOL-BREF评分无显著性差异（P＞0.05）；治疗6周后，两组患者的QOL-BREF评分较治疗前显著提高（t＞23.620，P＜0.05），且试验组显著高于对照组（t=12.719，P＜0.05）。健康状况评分比较，治疗前，两组患者的SF-36评分无显著性差异（P＞0.05）；治疗6周后，两组患者的SF-36评分较治疗前显著提高（t＞35.255，P＜0.05），且试验组显著高于对照组（t=16.075，P＜0.05）。 结论：形意八段锦训练有效地增强了冠心病PCI术后患者的心肺耐力，改善了其生存质量与健康状况，取得了良好的康复效果。

Abstract:

      Abstract Objective： To investigate the rehabilitation effect of Xingyi Baduanjin training on cardiac function and quality of life in postoperative percutaneous coronary intervention （PCI） patients with coronary heart disease. Method： From September 2017 to January 2021， a total of 119 postoperative PCI patients with coronary heart disease in the Department of Cardiovascular Medicine of the First Medical Center of the General Hospital of the People's Liberation Army （PLA） were selected and randomly divided into the experimental group （n=59） and the control group （n=60）. In the control group， a conventional cardiac rehabilitation program was executed， while in the experimental group， a rehabilitation program combining the conventional program with Xingyi Baduanjin training was executed. The treatment time was 6 weeks. Before and after the 6 weeks， the exercise endurance of the two groups was measured by cardiopulmonary exercise test， which mainly observed the changes in peak power， peak oxygen consumption， peak metabolic equivalent， peak oxygen pulse， and peak respiratory exchange rhythm. The Quality of Life Scale Brief Version （QOL-BREF） and the MOS 36-Item Short Form Health Survey （SF-36） were used to assess the quality of life and health status in patients. Result： Peak power， peak oxygen consumption， peak metabolic equivalents， peak oxygen pulse and peak respiratory exchange rate were not significantly different between the two groups before treatment （P>0.05）. Peak power， peak oxygen consumption， and peak metabolic equivalents in both groups after 6 weeks of treatment were significantly higher than before treatment （t>3.141， P<0.05）， and the experimental group was significantly higher than the control group （t>2.017， P<0.05）. Peak oxygen pulse in the experimental group was significantly higher than before treatment （t=7.459， P<0.05） and was significantly higher than that in the control group （t=5.866，P<0.05）. The respiratory exchange rate was significantly lower than before treatment （t=6.281，P<0.05） and was significantly lower than that in the control group （t=2.686， P<0.05）. The QOL-BREF scores were not significantly different between the two groups before treatment （P>0.05）. The QOL-BREF scores in both groups after 6 weeks of treatment were significantly higher than before treatment （t>23.620，P<0.05）， and the experimental group was significantly higher than the control group （t=12.719， P<0.05）. The SF-36 scores were not significantly different between the two groups before treatment （P>0.05）. The SF-36 scores in both groups after 6 weeks of treatment were significantly higher than before treatment （t>35.255，P<0.05）， and the experimental group was significantly higher than the control group （t=16.075， P<0.05）. Conclusion：Xingyi Baduanjin training can effectively enhance exercise endurance， which improves the quality of life and health status in postoperative PCI patients with coronary artery disease， and achieves a good rehabilitation effect.