作者：洪怡 ，王永斌 ，施晨 ，张雯 ，高奇 ，吴雪娇

单位：

1.200090上海市第一康复医院心内科　2.200090上海市第一康复医院呼吸科　3.200090上海市第一康复医院康复科

Units：

1.Department of Cardiology, Shanghai First Rehabilitation Hospital, Shanghai 200090, China 2.Department of Respiratory, Shanghai First Rehabilitation Hospital, Shanghai 200090, China 3.Department of Rehabilitation, Shanghai First Rehabilitation Hospital, Shanghai 200090, China

关键词：

冠心病；太极拳；心脏康复；心肺功能；生活质量

Keywords：

Coronary disease; Shadow boxing; Cardiac rehabilitation; Cardio-pulmonary function; Quality of life

CLC：

R 541.4

DOI：

10.12114/j.issn.1008-5971.2023.00.252

Funds：

杨浦区2022-2025年度医学重点学科（B类）（22YPZB08）

摘要：

目的　探讨太极拳训练对冠心病（CHD）患者心肺功能和生活质量的影响。方法　选取2020年6月至 2022年12月上海市第一康复医院收治的CHD患者60例，采用随机数字表法将其分为试验组和对照组，每组30例。对照 组进行常规药物治疗，试验组在对照组的基础上进行杨氏24式太极拳训练，两组均连续治疗12周。比较两组基线资料 及干预前后6分钟步行距离（6MWD）、脑钠肽（BNP）、超敏心肌肌钙蛋白I（hs-cTnI）、心肺运动试验（CPET）指 标〔峰值摄氧量、峰值氧脉搏、无氧阈（AT）、呼气末二氧化碳分压（PetCO2）、二氧化碳通气当量斜率〕、健康调 查简表（SF-36）评分。结果　试验组干预后6MWD长于干预前及对照组（P＜0.05）。两组干预后BNP、hs-cTnI分别 低于本组干预前，且试验组干预后BNP、hs-cTnI低于对照组（P＜0.05）。试验组干预后峰值摄氧量、峰值氧脉搏、 AT高于干预前和对照组，干预后二氧化碳通气当量斜率小于干预前和对照组（P＜0.05）。试验组干预后生理机能、 生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康维度评分高于干预前及对照组（P＜0.05）； 对照组干预后躯体疼痛、精神健康维度评分高于干预前（P＜0.05）。结论　太极拳训练延长了CHD患者的6MWD，降 低了BNP和hs-cTnI，提高了峰值摄氧量、峰值氧脉搏、AT及二氧化碳通气当量斜率，同时改善了患者的生理机能、生 理职能、躯体疼痛、总体健康、活力、社会功能、情感职能及精神健康，提高了患者的心肺功能和生活质量，为CHD 患者的康复提供了一种有效的方法。

Abstract：

　Objective To explore the effect of shadow boxing training on cardiopulmonary function and quality of life in patients with coronary heart disease (CHD) . Methods A total of 60 patients with CHD admitted to Shanghai First Rehabilitation Hospital from June 2020 to December 2022 were selected and divided into experimental group and control group by random table number method, with 30 cases in each group. The control group received conventional drug treatment, and the experimental group received Yang's 24 type shadow boxing training on the basis of the control group. Both groups were treated continuously for 12 weeks. Baseline data and 6-minute walking distance (6MWD) , brain natriuretic peptide (BNP) , high-sensitivity cardiac troponin I (hs-cTnI) , cardiopulmonary exercise testing (CPET) indexes [peak oxygen uptake, peak oxygen pulse, anaerobic threshold (AT) , partial pressure of end-tidal carbon dioxide (PetCO2) , dioxide ventilation equivalent slope] before and after intervention and the MOS Item Short from Health Survey (SF-36) scores before and after intervention were compared between the two groups. Results After intervention, 6MWD of experimental group was longer than that before intervention and that of control group after intervention (P < 0.05) . After intervention, BNP and hs-cTnI in both groups were lower than those before intervention respectively, and after intervention, BNP and hs-cTnI in the experimental group were lower than those in the control group (P < 0.05) . After intervention, the peak oxygen uptake, peak oxygen pulse, and AT of the experimental group were higher than those before intervention, and those of control group after intervention, and the carbon dioxide ventilation equivalent slope after treatment was lower than that before intervention and that of the control group after intervention (P < 0.05) . After intervention, the scores of physiological function, physiological function, physical pain, overall health, vitality, social function, emotional function, and mental health items of the experimental group were higher than those before intervention and those of the control group after intervention (P < 0.05) . After intervention, the scores of physical pain and mental health items of the experimental group were higher than those before treatment (P < 0.05) . Conclusion Shadow boxing training can prolong the 6MWD of CHD patients, reduce BNP and hs-cTnI, increase peak oxygen uptake, peak oxygen pulse, AT and carbon dioxide ventilation equivalent slope, and improve the patient's physical function, physical function, body pain, general health, vitality, social function, emotional function and mental health. It improves the cardiopulmonary function and quality of life of patients, and provides an effective method for the rehabilitation and prevention of CHD.

ReferenceList：