综合康复治疗对冠心病患者症状及运动能力改善的研究

Effects of comprehensive rehabilitation therapy on symptoms and exercise capacity in patients with coronary heart disease

目的:了解康复治疗对冠心病患者临床症状、心功能及运动能力的影响。方法:42例门诊冠心病者被随机分为康复组(21例,运动康复+药物治疗)、常规治疗组(21例,单纯药物治疗)。康复程序采用个体化原则,患者进行6个月的康复治疗,主要以运动疗法为主,兼以药物、心理治疗及康复咨询。结果:与治疗前比较,治疗后两组心绞痛发作频率有明显下降,硝酸甘油用量有明显减少,康复组疗效明显优于常规治疗组[心绞痛发作频率(0.9±0.5)次/周比(3.2±1.0)次/周,硝酸甘油用量:(1.2±0.5)片/周比(3.6±1.0)片/周,P<0.05];与治疗前比较,治疗后康复组运动能力明显增加[(3.1±1.5)METs比(4.0±1.6)METs],心功能分级明显改善[(2.5±0.6)级比(1.9±0.5)级,P均<0.05],常规治疗组治疗前后无明显差异(P>0.05)。结论:康复治疗可以改善冠心病患者的心功能、运动能力、临床症状。

Objective： To investigate influence of rehabilitation therapy on clinical symptoms, cardiac function and exercise capacity in patients with coronary heart disease （CHD）. Methods.. A total of 42 CHD outpatients were randomly divided into rehabilitation group （n = 21, received exercise rehabilitation ＋ drug treatment） and routine treatment group （n = 21, received pure drug treatment）. Rehabilitation program was individualized and patients underwent rehabilitation therapy for six months： mainly exercise therapy and combined with drug therapy, psychological therapy and rehabilitation consultation. Results： Compared with before treatment, there were significant decrease in frequency of angina pectoris and using amount of nitroglycerin in both groups after treatment, and therapeutic effects in rehabilitation group were significantly better than those of routine treatment group [-frequency of angina pectoris （0.9 ± 0.5） times/week vs. （3.2 ± 1.0） times/week, using amount of nitroglycerin： （1.2 ± 0.5） pills/week vs. （3.6 ± 1.0） pills/week, P〈0.05] . Compared with before treatment, there were significant increase in exercise capacity [ （3. 1 ± 1.5） METs vs. （4.0 ± 1.6） METs] and significant improvement in cardiac function class [（2.5 ± 0.6） classes vs. （1.9 ± 0.5） classes, P〈0.05 both] in rehabilitation group after treatment. There were no significant difference in above indicators in routine treatment group between before and after treatment （P〉 0.05）. Conclusion： Rehabilitation therapy can improve patients＇ clinical symptoms, cardiac function and exercise capacity.