不同运动环境下有氧运动对冠心病合并精神心理问题患者的疗效观察

Clinical effects of aerobic rehabilitation exercises in different environments among coronary heart disease patients with mental and psychological problems

目的观察分析在不同有氧康复运动环境中,群体有氧运动对冠心病合并精神心理问题患者的疗效,探讨冠心病合并精神心理问题患者康复的新疗法。方法选取宜昌市中心人民医院2012年3月至2013年1月收住入心内科54例冠心病合并精神心理问题患者,随机分为实验组28例和对照组28例。2组患者药物治疗采用相同原则,实验组在10人以上群体中进行规律有氧康复运动,对照组要求有氧运动,但对群体运动环境不做要求。两组患者在试验前后均给予Bruce方案亚极量分级运动试验进行心脏康复评定、汉密尔顿抑郁量表和汉密尔顿焦虑量表测定,观察患者精神心理问题改善情况以及心脏康复情况。结果两组患者在不同运动环境下的进行有氧康复运动试验后各项指标对比:汉密尔顿抑郁量表和汉密尔顿焦虑量表测定提示,实验组精神心理问题改善状况明显高于对照组,(P<0.05)有统计学意义;平板分级运动试验提示两组患者较治疗前都有改善,但实验组在治疗后各项指标较对照组改善明显。结论群体有氧运动环境下的有氧康复运动对冠心病合并精神心理问题患者改善状况明显高于对照组,可显著提高患者生存生活质量,对回归社会有重要意义。

Objective To observe and analyze the clinical effects of aerobic rehabilitation exercises in different environments among coronary heart disease （CHD） patients with mental and psychological problems, and to explore the new therapy for rehabilitation in CHD patients with mental and psychological problems. Methods Fifty-four CHD patients with mental and psychological problems admitted to the Department of Cardiology, Yichang Central People＆#39;s Hospital, from March 2012 to January 2013 were selected and randomly divided into experimental group （n=28） and control group （n=28）. The drug treatment for the two groups of patients followed the same principle. The experimental group carried out regular aerobic rehabilitation exercise in the group of more than 10 people; aerobic exercise was required in the control group, but the environment of group exercise was not required. The two groups underwent Bruce scheme submaximal graded exercise test before and after the experiment for cardiac rehabilitation assessment, Hamilton Depression Scale （HDS） measurement, and Hamilton Anxiety Scale （HAS） measurement, and the improvement in mental and psychological problems and the rehabilitation of the heart were evaluated. Results The experimental group had a significantly more improvement in mental and psychological problems than the control group （P〈0.05）, according to the HDS and HAS scores. The multistage treadmill exercise test suggested that both groups showed improvements after treatment, but the experimental group had more improvements in all indices. Conclusion Aerobic rehabilitation exercise leads to significantly more improvements in indices and significantly improves the quality of life in CHD patients with mental and psychological problems if it is carried out in the environment of group aerobic exercise, which is of great significance for their returning to society.