抗阻-耐力运动结合认知-行为团体心理疗法对冠心病患者术后疗效及脂质代谢的影响

Effects of resistance-endurance exercise combined with cognitive-behavioral group psychotherapy on postoperative efficacy and lipid metabolism in patients with coronary heart disease

目的探究抗阻-耐力运动结合认知-行为团体心理疗法对冠心病患者术后疗效及脂质代谢的影响,为临床干预提供参考。方法选取2019年1月—2020年1月于新疆医科大学第一附属医院就诊的冠心病患者100例,应用随机数字表法分为对照组(50例)和观察组(50例),对照组予以常规干预,观察组予以抗阻-耐力运动+认知-行为团体心理疗法。比较2组术后疗效、脂质代谢、炎性细胞因子[超敏C反应蛋白(hs-CRP)、白细胞介素(IL-6)、内皮素-1(ET-1)]、心功能指标[左室射血分数(LVEF)、N端B型脑钠肽前体(NT-proBNP)、6 min步行距离(6MWT)]及负性情绪[焦虑自评量表(SAS)和抑郁自量表(SDS)]。结果观察组总有效率明显高于对照组(88.00%vs.70.00%,P<0.05);干预后,观察组TG、TC、LDL-C及血清hs-CRP、IL-6、ET-1水平均明显低于对照组(P<0.05),HDL-C明显高于对照组(P<0.05);干预后,观察组NT-proBNP明显低于对照组(P<0.05),LVEF、6MWT明显高于对照组(P<0.05);干预后,与对照组相比,观察组SAS和SDS评分均降低(P<0.05)。结论对冠心病患者给予抗阻-耐力运动和认知-行为团体心理疗法,可有效提高术后疗效,改善脂质代谢,降低炎性细胞因子水平,改善心功能,并减轻患者负性情绪。

Objective To explore the effect of resistance-endurance exercise combined with cognitive-behavioral group psychotherapy on postoperative efficacy and lipid metabolism in patients with coronary heart disease,and to provide reference for clinical intervention.Methods A total of 100 patients with coronary heart disease admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2020 were selected and randomly divided into control group(50 cases)and observation group(50 cases)according to the random number table method.Routine intervention was given to the control group,while the observation group was given resistance-endurance exercise+cognitive-behavioral group psychotherapy.The curative effect,lipid metabolism,postoperative inflammatory cytokines[hypersensitive C-reactive protein(hs-CRP)and interleukin(IL-6),endothelin-1(ET-1)],cardiac function index[left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),6 min walking distance(6MWT)]and negative emotion[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)]of the two groups were compared.Results The total effective rate of the observation group was significantly higher than that of the control group(88.00%vs.70.00%,P<0.05).After the intervention,triglyceride,total cholesterol,low density lipoprotein cholesterol and serum hs-CRP,IL-6 and ET-1 levels in the observation group were significantly lower than those in the control group(P<0.05),and high density lipoprotein cholesterol was significantly higher than that in the control group(P<0.05);NT-proBNP in the observation group was significantly lower than that in the control group(P<0.05),and LVEF and 6MWT were significantly higher than those in the control group(P<0.05);SAS and SDS scores of the observation group decreased compared with those of the control group(P<0.05).Conclusion For patients with coronary heart disease,resistance-endurance exercise and cognitive-behavioral group psychotherapy can effectively improve postoperative efficacy,improve lipid metabolism,reduce the level of inflammatory cytokines,improve cardiac function,and reduce negative emotions in patients.