针灸联合有氧运动对气虚血瘀证慢性心力衰竭患者心功能及日常生活活动能力的影响

Effects of acupuncture combined with aerobic exercise on cardiac function and the ability of daily life activities in the chronic heart failure patients with Qi deficiency and blood stasis syndrome

目的探讨针灸联合有氧运动对气虚血瘀证慢性心力衰竭(chronic heart failure,CHF)患者心功能及日常生活活动能力的影响。方法选取2019年7月至2021年6月上海市第四康复医院的门诊及住院的稳定期气虚血瘀证CHF患者为研究对象,共80例。以随机数字表法分为观察组和对照组,各40例。随着研究进行,观察组脱离2例,余38例,对照组脱离5例,余35例。观察组和对照组患者均给予常规西医治疗及有氧运动,观察组患者在此基础上给予针灸治疗。2组患者治疗前后均测定中医证候积分、左室射血分数(left ventricular ejection fraction,LVEF)、心输出量(cardiac output,CO)以及B型利钠肽(B⁃type natriuretic peptid,BNP)水平。采用巴氏指数(Barthel index,BI)评定日常生活活动能力(activities of daily living,ADL)。比较2组患者治疗前后及各组间检测指标的差异。结果治疗后,观察组和对照组患者在中医证候积分(气短、心悸、胸部疼痛、唇甲青紫、面色晦暗)、心功能(BNP、LVEF)、ADL(BI)方面较治疗前均明显改善(P<0.05),且观察组优于对照组(P<0.05)。治疗后,2组患者的CO均较治疗前明显改善(P<0.05),但2组间比较,差异无统计学意义(P>0.05)。观察组患者的有效率(81.58%)高于对照组(60.00%),差异有统计学意义(P=0.042)。结论针灸联合有氧运动明显改善气虚血瘀证CHF患者心功能及日常生活活动能力。

Objective To investigate the effects of acupuncture combined with aerobic exercise on the cardiac function and ability of daily life activities in the chronic heart failure(CHF)patients with Qi deficiency and blood stasis syndrome.Method A total of 80 stable CHF patients with Qi deficiency and blood stasis syndrome who either sought medical care or admitted in the hospital from July 2019 to June 2021 were selected as research objects.They were randomly divided into the observation group and the control group,each consisting of 40.With the progress of study,the observation group dropped 2 cases(with remaining 382 cases)and the control group dropped 5 cases(with remaining 35 cases).Both the observation group and the control group were given conventional western medicine treatment and aerobic exercise,however,the observation group further received acupuncture on the basis of the above treatment.Scores or levels of TCM syndrome,left ventricular ejection fraction(LVEF)and cardiac output(CO),B⁃type natriuretic peptide were detected by biochemical examination for the 2 groups both before and after treatment.Barthel indexes(BI)were used to assess the ability of daily life activities,and the differences in the detected parameters before and after treatment were compared between the 2 groups.Results After treatment,the TCM syndrome scores,such as shortness of breath,palpitation,chest pain,blue nail,dark complexion),as well as type B natriuretic peptide,LVEF and BI significantly improved in both groups(all P<0.05),with the indexes of the observation group being superior to those of the control group(all P<0.05).Compared with those before treatment,the CO levels of both groups significantly improved as compared with those before treatment(all P<0.05),however,no significant differences could be seen when comparisons were made between the two groups(P>0.05).The effective rate of the observation group was 81.58%,which was higher than 60.00%of the control group,with statistical significance(P=0.042).Conclusions Acupuncture combined with aerobic exercise could significantly improve cardiac function and the ability of daily life activities in the CHF patients with Qi deficiency and blood stasis syndrome.