可穿戴设备干预下八段锦对老年心衰患者的临床疗效观察

Clinical observation of Baduanjin training with wearable device on the elderly patients with heart failure

目的观察可穿戴设备干预下八段锦对老年心衰患者的临床疗效。方法选取2020年6月至2021年12月在上海中医药大学附属龙华医院心病科就诊的老年慢性心力衰竭60例患者为研究对象,采用简单随机法分为对照组和干预组,分别通过常规康复(标准化药物治疗与八段锦练习)和常规康复联合穿戴设备质控3个月。治疗前及治疗3个月后,对患者进行心肺运动试验,检测并记录心肺功能指标峰值摄氧量(VO_(2)peak)、无氧阈(VO_(2)@AT);同时检测患者治疗前后的左心射血分数(LVEF)、氨基末端脑利钠肽前体(NT-proBNP),并采用基于中国文化改良的明尼苏达质量评分表(C-M LHF)对患者生活质量进行评分。结果治疗后治疗组在峰值摄氧量(VO_(2)peak)、无氧阈(VO_(2)@AT)、左心射血分数(LVEF)、氨基末端脑利钠肽前体(NT-proBNP)、明尼苏达质量评分(C-M LHF)均优于对照组,差异有统计学意义(P<0.05)。对照组在治疗3个月前后,峰值摄氧量VO_(2)peak、无氧阈VO_(2)@AT、NT-proBNP、C-M LHF比较,治疗后结果优于治疗前,差异有统计学意义(P<0.05),治疗前后LVEF无明显差异(P>0.05)。治疗组在治疗3个月前后,峰值摄氧量VO_(2)peak、无氧阈VO_(2)@AT、NT-proBNP、C-M LHF比较,治疗后结果优于治疗前,差异有统计学意义(P<0.05),治疗前后LVEF无明显差异(P>0.05)。结论在可穿戴设备干预下,以无氧阈强度心率为参考的目标心率范围的设定与监测可以有效做好运动强度的质控,有效提高老年心衰患者的峰值摄氧量(VO_(2)peak)、无氧阈(VO_(2)@AT)、左心射血分数(LVEF)、氨基末端脑利钠肽前体(NT-proBNP)、明尼苏达质量评分(C-M LHF)。

Objective To observe the clinical effect of Baduanjin training with wearable device on the elderly patients with heart failure.Methods A total of 60 elderly patients with chronic heart failure were selected from the Department of Cardiology of Longhua Hospital from June 2020 to December 2021.The patients were randomly divided into control group and intervention group.They were given routine rehabilitation(standardized drug therapy and Baduanjin exercises)or routine rehabilitation and wearable device quality control for 3 months,before and after treatment,respectively.Cardiopulmonary exercise test was performed on the patients,and peak oxygen uptake of cardiopulmonary function index(VO_(2)peak)and anaerobic threshold oxygen uptake(VO_(2)@AT)were detected and recorded.At the same time,EF and NT-proBNP before and after treatment were detected,and the quality of life of patients was scored using the Minnesota Quality Rating Scale(C-M LHF)based on Chinese culture improvement.Results The maximum oxygen uptake(VO_(2)peak),anaerobic threshold(VO_(2)@AT),left ventricular ejection fraction(LVEF),amino terminal brain natriuretic peptide precursor(NT-proBNP)and Minnesota quality score(C-M LHF)in treatment group were superior to those in control group,with statistical significance(P<0.05).The comparison of peak oxygen intake VO_(2)peak,anaerobic threshold VO_(2)@AT,NT-proBNP and C-M LHF in the control group before and after 3 months of treatment showed that the results after treatment were better than those before and after treatment,with statistical significance(P<0.05),while there was no significant difference in LVEF before and after treatment(P>0.05).The comparison of peak oxygen intake VO_(2)peak,anaerobic threshold VO_(2)@AT,NT-proBNP and C-M LHF before and after 3 months of treatment in the treatment group showed that the results after treatment were better than those before and after treatment,with statistical significance(P<0.05),while there was no significant difference in LVEF before and after treatment(P>0.05).Conclusion Under the wearable device,the setting and monitoring of the target heart rate range based on the anaerobic threshold heart rate can effectively control the quality of exercise intensity.Effectively improve the maximal oxygen uptake(VO_(2)peak),anaerobic threshold(VO_(2)@AT),left ventricular ejection fraction(LVEF),amino terminal brain natriuretic peptide precursor(NT-proBNP),Minnesota quality score(C-M LHF)in elderly patients with heart failure.