中强度间歇训练联合增强型体外反搏对冠状动脉粥样硬化性心脏病患者的疗效观察

Effect of Moderate Intensity Interval Training Combined with Enhanced External Counterpulsation in Patients with Coronary Artery Disease

目的观察中强度间歇训练联合增强型体外反搏对冠状动脉粥样硬化性心脏病(冠心病)患者的治疗效果。方法本研究纳入2021年2月至2022年10月在江苏省荣军医院住院的冠心病患者90例,随机分为对照组、康复A组和康复B组,每组30例,所有患者均接受冠心病常规药物治疗。对照组采用有氧训练,康复A组接受有氧训练+增强型体外反搏治疗,康复B组接受增强型体外反搏治疗+中强度间歇训练。有氧训练每天1次,每次训练总时间30 min,每周训练4 d,共训练10周。增强型体外反搏治疗每天1次,每次45 min,每周4 d,共治疗10周。中强度间歇训练每天1次,每次训练30 min,每周训练3 d,共训练10周。分别于治疗前和治疗10周后采用左心室射血分数(left ventricular ejection fraction,LVEF)和每搏输出量(stroke volume,SV)评估3组患者的心脏储备指标,采用三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)评估3组患者的血脂水平,采用峰值摄氧量(peak oxygen uptake,VO_(2)peak)、峰值代谢当量(peak metabolic equivalent,METs)和6 min步行距离试验(6-min walking distance test,6MWD)评估3组患者的运动能力,采用西雅图心绞痛量表(Seattle angina scale,SAQ)评估3组患者的生活质量。结果3组患者干预10周后的LVEF、SV、VO_(2)peak、METs、6MWD和SAQ评分均明显高于治疗前,3组患者的TC、TG、HDL-C和LDL-C浓度低于治疗前,差异均有统计学意义(P<0.05)。干预10周后,康复A组患者的LVEF、SV、VO_(2)peak、METs、6MWD和SAQ评分明显均高于对照组,康复B组患者的LVEF、SV、VO_(2)peak、METs、6MWD和SAQ评分明显均高于康复A组和对照组,康复A组患者的TC、TG、HDL-C和LDL-C浓度低于对照组,康复B组患者的TC、TG、HDL-C和LDL-C浓度低于康复A组,差异有统计学意义(P<0.05)。结论冠心病患者在药物治疗和有氧训练基础上应用增强型体外反搏治疗,可以更好地改善心脏储备功能,降低血脂水平,提升运动耐力和生活质量。中强度间歇训练的效果也优于有氧训练,而且安全可靠,值得临床推广应用。

Objectives To observe the therapeutic effect of moderate intensity interval training(MIIT)combined with enhanced external counterpulsation(EECP)in patients with coronary artery disease(CAD).Methods This study included 90 patients with CAD from February 2021 to October 2022 in Jiangsu Province Rongjun Hospital.The patients were randomly divided into control group,rehabilitation group A and rehabilitation group B,30 patients in each group,and all the patients received conventional drug treatment for CAD.Control group used aerobic training,rehabilitation group A received aerobic training+EECP therapy,and rehabilitation group B received EECP therapy+MIIT.Aerobic training was performed once a day for a total of 30 minutes,4 days a week for a total of 10 weeks.EECP treatment was performed once daily for 45 minutes,4 days a week,for 10 weeks.MIIT was performed once a day for 30 minutes,training 3 days a week for 10 weeks.In the three groups,the cardiac reserve indexes were evaluated by left ventricular ejection fraction(LVEF)and stroke volume(SV);blood lipid level was evaluated by concentrations of triacylglycerol(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C);sports ability was evaluated by peak oxygen uptake(VO_(2)peak),peak metabolic equivalent(METs),and 6-minutes walking distance test(6 MWD);and the quality of life was evaluated by the Seattle angina scale(SAQ).Results After 10 weeks of intervention,the LVEF,SV,VO_(2)peak,METs,6 MWD,and SAQ scores were significantly higher than before treatment,and concentrations of TC,TG,HDL-C,and LDL-C were significantly lower in the three groups,with statistically significant differences(P<0.05).After 10 weeks of intervention,LVEF,SV,VO_(2)peak,METs,6 MWD,and SAQ scores in rehabilitation group A were significantly higher than those in control group;LVEF,SV,VO_(2)peak,METs,6 MWD,and SAQ scores in rehabilitation group B were significantly higher than those in rehabilitation group A and control group;concentrations of TC,TG,HDL-C and LDL-C in rehabilitation group A were lower than those in control group;concentrations of TC,TG,HDL-C and LDL-C in rehabilitation group B were lower than those in rehabilitation group A,with statistically significant differences(P<0.05).Conclusions Using EECP base on conventional drug treatment and aerobic training in patients with CAD can better improve heart reserve function,reduce blood lipid level,improve exercise endurance and quality of life.The effect of MIIT is also better than that of aerobic training,and it is safe and reliable,which is worthy of clinical application.