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真武汤联合八段锦对老年冠心病患者心肺运动功能及生存质量的影响

Clinical effects of Zhenwu Decoction combined with Baduanjin Qigong on the cardiopulmonary function and quality of life in older adults with coronary heart disease
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摘要 目的探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病(冠心病)患者中的应用效果。方法将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果治疗后干预组中医临床疗效(P=0.023)和中医证候积分(P<0.001)均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量(Peak VO_(2),P=0.005)、最大摄氧量(VO_(2)max,P=0.001)、氧脉搏(VO_(2)HR,P=0.002)和无氧阈值时最大代谢当量(MET,P=0.001),以及降低无氧阈值(AT,P<0.001)和二氧化碳通气当量(VE/VCO_(2),P=0.020)方面比对照组更明显。两组患者在36项简明健康状态调查表(SF-36)评分的8个维度中评分均有所升高,其中在生理机能(P=0.001)、生理职能(P<0.001)、一般健康状况(P=0.018)、精力(P=0.007)、社会职能(P=0.010)、精神健康(P=0.004)方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义(P>0.05)。两组患者的匹兹堡睡眠质量指数(PSQI)均有所改善,且干预组效果优于对照组(P<0.001)。结论真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO_(2)、VO_(2)max、VO_(2)/HR、MET、AT、VE/VCO_(2)等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。 Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease(CHD).Methods Ninety-six patients with CHD aged≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group.Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment.Results After treatment,both groups showed improvement in the traditional Chinese medicine(TCM)clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index(PSQI)scores;increase in Peak VO_(2),VO_(2)max,VO_(2)/HR,and metabolic equivalent(MET);and decrease in AT and VE/VCO_(2).However,the treatment group had a more pronounced improvement in the TCM clinical efficacy(P=0.023),TCM syndrome(P<0.001),PSQI scores(P<0.001),and cardiopulmonary exercise testing(CPET)indicators including Peak VO_(2)(P=0.005),VO_(2)max(P=0.001),VO_(2)/HR(P=0.002),MET(P=0.001),AT(P<0.001)and VE/VCO_(2)(P=0.020),compared to their control counterparts.For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning(P=0.001),role limitations due to physical health(P<0.001),general health(P=0.018),vitality(P=0.007),social functioning(P=0.010)and mental health(P=0.004),but not in pain or role limitations due to emotional problems.Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO_(2)、VO_(2)max、VO_(2)/HR、MET、AT and VE/VCO_(2),and elevate both quality of life and sleep quality among older adults with CHD.
作者 林梅兰 王珊 江芷珊 马军 LIN Meilan;WANG Shan;JIANG Zhishan;MA Jun(Department of Geriatrics,Guangzhou First People’s Hospital,the Second Affiliated Hospital of South China University of Technology,Guangzhou 510180,China)
出处 《广州医药》 2024年第12期1470-1475,共6页 Guangzhou Medical Journal
基金 广东省中医药局科研项目(20231262)。
关键词 真武汤 八段锦 老年 冠状动脉粥样硬化性心脏病 心肺功能 生存质量 Zhenwu Decoction Baduanjin Qigong older adults coronary heart disease cardiopulmonary function quality of life
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