太极拳和八段锦对慢性心力衰竭患者运动耐量和生活质量的影响

Shadowboxing and Eight-section Brocade Has Effect on Exercise Tolerance and the Quality of Life of Patients with Chronic Heart Failure

目的:观察太极拳和八段锦对慢性心力衰竭(CHF)气虚血瘀证患者运动耐量和生活质量的改善作用。方法:选取98例CHF气虚血瘀证患者,随机分为治疗组和对照组各49例。对照组给予常规干预措施,治疗组在对照组基础上予太极拳和八段锦干预。2组均连续观察12周。比较2组治疗前后的心功能指标[左室收缩末径(LVSEd)、左室舒张末径(LVDEd)、左室射血分数(LVEF)、舒张早期最大血流速度/舒张晚期最大血流速度(E/A)]、6 min步行距离、心肺运动试验指标[运动峰耗氧量(PVO_2)、每搏耗氧量(VO_2/HR)]。采用中文版健康调查简表(SF-36)评定2组患者治疗前后的生活质量。结果:治疗后,2组LVDEd和LVSEd均较治疗前减少(P <0.01),LVEF和E/A均较治疗前提高(P <0.01);治疗组LVDEd和LVSEd均低于对照组(P <0.01),LVEF和E/A均高于对照组(P <0.01)。2组6 min步行距离、PVO_2、VO_2/HR均较治疗前增加(P <0.01);治疗组6 min步行距离、PVO_2、VO_2/HR均多于对照组(P <0.05)。2组SF-36量表生理功能、躯体疼痛、生理职能、活力、社会功能、情感职能以及精神健康评分均较治疗前增加(P <0.01);治疗组各指标评分均高于对照组(P <0.01)。结论:在常规治疗基础上加予太极拳和八段锦干预,可明显提高CHF气虚血瘀证患者的运动耐量、生活质量,进而改善患者的心功能。

Objective:To observe the improving effect of shadowboxing and eight-section brocade on exercise tolerance and the quality of life of patients with chronic heart failure(CHF) with qi deficiency and blood stasis syndrome. Methods:Selected 98 cases of patients with CHF with qi deficiency and blood stasis syndrome,and divided them into the treatment group and the control group randomly,49 cases in each group. The control group received routine intervention,while the treatment group additionally received intervention of shadowboxing and eight-section brocade. The observation in the two groups continuously lasted for 12 weeks. Compared the indexes of heart function including left ventricular systolic end diameter(LVSEd),left ventricular diastolic end diameter(LVDEd),left ventricular ejection fraction(LVEF) and the ratio value of peak systolic velocity in early diastolic phase by peak systolic velocity in late diastolic phase(E/A),the walking distance of six minutes,and the indexes of cardiopulmonary exercise test including peak oxygen consumption(PVO2) and oxygen pulse(VO2/HR) in the two groups before and after treatment. Evaluated the quality of life in the two groups before and after treatment by the Chinese version of the MOS item short from health survey(SF-36). Results:After treatment,LVSEd and LVDEd in the two groups were decreased when compared with those before treatment(P < 0.01),LVEF and E/A were increased when compared with those before treatment(P < 0.01). LVSEd and LVDEd in the treatment group were lower than those in the control group(P < 0.01),and LVEF and E/A were higher than those in the control group(P < 0.01). Six-minute walking distance,PVO2 and VO2/HR in the two groups were increased when compared with those before treatment(P < 0.01),and six-minute walking distance,PVO2 and VO2/HR in the treatment group were more than those in the control group(P < 0.05). Scores of physiological function,body pain,physiological role,vigor,social function,emotional role and mental health in SF-36 scale were increased in the two groups when compared with those before treatment(P < 0.01),and the above scores in the treatment group were higher than those in the control group(P < 0.01). Conclusion:Based on the routine treatment,the intervention of shadowboxing and eight-section brocade can effectively improve the exercise tolerance and the quality of life of patients with CHF with qi deficiency and blood stasis syndrome,and then improve the heart function of patients.