世界中医药

目的:评估八段锦作为运动处方,在急性ST段抬高心肌梗死(STEMI)经皮冠状动脉介入术(PCI)术后患者Ⅱ期心脏康复治疗中的有效性。方法:选取2020年1月至2020年6月广西中医药大学第三附属医院心病科出院的STEMI行PCI手术患者60例作为研究对象,按照随机数字表法分为观察组和对照组,每组30例,对观察组给予八段锦运动康复指导,对照组未选取八段锦运动处方,2组其余的治疗措施相同。比较患者治疗前后的N端前脑钠肽(NT-proBNP)、左室射血分数(LVEF)、6分钟步行试验(6 MWT)、西雅图心绞痛量表积分、生命质量积分(QOL-BREF)等情况和2组治疗期间的心绞痛发作、再发急性心肌梗死、靶血管血运重建、心功能恶化、心源性死亡次数等,同时比较不同运动等级下不良事件发生情况。结果:观察组治疗后NT-proBNP、LVEF、6 MWT、西雅图心绞痛量表积分、QOL-BREF积分均有显著改善(P<0.05);观察组的心脏不良事件显著降低(P<0.05);观察组的运动等级有显著改善(P<0.05);2组由低到高的运动等级中,不良事件均呈下降趋势,而观察组较对照组更加显著(P<0.05)。结论:在STEMI患者PCI术后的Ⅱ期心脏康复中,八段锦作运动处方能显著改善心脏功能、心绞痛、运动耐量,降低了心脏不良事件发生率。

English Summary:

To evaluate the efficacy of Baduanjin as an exercise prescription in phase Ⅱ cardiac rehabilitation of patients after percutaneous coronary intervention(PCI) for acute ST-segment elevation myocardial infarction(STEMI).Methods:Sixty patients with STEMI who were discharged from the Department of Cardiology，the Third Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2020 to June 2020 were included and randomly divided into a Baduanjin group and a control group，with 30 cases in each group.The Baduanjin group was given Baduanjin exercise rehabilitation guidance，while the control group did not select the Baduanjin exercise prescription.Other treatment measures of the two groups were the same.The N-terminal pro brain natriuretic peptide(NT-proBNP)，left ventricular ejection fraction(LVEF)，6-minute walk test(6MWT)，Seattle Angina Pectoris Scale score，and quality of life(QOL-BREF) score of the patients in the two groups before and after treatment were compared，and the angina attack，recurrent acute myocardial infarction，target vessel revascularization，deterioration of cardiac function，and cardiogenic death times of the two groups during treatment were compared.In addition，the incidence of adverse events in different levels of exercise of the two groups was compared.Results:There were significant improvements in the NT-proBNP，LVEF，6MWT，Seattle Angina Scale score，and QOL-BREF score in the Baduanjin group after treatment(P<0.05).The incidence of adverse cardiac events in the Baduanjin group was decreased(P<0.05)，and the exercise class was improved(P<0.05).The adverse events in both groups showed a decreasing trend from low to high exercise levels，and the Baduanjin group was more significant than the control group(P<0.05).Conclusion:In phase Ⅱ cardiac rehabilitation of patients after PCI for STEMI，Baduanjin as an exercise prescription significantly improves cardiac function，angina，and exercise tolerance，and reduces the incidence of adverse cardiac events.

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