太极拳对慢性心力衰竭患者心肺功能的影响

发布时间：2018-04-10 04:05

本文选题：慢性心力衰竭　切入点：心肺功能　出处：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:观察常规药物治疗联合太极拳运动对慢性心力衰竭患者心肺功能参数、NT-pro BNP、左室射血分数的作用,以及对明尼苏达心衰生活质量评分的影响,探讨太极拳运动在慢性心力衰竭患者康复治疗中的作用。资料与方法:选取2015年6月至2016年4月于辽宁省人民医院心内科住院治疗的慢性心力衰竭(心功能II-III级)患者60例,男31例,女29例,平均年龄61.2±6.1(50-70)岁,按随机数字表随机分为常规治疗组(对照组)和太极拳组(试验组),两组根据《2016ESC急慢性心力衰竭诊断和治疗指南》进行诊断及治疗,采用美国纽约心脏病学会的心功能分级标准进行分级。对照组依据上述指南进行常规药物治疗,太极拳组在常规药物治疗基础上增加6个月的24式太极拳锻炼,每周锻炼3-5次,每次30min。记录年龄、性别、身高、体重、BMI、血压等一般情况以及治疗前后心肺功能参数、NT-pro BNP、左室射血分数(LVEF)以及明尼苏达心衰生活质量评分,并进行比较。结果:1.心肺功能指标:治疗前常规治疗组与太极拳组无氧阈值(AT)、峰值摄氧量(VO2max)、氧脉比(AT:9.08±0.53ml/kg.min vs.8.96±0.49ml/kg.min,P0.05;VO2max:14.55±1.04 ml/kg.min vs.14.66±1.05ml/kg.min,P0.05;氧脉比:8.40±0.47 ml/bpm vs.8.57±0.52ml/bpm,P0.05)无显著性差异;治疗后常规治疗组与太极拳组AT、VO2max及氧脉比(AT:9.57±0.63ml/kg.min vs.10.38±0.48ml/kg.min,P0.05;VO2max:15.49±0.87ml/kg.min vs.16.72±1.05ml/kg.min,P0.05;氧脉比:9.48±0.52ml/bpm vs.10.25±1.23ml/bpm,P0.05)均升高,与常规治疗组相比,太极拳组升高更显著;治疗前后常规治疗组与太极拳组AT、VO2max、氧脉比(AT:9.08±0.53ml/kg.min vs.9.57±0.63ml/kg.min,8.96±0.49ml/kg.min vs.10.38±0.48ml/kg.min,P0.05);VO2max:14.55±1.04 ml/kg.min vs.15.49±0.87ml/kg.min,14.66±1.05ml/kg.min vs.16.72±1.05ml/kg.min,P0.05;氧脉比:8.40±0.47 ml/bpm vs.9.48±0.52ml/bpm,8.57±0.52ml/bpm vs.10.25±1.23ml/bpm,P0.05)比较有统计学差异。2.NT-pro BNP:治疗前常规治疗组与太极拳组NT-pro BNP值(435.9±199.7ng/l vs.415.0±240.8ng/l,P0.05)比较无统计学差异;治疗后常规治疗组与太极拳组NT-pro BNP值均下降(338.9±213.6ng/l vs.203.1±231.6ng/l,P0.05),与常规治疗组相比,太极拳组降低更显著;治疗前后常规治疗组与太极拳组NT-pro BNP值(435.9±199.7ng/l vs.338.9±213.6ng/l,415.0±240.8ng/l vs.203.1±231.6ng/l,P0.05)比较有统计学差异。3.左室射血分数:治疗前常规治疗组与太极拳组LVEF值(0.42±0.06 vs.0.40±0.07,P0.05)比较无统计学差异;治疗后常规治疗组与太极拳组LVEF值(0.44±0.08vs.0.42±0.03,P0.05)均升高,但无统计学差异;治疗前后常规治疗组与太极拳组LVEF值(0.42±0.06 vs.0.44±0.08,0.40±0.07 vs.0.42±0.03,P0.05)比较亦无统计学差异。4.明尼苏达心衰生活质量评分表:治疗前常规治疗组与太极拳组评分(43.39±9.18vs.46.66±10.94,P0.05)比较无统计学差异;治疗后常规治疗组与太极拳组评分均降低(33.96±9.58 vs.25.22±6.97,P0.05),与常规治疗组相比,太极拳组降低更显著;治疗前后常规治疗组与太极拳组评分(43.39±9.18 vs.33.96±9.58,46.66±10.94vs.25.22±6.97,P0.05)有统计学差异。结论:1.药物联合太极拳运动,能进一步的提高慢性心力衰竭患者的无氧阈值、峰值摄氧量和氧脉比,降低NT-pro BNP水平。2.通过药物联合太极拳运动能更好的改善慢性心力衰竭患者的运动耐量,提高患者的生存质量。3.心肺功能指标能准确客观的评价慢性心力衰竭患者的状况。
[Abstract]:Objective: To observe the routine drug therapy combined with Taijiquan exercise parameters on cardiopulmonary function in patients with chronic heart failure NT-pro BNP, left ventricular ejection fraction, and the influence on the quality of life score of heart failure in Minnesota, to explore the Taijiquan exercise rehabilitation in patients with chronic heart failure Kang. Materials and methods: from June 2015 to April 2016 Liaoning Provincial People's Hospital Department of Cardiology hospitalized chronic heart failure (NYHA class II-III) 60 cases, male 31 cases, female 29 cases, mean age 61.2 + 6.1 (50-70) years old, were randomly divided into routine treatment group (control group) and Taijiquan group (experimental group), two groups according to the <2016ESC "guidelines for diagnosis and treatment of chronic heart failure diagnosis and treatment, the New York Heart Association standard classification of cardiac function classification. The control group on the basis of the above guidelines for routine drug treatment The Tai Chi Group, an increase of 24 Style Taijiquan exercise for 6 months on the basis of conventional drug treatment, exercise 3-5 times a week, every time 30min. record the age, gender, height, weight, BMI, blood pressure and other general situation before and after the treatment of heart and lung function parameters, NT-pro BNP, left ventricular ejection fraction (LVEF) and the quality of life of Minnesota heart failure score, and compared. Results: 1. heart lung function index: before treatment, the conventional treatment group and Taijiquan group anaerobic threshold (AT), peak oxygen uptake (VO2max), oxygen pulse ratio (AT:9.08 + 0.53ml/kg.min vs.8.96 + 0.49ml/kg.min, P0.05 + 1.04 ml/kg.min vs.14.66 + VO2max:14.55; 1.05ml/kg.min, P0.05; oxygen pulse ratio: 8.40 + 0.47 ml/bpm vs.8.57 + 0.52ml/bpm, P0.05) had no significant difference; after treatment, routine treatment group and Taijiquan group AT, VO2max and oxygen pulse ratio (AT:9.57 + 0.63ml/kg.min vs.10.38 + 0.48ml/kg.min, VO2max:15.49 + 0.87ml/kg.min vs.1 P0.05; 6.72 + 1.05ml/kg.min, P0.05; oxygen pulse ratio: 9.48 + 0.52ml/bpm vs.10.25 + 1.23ml/bpm, P0.05) were increased, compared with the conventional treatment group, Taiji group increased more significantly after treatment; the routine treatment group and Taijiquan group AT, VO2max, oxygen pulse ratio (AT:9.08 + 0.53ml/kg.min vs.9.57 + 0.63ml/kg.min, 8.96 + 0.49ml/kg.min + vs.10.38 0.48ml/kg.min, P0.05); VO2max:14.55 + 1.04 ml/kg.min vs.15.49 + 0.87ml/kg.min, 14.66 + 1.05ml/kg.min vs.16.72 + 1.05ml/kg.min, P0.05; oxygen pulse ratio: 8.40 + 0.47 ml/bpm vs.9.48 + 0.52ml/bpm, 8.57 + 0.52ml/bpm vs.10.25 + 1.23ml/bpm, P0.05) were statistically significant difference.2.NT-pro BNP: before treatment, routine treatment group and Taijiquan group NT-pro BNP value (435.9. 199.7ng/l vs.415.0 + 240.8ng/l, P0.05) showed no significant difference; after treatment, routine treatment group and Taijiquan group NT-pro BNP decreased (338.9 + 213.6ng/l + 231 vs.203.1 .6ng/l, P0.05), compared with the conventional treatment group, Taiji group decreased more significantly; the routine treatment group and Taijiquan group NT-pro BNP value before and after treatment (435.9 + 199.7ng/l vs.338.9 415 + 240.8ng/l + 213.6ng/l, vs.203.1 + 231.6ng/l, P0.05) compared with left ventricular ejection fraction:.3. significant difference before treatment and treatment group the Tai Chi Group LVEF (0.42 + 0.06 vs.0.40 + 0.07, P0.05) showed no significant difference; the routine treatment group and Taijiquan group LVEF value after treatment (0.44 + 0.08vs.0.42 + 0.03, P0.05) were increased, but the difference was not statistically significant; the routine treatment group and Taijiquan group LVEF values before and after treatment (0.42 + 0.06 vs.0.44 + 0.08,0.40 + 0.07 vs.0.42 + 0.03, P0.05) is also no significant difference in the.4. Minnesota heart failure quality of life scale: before treatment, the conventional treatment group and Taijiquan group score (43.39 + 9.18vs.46.66 + 10.94, P0.05) and there was no significant difference in treatment; After conventional treatment group and Taijiquan group were significantly reduced (33.96 + 9.58 vs.25.22 + 6.97, P0.05), compared with the conventional treatment group, Taiji group decreased more significantly after treatment; the routine treatment group and Taijiquan group score (43.39 + 9.18 vs.33.96 + 9.58,46.66 + 10.94vs.25.22 + 6.97, P0.05). Conclusion there is significant difference 1. drugs combined with Taijiquan exercise, can further improve the anaerobic threshold in patients with chronic heart failure, peak oxygen uptake and oxygen pulse ratio, reduce the NT-pro level of BNP.2. can better through drugs combined with Taijiquan exercise to improve exercise tolerance in patients with chronic heart failure, improve the quality of life of.3. heart and lung function indices in patients with accurate and objective the evaluation of patients with chronic heart failure.

【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

【参考文献】