八段锦结合药物治疗对急性心肌梗死患者心脏康复的作用

摘要

目的:探讨八段锦结合药物治疗对急性心肌梗死(AMI )患者心脏康复的作用.方法:选择我院收治的AMI患者106例作为研究对象,按照随机数字表法分为药物治疗组(常规治疗基础上加用通心络)和联合治疗组(在药物治疗组基础上联合八段锦运动) ,各53例.治疗4周,观察并比较两组临床疗效、左室舒张末期容积(LVEDV)、左室收缩末内径(LVESd)、左室射血分数(LVEF)、肿瘤坏死因子-α (TNF-α)、高敏 C反应蛋白(hsCRP) 、白介素-6 (IL-6) 、 N末端 B型利钠肽原(NT-proBNP)水平.结果:联合治疗组总有效率显著高于药物治疗组(92.45% 比75.47%, P＝0.017) ;与治疗前比较,治疗后两组LVEDV 、 LVEF水平显著提高, LVESd显著缩小, hsCRP 、 TNF-α 、 IL-6 、 NT-proBNP水平明显降低( P＜0. 05或＜0.01) ,且与药物治疗组比较,联合治疗组治疗后LVEDV [ (153.58 ± 25.17) ml比(165.27 ± 25.46) ml]、 LVEF [ (51.43 ± 4.28)% 比(55.37 ± 4.26)% ] 水平显著提高,LVESd [(33.46±2.24)mm比(30.29±2.32)mm] 显著缩小,hsCRP [(4.54±1.12) mg/L比(3.48 ± 1.05) mg/L]、 TNF-α [ (117.85 ± 15.46) ng/L比(96.59 ± 14.23) ng/L]、 IL-6 [ (14.38 ± 3.34) pg/ml比(10.67 ± 3.29) pg/ml]、 NT-proBNP [ (456.29 ± 53.76) ng/L比(368.49 ± 53.65) ng/L] 水平明显降低(P＜0.05或＜0.01).结论:八段锦结合通心络胶囊能够有效改善急性心肌梗死患者心功能,降低炎症因子水平,提高治疗效果.%Objective :To explore effects of Baduanjin combined medication on cardiac rehabilitation in patients with acute myocardial infarction (AMI).Methods :A total of 106 AMI cases treated in our hospital were enrolled .Ac-cording to random number table ,they were randomly and equally divided into medication group (received Tongxin-luo based on routine treatment ) and combined treatment group (received Baduanjin exercise based on medication group) ,both groups were treated for four weeks .Left ventricular end-diastolic volume (LVEDV) ,left ventricular end-systolic dimension (LVESd) ,left ventricular ejection fraction (LVEF) ,levels of tumor necrosis factor (TNF)-α ,high sensitive C reactive protein (hsCRP) ,interleukin (IL)-6 and N terminal pro brain natriuretic peptide (NT-proBNP) were observed and compared between two groups .Results : Total effective rate of combined treatment group was significantly higher than that of medication group (92.45% vs.75.47%,P＝0.017).Compared with be-fore treatment ,after treatment , there were significant rise in LVEDV and LVEF , and significant reductions in LVESd ,levels of hsCRP ,TNF-α ,IL-6 and NT-proBNP in two groups (P＜0.05 or ＜0.01).Compared with medi-cation group after treatment ,there were significant rise in LVEDV [ (153.58 ± 25.17) ml vs .(165.27 ± 25.46) ml] ,LVEF [(51.43 ± 4.28)% vs.(55.37 ± 4.26)% ] ,and significant reductions in LVESd [(33.46 ± 2.24) mm vs. (30.29 ± 2.32) mm] ,levels of hsCRP [ (4.54 ± 1.12) mg/L vs.(3.48 ± 1.05) mg/L] ,TNF-α [ (117.85 ± 15.46) ng/L vs.(96.59 ± 14.23) ng/L] ,IL-6 [ (14.38 ± 3.34) pg/ml vs.(10.67 ± 3.29) pg/ml] ,NT-proBNP [ (456.29 ± 53.76) ng/L vs.(368.49 ± 53.65) ng/L] in combined treatment group ,P＜0.05 or ＜0.01. Conclusion :Baduan-jin combined Tongxinluo capsule can effectively improve cardiac function ,reduce levels of inflammatory factors and improve therapeutic effect in patients with acute myocardial infarction .