[关键词]
[摘要]
【目的】 观察心三针联合太极球对冠心病经皮冠状动脉介入术(PCI)后早期康复的有效性与安全性。【方法】 选取 2023 年5月至2024年12月深圳市中西医结合医院心血管病科收治的80例PCI术后患者为研究对象。按随机数字表将患者随 机分为观察组和对照组,每组各40例。2组患者均给予常规治疗。对照组在常规治疗的基础上,给予太极球康复训练。观察 组在对照组治疗的基础上,给予心三针治疗。连续治疗28 d,并于治疗后56 d进行门诊随访。观察2组患者治疗前后及随访 时中医证候积分和西雅图心绞痛量表(SAQ)评分的变化情况,以及氨基末端脑利钠肽前体(NT-pro BNP)、低密度脂蛋白 (LDL)、C-反应蛋白(CRP)水平。比较 2组患者治疗后及随访时 6 min步行距离的变化情况。并评价 2组的安全性及不良反 应的发生情况。【结果】(1)治疗后和随访时,2组患者的中医证候积分均明显改善(P<0.05),且观察组在改善中医证候积分 方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后和随访时,2组患者的NT-proBNP、LDL、CRP水平均明显改 善(P<0.05),且观察组在改善 NT-proBNP、LDL、CRP 水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治 疗后,2 组患者 6 min步行距离比较,差异无统计学意义(P>0.05)。随访时,2 组患者的 6 min 步行距离明显改善(P< 0.05),且观察组在改善 6 min步行距离方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后和随访时,2组患者 的SAQ评分除AS评分外,其余项目评分均明显改善(P<0.05),且观察组在改善SAQ评分除AS评分外,其余项目评分方面 均明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗期间,2组患者均无明显不良反应情况发生。观察组与对照组的 不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】 心三针联合太极球对冠心病PCI术后早期康复具有明显的改善 作用,能够助力PCI术后患者的心脏康复,提升患者术后生活质量,并减少心绞痛的发生,进而提高患者的心功能,改善患 者的临床症状。
[Key word]
[Abstract]
Objective To evaluate the efficacy and safety of Xin Sanzhen(a set of three acupoints used for heart and spirit regulation) acupuncture therapy combined with Taiji ball exercise for early rehabilitation in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods Eighty patients who underwent PCI at the Department of Cardiovascular Diseases,Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between May 2023 and December 2024 were enrolled. They were randomly assigned via a random number table to either the observation group or the control group,with 40 patients in each group. Both groups received conventional post-PCI treatment. The control group received additional Taiji ball rehabilitation training on top of conventional treatment. The observation group received Xin Sanzhen acupuncture therapy in addition to the control group’s regimen. The intervention lasted for 28 consecutive days,with an outpatient followup at 56 days post-treatment. Changes in traditional Chinese medicine (TCM) syndrome scores and Seattle Angina Questionnaire (SAQ) scores were observed before and after treatment and at follow-up. Levels of N-terminal proB-type natriuretic peptide (NT-proBNP),low-density lipoprotein (LDL),and C-reactive protein (CRP) were measured. The 6-minute walking distance (6MWD) was compared between the two groups after treatment and at follow-up. Safety and the incidence of adverse reactions were evaluated in both groups. Results (1) After treatment and at follow-up,TCM syndrome scores were significantly improved in both groups (P<0.05),and the observation group showed significantly greater improvement than the control group,with a statistically significant difference (P<0.05). (2) After treatment and at follow-up, levels of NT-proBNP, LDL, and CRP were significantly improved in both groups (P<0.05), and the observation group demonstrated significantly greater improvement than the control group,with a statistically significant difference (P<0.05).(3) After treatment,no statistically significant difference was found in the 6MWD between the two groups (P>0.05). At follow-up,the 6MWD was significantly improved in both groups (P<0.05),and the observation group showed significantly greater improvement than the control group,with a statistically significant difference (P<0.05).(4) After treatment and at follow-up, all SAQ domain scores except for the AS score were significantly improved in both groups (P< 0.05),and the observation group demonstrated significantly greater improvement in all these domains except for the AS score compared to the control group,with statistically significant differences (P<0.05).(5) During the treatment period,no significant adverse reactions were observed in either group. The difference in the incidence of adverse reactions between the observation group and the control group was not statistically significant (P>0.05). Conclusion Xin Sanzhen acupuncture therapy combined with Taiji ball exercise significantly improves early rehabilitation outcomes in CHD patients after PCI. This combined approach aids in cardiac rehabilitation, enhances postoperative quality of life,reduces angina attacks,and consequently improves cardiac function and clinical symptoms.
[中图分类号]
关键词:心三针;太极球;冠心病;经皮冠状动脉介入术;6 min步行距离;西雅图心绞痛评分;临床观察 R541.4
[基金项目]
国家级中西医协同旗舰科室建设资助项目(编号:10000015Z155080000004);广东省中医药管理局资助项目(编号:20241273); 深圳市宝安区科技创新局资助项目(编号:2022JD271);深圳市宝安区中医药基金会资助项目(编号:2022KJCX-ZJZL-2);深圳市“医疗 卫生三名工程”资助项目(编号:SZZYSM202106006)