论著
目的 探讨真武汤联合八段锦在老年冠状动脉粥样硬化性心脏病(冠心病)患者中的应用效果。方法 将96例75岁以上冠心病患者按照随机数字表法分为对照组与干预组,每组各48例。在12周的临床研究期间,对照组用规范的冠心病二级预防药物治疗;干预组在规范的冠心病二级预防药物治疗基础上,增加真武汤以及八段锦运动处方。结果 治疗后干预组中医临床疗效(P=0.023)和中医证候积分(P<0.001)均优于对照组。两组患者的心肺运动试验指标均有改善,且干预组在升高峰值摄氧量(Peak VO2,P=0.005)、最大摄氧量(VO2max,P=0.001)、氧脉搏(VO2/HR,P=0.002)和无氧阈值时最大代谢当量(MET,P=0.001),以及降低无氧阈值(AT,P<0.001)和二氧化碳通气当量(VE/VCO2,P=0.020)方面比对照组更明显。两组患者在36项简明健康状态调查表(SF-36)评分的8个维度中评分均有所升高,其中在生理机能(P=0.001)、生理职能(P<0.001)、一般健康状况(P=0.018)、精力(P=0.007)、社会职能(P=0.010)、精神健康(P=0.004)方面,干预组效果优于对照组;而在躯体疼痛、情感职能维度改善方面,两组间结果相近,差异无统计学意义(P>0.05)。两组患者的匹兹堡睡眠质量指数(PSQI)均有所改善,且干预组效果优于对照组(P<0.001)。结论 真武汤联合八段锦能够进一步增强老年冠心病患者中医证候疗效,改善心肺运动试验Peak VO2、VO2max、VO2/HR、MET、AT、VE/VCO2等指标,并提高SF-36评分多个维度的生活质量及睡眠质量。
Objective To explore the therapeutic effects of Zhenwu Decoction combined with Baduanjin Qigong in older adults with coronary heart disease(CHD).Methods Ninety-six patients with CHD aged ≥75 years were randomly divided into a treatment group and a control group,with 48 patients in each group.Within the 12-week period,the control group received standard secondary prevention therapy for CHD,while the treatment group received Zhenwu Decoction and Baduanjin Qigong prescription,in addition to the standard treatment.Results After treatment,both groups showed improvement in the traditional Chinese medicine(TCM)clinical efficacy,TCM syndrome,SF-36 scores and Pittsburgh Sleep Quality Index(PSQI)scores;increase in Peak VO2,VO2max,VO2/HR,and metabolic equivalent(MET);and decrease in AT and VE/VCO2.However,the treatment group had a more pronounced improvement in the TCM clinical efficacy(P=0.023),TCM syndrome(P<0.001),PSQI scores(P<0.001),and cardiopulmonary exercise testing(CPET)indicators including Peak VO2(P=0.005),VO2max(P=0.001),VO2/HR(P=0.002),MET(P=0.001),AT(P<0.001)and VE/VCO2(P=0.020),compared to their control counterparts. For the SF-36 scores,in comparison to the control group,the treatment group presented better outcomes in enhancing physical functioning(P=0.001),role limitations due to physical health(P<0.001),general health(P=0.018),vitality(P=0.007),social functioning(P=0.010)and mental health(P=0.004),but not in pain or role limitations due to emotional problems.Conclusions The Zhenwu Decoction combined with Baduanjin Qigong can enhance the TCM syndrome,improve various CPET indicators such as Peak VO2、VO2max、VO2/HR、MET、AT and VE/VCO2,and elevate both quality of life and sleep quality among older adults with CHD.
临床诊疗
目的 了解某市不同性别在职高级干部营养“知识-态度-行为”(KAP)现状及其健康状况,为开展健康教育工作提供理论依据。方法 采用整群抽样方法抽取228名在职高级干部作为调查对象,采用自行设计的问卷调查营养KAP,根据统一健康体检数据,分析两者之间的相关性。结果 某市在职高级干部男性干部与女性干部在营养知识、营养行为得分两者间有显著差异P<0.05。营养态度得分两组间无差异P>0.01。体检结果男性干部总体异常及脂肪肝、高脂血症和高尿酸血症发病率均显著高于女性干部,差异有统计学意义(P<0.05)。健康状况得分8.27±1.57分(满分10分),与营养KAP得分有明显正相关关系(r=0.481,P<0.01)。结论 某市不同性别在职高级干部营养知识水平有待提高,营养态度良好,饮食行为不够合理,应采用多种方式进行营养健康指导,增强自我保健意识,提高整体健康水平。