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．

       运动可以调节机体代谢，预防和治疗由糖脂代谢紊乱所引发的心血管疾病。运动因子是在运动过程中，由肌肉、脂肪以及肝脏等多个组织合成和分泌的一系列生物活性物质，包括蛋白质和多肽类分子、小分子代谢物以及核酸等。诸多研究证实，运动因子是运动调节机体代谢的重要因素之一，也是机体从运动中获益的关键分子机制。近年来，随着蛋白质组学、代谢组学以及高通量测序等相关技术的飞速发展，越来越多的运动因子被陆续发现和证实。这不仅拓宽了人们对机体从运动中获益相关机制的认知，还激发了人们对运动因子在健康领域应用前景的浓厚兴趣。文章系统地阐述了运动因子对机体心血管系统的影响，旨在揭示运动因子在促进心血管健康以及治疗心血管疾病等方面的积极效用。

       Exercise can prevent and treat cardiovascular diseases resulting from the metabolic disorders of glucose and lipid．Exerkines are defined as a series of bioactive substances in response to exercise including proteins，peptides，small molecular metabolites and nucleic acids．Multiple tissues can produce exerkines，such as skeletal muscle，adipose tissue，and liver．Many studies indicate that exerkines play essential roles in improving glucose and lipid metabolism，which are crucial to harness the health-related benefits mediated by exercise．In recent years，with the progression of proteomics，metabolomics and high-throughput sequencings，an increasing number of exerkines are discovered．These findings expand the research on beneficial effects of exercise and draw attention to the clinical implications of exerkines．This review aims to explore the influence of exerkines on cardiovascular system and reveal their potential roles in the prevention and treatment of cardiovascular disease．