六子诀锻炼与常规呼吸训练对心脏手术后患者的疗效比较：随机对照研究

ZHANG Qiao-li; GE Min; CHEN Cheng; FAN Fu-dong; JIN Yan; ZHANG Ning; WANG Lei

doi:10.1007/s11655-023-3637-9

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六子诀锻炼与常规呼吸训练对心脏手术后患者的疗效比较：随机对照研究

Original Article | Updated：2023-06-27

- 六子诀锻炼与常规呼吸训练对心脏手术后患者的疗效比较：随机对照研究
- Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery:A Randomized Controlled Trial^*
- 中国结合医学杂志（英文版） 2023年29卷第7期页码：579-589
- Affiliations：
  
  1.Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, Clinical College of Nanjing University of Chinese Medicine, Nanjing (210008), China
  2.Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing(210023), China
  3.Department of Cardio-Thoracic Surgery,Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing (210008), China
  4.Department of Ultrasound, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing (210008), China
- Author bio：
  
  Prof. WANG Lei, E-mail: wanglei@njucm.edu.cn
- Funds：
  
  Nanjing Drum Tower Hospital Clinical Research Special Fund(2022-LCYJ-MS-32);NHC Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center Fund(JSHD2021001)
- DOI：10.1007/s11655-023-3637-9
  中图分类号：
- 纸质出版日期：2023-07，
  
  网络出版日期：2023-05-27，
  
  录用日期：2023-03-29
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六子诀锻炼与常规呼吸训练对心脏手术后患者的疗效比较：随机对照研究[J]. 中国结合医学杂志（英文版）, 2023,29(7):579-589.

ZHANG Qiao-li, GE Min, CHEN Cheng, et al. Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery:A Randomized Controlled Trial^*[J]. Chinese Journal of Integrative Medicine, 2023,29(7):579-589.
六子诀锻炼与常规呼吸训练对心脏手术后患者的疗效比较：随机对照研究[J]. 中国结合医学杂志（英文版）, 2023,29(7):579-589. DOI： 10.1007/s11655-023-3637-9.

ZHANG Qiao-li, GE Min, CHEN Cheng, et al. Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery:A Randomized Controlled Trial^*[J]. Chinese Journal of Integrative Medicine, 2023,29(7):579-589. DOI： 10.1007/s11655-023-3637-9.

摘要

目的:

评价六子诀锻炼 (Liuzijue exercise

LE) 对心脏术后患者临床疗效的可行性和安全性.

方法:

选择2022年7月至10月在南京鼓楼医院心胸外科重症监护室接受心脏手术的患者120例

按照随机数字表法以1:1:1的比例分为LE组、常规呼吸训练 (conventional respiratory training

CRT) 组和对照组; 每组40例患者. 所有患者均接受常规治疗和心脏康复. LE组和CRT组分别进行LE和CRT

每天1次

每次30 min

连续7天. 对照组不接受专门的呼吸训练. 于干预前、干预3天和7天后评估三组患者的用力肺活量、1秒用力呼气量、最大吸气流速、最大呼气流速、最大吸气压力、最大呼气压力、改良Barthel指数 (modified Barthel index

MBI) 和汉密尔顿焦虑量表 (Hamilton Rating Scale for Anxiety

HAM-A) . 此外

还比较了术后住院时间 (postoperative length of hospital stay

LOS) 和干预期间发生的不良事件.

结果:

共有107例患者完成研究

对120例患者进行分析. 干预3天后

所有患者的肺功能、呼吸肌肌力、MBI和HAM-A评分较干预前均改善 (

0.05或

0.01) . 与对照组相比

CRT和LE组患者的肺功能和呼吸肌肌力均显著改善 (

0.05或

0.01) . LE组的MBI和HAM-A较对照组和CRT组显著改善 (

0.05或

0.01) . 干预7天后

这些差异仍然显著 (

0.01)

且与干预3天后相比差异有统计学意义 (

0.05或

0.01) . 此外

干预7天后

LE组的肺功能和呼吸肌肌力较CRT组明显增加 (

0.01) . CRT组的MBI和HAM-A评分较对照组显著改善 (

0.01) . 三组患者术后LOS比较差异无统计学意义 (

0.05) . 干预期间未发生与训练相关的不良事件.

结论:

LE在改善心脏手术后患者肺功能、呼吸肌肌力、日常生活活动能力以及减轻焦虑方面安全可行 (注册号: ChiCTR2200062964) .

Abstract

Objective:

To evaluate the feasibility and safety of Liuzijue exercise (LE) for the clinical effect in patients after cardiac surgery.

Methods:

Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober

2022 were allocated to the LE group

the conventional respiratory training (CRT) group

and the control group by a random number table at a ratio of 1:1:1; 40 patients in each group. All patients received routine treatment and cardiac rehabilitation. LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days. Control group did not receive specialized respiratory training. The forced vital capacity

forced expiratory volume in 1 s

peak inspiratory flow rate

peak expiratory flow rate

maximum inspiratory pressure

maximum expiratory pressure

modified Barthel index (MBI)

and Hamilton Rating Scale for Anxiety (HAM-A) were evaluated before

after 3 and 7 days of intervention. In addition

the postoperative length of hospital stay (LOS) and the adverse events that occurred during the intervention period were compared.

Results:

A total of 107 patients completed the study

120 patients were included in the analysis. After 3 days of intervention

the pulmonary function

respiratory muscle strength

MBI and HAM-A of all 3 groups improved compared with that before the intervention (

0.05 or

0.01). Compared with the control group

pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups (

0.05 or

0.01). MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups (

0.05 or

0.01). On the 7th day after intervention

the difference was still statistically significant (

0.01)

and was significantly different from that on the 3rd day (

0.05 or

0.01). In addition

on the 7th day of intervention

the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group (

0.01). MBI and HAM-A were significantly improved in the CRT group compared with the control group (

0.01). There were no significant differences in postoperative LOS among the 3 groups (

0.05). No training-related adverse events occurred during the intervention period.

Conclusions:

LE is safe and feasible for improving pulmonary function

respiratory muscle strength

the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery (Registration No. ChiCTR2200062964).

关键词

六字诀锻炼肺功能呼吸肌肌力日常生活活动能力焦虑心脏外科手术

Keywords

Liuzijue exercisepulmonary functionrespiratory muscle strengthactivities of daily livinganxietycardiac surgery

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