抗阻-耐力运动结合认知-行为团体心理疗法对冠心病患者术后疗效及脂质代谢的影响

马依热·买买提; 热依拉·阿吾提; 尼加提·阿布都热合曼; 帕热旦木·托乎提; 郭驹

doi:10.16766/j.cnki.issn.1674-4152.003052

抗阻-耐力运动结合认知-行为团体心理疗法对冠心病患者术后疗效及脂质代谢的影响

doi: 10.16766/j.cnki.issn.1674-4152.003052

1.
新疆医科大学第一附属医院重症医学二科，新疆乌鲁木齐 830011
2.
新疆医科大学第一附属医院肾脏疾病中心血液透析科

基金项目:

新疆维吾尔自治区自然科学基金资助项目 2022D01C227

详细信息

通讯作者:
郭驹，E-mail：guoju_1110@163.com

中图分类号: R473.54 R541.4
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- 文章访问数: 73
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- 被引次数: 0
出版历程
- 收稿日期: 2022-06-28
- 网络出版日期: 2023-08-26

Effects of resistance-endurance exercise combined with cognitive-behavioral group psychotherapy on postoperative efficacy and lipid metabolism in patients with coronary heart disease

1.
Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China

摘要

摘要: 目的探究抗阻-耐力运动结合认知-行为团体心理疗法对冠心病患者术后疗效及脂质代谢的影响，为临床干预提供参考。方法选取2019年1月—2020年1月于新疆医科大学第一附属医院就诊的冠心病患者100例，应用随机数字表法分为对照组(50例)和观察组(50例), 对照组予以常规干预，观察组予以抗阻-耐力运动+认知-行为团体心理疗法。比较2组术后疗效、脂质代谢、炎性细胞因子[超敏C反应蛋白(hs-CRP)、白细胞介素(IL-6)、内皮素-1(ET-1)]、心功能指标[左室射血分数(LVEF)、N端B型脑钠肽前体(NT-proBNP)、6 min步行距离(6MWT)]及负性情绪[焦虑自评量表(SAS)和抑郁自量表(SDS)]。结果观察组总有效率明显高于对照组(88.00% vs. 70.00%，P < 0.05)；干预后，观察组TG、TC、LDL-C及血清hs-CRP、IL-6、ET-1水平均明显低于对照组(P < 0.05)，HDL-C明显高于对照组(P < 0.05)；干预后，观察组NT-proBNP明显低于对照组(P < 0.05)，LVEF、6MWT明显高于对照组(P < 0.05)；干预后，与对照组相比，观察组SAS和SDS评分均降低(P < 0.05)。结论对冠心病患者给予抗阻-耐力运动和认知-行为团体心理疗法，可有效提高术后疗效，改善脂质代谢，降低炎性细胞因子水平，改善心功能，并减轻患者负性情绪。
- 抗阻-耐力运动 /
- 认知-行为团体心理疗法 /
- 冠心病 /
- 心功能 /
- 脂质代谢 /
- 炎性细胞因子
Abstract: Objective To explore the effect of resistance-endurance exercise combined with cognitive-behavioral group psychotherapy on postoperative efficacy and lipid metabolism in patients with coronary heart disease, and to provide reference for clinical intervention. Methods A total of 100 patients with coronary heart disease admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2020 were selected and randomly divided into control group (50 cases) and observation group (50 cases) according to the random number table method. Routine intervention was given to the control group, while the observation group was given resistance-endurance exercise + cognitive-behavioral group psychotherapy. The curative effect, lipid metabolism, postoperative inflammatory cytokines [hypersensitive C-reactive protein (hs-CRP) and interleukin (IL-6), endothelin-1 (ET-1)], cardiac function index [left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), 6 min walking distance (6MWT)] and negative emotion [self-rating anxiety scale (SAS) and self-rating depression scale (SDS)] of the two groups were compared. Results The total effective rate of the observation group was significantly higher than that of the control group (88.00% vs. 70.00%, P < 0.05). After the intervention, triglyceride, total cholesterol, low density lipoprotein cholesterol and serum hs-CRP, IL-6 and ET-1 levels in the observation group were significantly lower than those in the control group (P < 0.05), and high density lipoprotein cholesterol was significantly higher than that in the control group (P < 0.05); NT-proBNP in the observation group was significantly lower than that in the control group (P < 0.05), and LVEF and 6MWT were significantly higher than those in the control group (P < 0.05); SAS and SDS scores of the observation group decreased compared with those of the control group (P < 0.05). Conclusion For patients with coronary heart disease, resistance-endurance exercise and cognitive-behavioral group psychotherapy can effectively improve postoperative efficacy, improve lipid metabolism, reduce the level of inflammatory cytokines, improve cardiac function, and reduce negative emotions in patients.
- Resistance-endurance exercise /
- Cognitive-behavioral group psychotherapy /
- Coronary heart disease /
- Cardiac function /
- Lipid metabolism /
- Inflammatory cytokines

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表 1 2组冠心病患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with coronary heart disease

组别	例数	性别(例)		年龄(x±s，岁)	病程(年)	文化水平(例)			合并基础疾病(例)
组别	例数	男性	女性	年龄(x±s，岁)	病程(年)	初中	高中	大学及以上	高血压	高血脂	糖尿病
观察组	50	29	21	67.96±3.58	1.78±0.28	15	24	11	22	6	13
对照组	50	23	27	68.87±3.96	1.83±0.31	13	28	9	18	10	8
统计量		1.442^a		1.205^b	0.846^b	0.002^c			0.667^a	1.190^a	1.507^a
P值		0.230		0.231	0.399	0.976			0.414	0.275	0.220
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组冠心病患者临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy between the two groups of patients with coronary heart disease [cases(%)]

组别	例数	显效	好转	无效	总有效
观察组	50	25(50.00)	19(38.00)	6(12.00)	44(88.00)
对照组	50	19(38.00)	16(32.00)	15(30.00)	35(70.00)
注：2组总有效率比较，χ²=4.882，P=0.027。

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表 3 2组冠心病患者脂质代谢指标水平比较(x±s，mmol/L)

Table 3. Comparison of lipid metabolism indexes between the two groups of patients with coronary heart disease (x±s, mmol/L)

组别	例数	TG		TC		LDL-C		HDL-C
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	50	1.85±0.40	1.21±0.25^a	4.44±1.05	3.69±0.51^a	2.83±0.54	1.88±0.41^a	0.60±0.14	1.23±0.23^a
对照组	50	1.81±0.38	1.54±0.33^a	4.38±0.98	4.00±0.58^a	2.87±0.59	2.29±0.46^a	0.63±0.15	0.91±0.19^a
t值		0.513	5.636	0.295	2.838	0.354	4.705	1.034	7.585
P值		0.609	<0.001	0.768	0.006	0.724	<0.001	0.304	<0.001
注：与同组干预前比较，^aP<0.05。

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表 4 2组冠心病患者血清炎性细胞因子水平比较(x±s)

Table 4. Comparison of serum inflammatory cytokines levels between the two groups of patients with coronary heart disease (x±s)

组别	例数	hs-CRP(mg/L)		IL-6(pg/mL)		EF-1(pg/mL)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	50	16.21±2.45	4.36±1.36^a	65.42±5.65	6.85±1.58^a	172.56±19.25	72.45±12.58^a
对照组	50	15.78±2.64	7.56±2.21^a	64.15±6.45	14.25±3.75^a	168.74±17.65	94.56±14.25^a
t值		0.844	8.720	1.047	12.859	1.034	8.225
P值		0.401	<0.001	0.298	<0.001	0.304	<0.001
注：与同组干预前比较，^aP<0.05。

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表 5 2组冠心病患者心功能指标比较(x±s)

Table 5. Comparison of cardiac function indexes between the two groups of patients with coronary heart disease (x±s)

组别	例数	LVEF(%)		NT-proBNP(pg/ml)		6MWT(m)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	50	51.26±5.65	64.12±5.12^a	378.56±26.54	196.54±25.48^a	396.54±48.54	556.74±57.58^a
对照组	50	51.21±6.15	57.54±5.89^a	381.54±29.52	265.87±29.65^a	399.87±51.26	488.54±62.15^a
t值		0.042	5.962	0.531	12.540	0.334	5.692
P值		0.966	<0.001	0.597	<0.001	0.739	<0.001
注：与同组干预前比较，^aP<0.05。

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表 6 2组冠心病患者负性情绪比较(x±s，分)

Table 6. Comparison of negative emotions between the two groups of patients with coronary heart disease (x±s, points)

组别	例数	SAS		SDS
组别	例数	干预前	干预后	干预前	干预后
观察组	50	53.54±4.87	42.26±4.21^a	55.75±6.10	44.20±4.79^a
对照组	50	53.29±4.60	47.33±4.51^a	55.39±5.96	48.77±5.46^a
t值		0.263	5.811	0.298	4.449
P值		0.792	<0.001	0.766	<0.001
注：与同组干预前比较，^aP<0.05。

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