| Objective:To observe the improvement of cardiopulmonary function and quality of life in patients with coronary heart disease by acupoint pressure external counterpul sation combined with exercise training.Methods:A randomized controlled trial was used to include CHD patients who were admitted to the outpatient department of cardiology and inpatient wards of our h ospital from December 2018 to July 2021,and they were randomly divided into three groups:routine group,counterpulsation group,and acupoint group.Normal group was given conventional cardiac rehabilitation therapy(cardiac rehabilitation:mainly for card io load experiment under the guidance of individualized aerobic exercise),counterpulsa tion group in conventional external counterpulsation was given on the basis of acupun cture point group on the basis of the conventional group for gas pressure external cou nterpulsation therapy(acupoints selected:ST36,ST40,SP9),all patients in three group s were given secondary prophylactic drugs for coronary heart disease.The course of tre atment was 12 times of rehabilitation treatment and corresponding intervention measure s.Cardiopulmonary exercise test data and concise quality of life scale scores of patien ts were collected before and after the treatment,and statistical analysis was conducted.Results:1 A total of 70 CHD patients were included in the study,6 cases were lost,and finally 64 patients were included in the analysis,including 22 patients in the convent ional group,19 patients in the counterpulsation group,and 23 patients in the meridian acupoint group.There were no significant differences in general data(except gender),cardiopulmonary exercise test results and quality of life scale among the three groups before treatment(P>0.05),indicating comparability between the groups.2 Cardiopulmonary exercise testing2.1 Exercise heart function:Intra-group comparison:The maximal oxygen uptake per kilogram(VO2max/kg)level of patients in the three groups after treatment was hi gher than that before treatment,but there was no statistical significance between the t hree groups after treatment(P=0.573>0.05);The percentage of maximal oxygen u ptake per kilogram(VO2max/kg%pred)level of patients in the three groups increased after treatment compared with before,and the difference between the three groups was statistically significant(P=0.006<0.01).Pair comparison showed that the improve ment of the meridian point group was better than that of the conventional group.2.2 Exercise tolerance:Intra-group comparison:The maximum metabolic equivalent(METSmax)and maximum exercise power(WRmax)levels in 3 groups were increas ed compared with before treatment,but there was no statistical significance between t he 3 groups after treatment(P value was 0.568,0.668>0.05).The percentage of the maximum oxygen pulse to the predicted value(VO2max/HR%pred)in counterpulsatio n group and acupoint group was higher than that before treatment,but there was no s ignificant change before and after treatment in conventional group.After treatment,ther e was statistically significant difference among the three groups(P=0.003<0.05).Af ter pairwise comparison,it was found that the improvement of the meridian acupoint group was better than that of the conventional group.2.3 Regulation function of cardiac autonomic nerve:Intra-group comparison:After treatment,the maximum heart rate(HRmax)level was increased and the heart rate re serve(HRR)level was decreased in the acupoint group,with statistical significance(P<0.05),while there was no significant difference between the conventional group an d the counterpulsation group before and after treatment.There was no significant differ ence in HRmax and HRR levels among the three groups after treatment(P value was 0.237 and 0.219>0.05,respectively).2.4 Exercise lung function:Intra-group comparison:before and after treatment,the meridian acupoint group:The maximum minute ventilatory volume(VEmax),the perce ntage of maximum minute ventilatory volume to the estimated value(VEmax%pred),t he ratio of forced expiratory volume in the first second to forced vital capacity(FEV 1/FVC),and the percentage of maximum chase volume to the estimated value(MV V%pred)were higher than those before treatment.The percentage of maximum respirat ory reserve(BRmax)and predicted value of maximum respiratory reserve(BRmax%pr ed)were significantly lower than those before treatment(P<0.05).In the counterpulsa tion group,MVV%pred and the percentage of forced expiratory volume in the first se cond(FEV1%pred)were higher than those before treatment,and the difference was st atistically significant(P<0.05).In routine group,the percentage of maximum vital ca pacity to predicted value(VCmax%pred),MVV%pred and FEV1%pred were higher th an those before treatment,and the difference was statistically significant(P<0.05).Th e slope of carbon dioxide ventilation efficiency(VE/VCO2-slope)in the three groups showed no significant difference before and after treatment.Comparison between groups:After treatment,there were statistically significant dif ferences in VEmax%pred and VE/VCO2-slope among all groups(P values were 0.031 and 0.033<0.05,respectively).After pairwise comparison of VEmax%pred,the impr ovement of the meridian acupoint group was better than that of the conventional grou p.The improvement of VE/VCO2-slope index in the acupoint group whs better than th at in the counterpulsation group.3 Quality of Life scoreIntra-group comparison:After treatment,the factors of HT,MH,RE,VT,GH,BP,RP,PF,PCS and MCS in the acupoint group were higher than those before treatmen t,and the difference was statistically significant(P<0.05).The factors of HT,RE,G H,BP,RP,PF,PCS and MCS in the counterpulsation group were higher than those b efore treatment,and the difference was statistically significant(P<0.05).In the conve ntional group,GH,BP,RP and PCS factors were higher than those before treatment,and the differences were statistically significant(P<0.05).Comparison between groups after treatment:There were statistically significant diff erences in MH,VT,MCS factors among the three groups(P values were 0.004,0.028,0.024<0.05,respectively).After pairwise comparison,it was found that the impro vement of the meridian acupoint group was better than that of the conventional group.Conclusion:1.Cardiopulmonary function:Acupoint pressure extracorporeal counterpulsation co mbined with routine cardiac rehabilitation and extracorporeal counterpulsation combined with routine cardiac rehabilitation can improve VO2max/kg%pred to improve cardiac function.METSmax,WRmax,VO2max/HR,VO2max/HR%pred were increased to impro ve exercise tolerance.MVV%pred was increased to improve exercise lung function.Acu point pressure external counterpulsation can improve the autonomic nerve regulation fu nction of patients,increase VEmax%pred and decrease VE/VCO2-slope to improve the motor lung function of patients,Acupoint pressure external counterpulsation combined with cardiac rehabilitation is better than conventional cardiac rehabilitation.2.Quality of life:Acupoint pressure extracorporeal counterpulsation combined wit h routine cardiac rehabilitation and extracorporeal counterpulsation combined with routi ne cardiac rehabilitation can improve the scores of GH,BP,RP,PCS and MCS factor s,In MH,VT,MCS factor improvement,acupoint pressure external counterpulsation c ombined with routine cardiac rehabilitation is better than routine cardiac rehabilitation. |
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