| Coronary heart disease is a disease that seriously endangers human life and is the most significant global disease burden of our time.With the rapid socio-economic development in China and the drastic changes in people’s lifestyle,especially with the advent of population ageing and rapid urbanisation,its incidence continues to increase,making the economic burden on the people and society increasingly heavy,and has become a major social public health problem.Unstable angina pectoris(UA)is one of the clinical subtypes of coronary artery disease and refers to the clinical state between acute myocardial infarction and stable angina pectoris,including primary exertional angina,worsening exertional angina and all other types of spontaneous angina pectoris;it is the occurrence of coronary artery atherosclerotic lesions on the basis of human coronary artery It is caused by subintimal haemorrhage,plaque rupture,thrombus formation by platelet and fibrin agglutination at the site of rupture,coronary artery spasm and embolism of small distal vessels,resulting in acute or sub-acute myocardial blood and oxygen supply reduction.Currently,the main clinical treatments are drug therapy and revascularisation therapy,which includes percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG).However,there are still many patients who are unable to undergo revascularisation due to subjective or objective reasons,and some of them still have clinical symptoms or experience reduced exercise capacity and tolerance as well as anxiety and/or depression that cannot be resolved by conventional drugs after revascularisation surgery.This not only places a huge financial and emotional burden on the family,but also on society as a whole in terms of economic and labour losses.Exercise rehabilitation therapy can significantly improve the overall mortality rate,the incidence of adverse cardiovascular events and all-cause mortality in patients with coronary heart disease,as well as reduce functional impairment associated with cardiovascular disease,improve mental and psychological abnormalities such as anxiety and depression,and improve the quality of life.It has become an integral part of the health management of patients with coronary heart disease.Cardiac rehabilitation for UA patients is now being implemented in many countries.In China,cardiac rehabilitation is a late start,and due to the limitations of space,equipment,medical insurance and economic conditions,there are limitations to replicate the rehabilitation model of the developed Western countries,which uses equipment as the core of cardiac rehabilitation;therefore,finding a suitable exercise rehabilitation method for UA patients in China and finding a cardiac rehabilitation model with Chinese characteristics has become an urgent problem.Cardiac rehabilitation based on traditional Chinese medicine exercises has now become an important rehabilitation tool for patients with coronary heart disease in China,especially Taijiquan,which has been proven in many studies to improve the clinical symptoms and quality of life of patients with coronary heart disease.However,long-term taijiquan exercise is difficult to control its intensity and exercise load,and may cause lower limb and knee injuries,so it has not been effectively promoted.The Shuxin Taijiquan,created by a professional team from the School of Sports Medicine and Rehabilitation of Beijing Sports University,is a medium-intensity exercise that is easy to learn,safe and reliable,and more suitable for cardiovascular diseases;previous studies have shown that this gongfu can increase coronary blood flow and promote the establishment of collateral circulation,which is effective for coronary heart disease and hypertension,but there is a lack of evidence-based medical evidence on the efficacy of cardiac rehabilitation for UA patients;based on this,this project The aim of this project is to investigate the efficacy of Shu Xin Taijiquan on the cardiac rehabilitation of UA patients through a prospective randomised controlled trial,to explore the suitable exercise rehabilitation programme for UA patients,and to provide evidence-based medical evidence for the promotion and application of traditional Chinese medicine gong methods.OBJECTIVE:To investigate the effect of Shuxin Taijiquan on the cardiac rehabilitation of patients with unstable angina pectoris in coronary heart disease.METHODS:In this study,patients with unstable angina pectoris in coronary artery disease were randomly divided into treatment group and control group by using a prospective randomized controlled trial study.The efficacy indexes were He Qingyong Chinese Medicine Evidence Efficacy Evaluation Scale for Coronary Angina,6-minute walk test(6MWT),Seattle Angina Questionnaire(SAQ),Self-Rating Anxiety Scale(SAS),and Depression SelfRating Scale(SAS).(SAS),Self-rating depression scale(SDS).left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVED),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVED),and left ventricular ejection fraction(LVEF).diameter,LVED).RESULTS:A total of 60 patients with unstable angina pectoris in coronary artery disease were included in this study,all from the Dongfang Hospital of Beijing University of Chinese Medicine.A total of 58 patients(2 cases of shedding)were finally completed in the trial,including 28 patients(2 cases of shedding)in the treatment group and 30 patients in the control group.The baseline data of the patients in both groups were comparable.1.TCM syndrome efficacy evaluation Scale scores of coronary heart disease angina pectoris:The results showed that after treatment,TCM syndrome scores of both control group and treatment group were reduced to a certain extent,the difference was statistically significant(P<0.05).The total score of TCM syndrome after treatment was compared between the two groups,and the total score of the treatment group was lower than that of the control group,the difference was statistically significant(P<0.05).In the aspect of TCM syndrome efficacy,after treatment,the total effective rate of the control group was 70%,and the total effective rate of the treatment group was 100%,the difference between the groups was statistically significant(P<0.05),indicating that Shuxin Tai Chi has better efficacy and advantages in improving the TCM syndrome of patients with unstable angina pectoris.2.6 minutes walking test:Standard 6MWT was carried out in this study.The results showed that the distance of 6-minute walking test before treatment was comparable between the two groups,which was 505.60 ± 40.99 m in the control group and 503.5 7 ± 22.94 m in the treatment group.There was no statistical difference between the two groups(P>0.05).After treatment,the 6-minute walking distance of patients in the control group and the treatment group was significantly increased,which was 508.23±41.21 m in the control group and 531.68±26.12 m in the treatment group.The difference between the two groups before and after the comparison was statistically significant(P<0.05).The average distance of 6-minute walking in the treatment group was higher than that in the control group,and the difference was statistically significant(P<0.05),indicating that Shuxin Tai Chi has a good effect on improving exercise tolerance in patients with unstable angina pectoris.3.Seattle Angina Scale:The results of the study showed that after treatment,the standard scores of all major items of SAQ increased in both groups compared with those before treatment,and the difference was statistically significant(P<0.05).A comparison between the groups showed that after treatment,the standard scores for the angina frequency(AF)item were significantly higher in the treatment group than in the control group,with a statistically significant difference(P<0.05).There was no significant difference between the two groups in the standard scores for the four items of physical activity limitation(PL),angina stability(AS),treatment satisfaction(TS)and disease awareness(DS)(P>0.05),indicating that Shu Xin Tai Chi Quan has a certain effect in improving the quality of life of patients,especially in improving the frequency of angina attacks(AF),compared with conventional therapy However,in terms of improving the degree of limitation of physical activity(PL),angina stability(AS),treatment satisfaction(TS)and disease awareness(DS),the advantages over conventional therapy were not outstanding.4.Anxiety self-assessment scale:The results of the study showed that after treatment,the SAS standard scores of both groups decreased,and the difference was statistically significant(P<0.05);the comparison between groups showed that after treatment,the SAS standard scores of the treatment group were lower than those of the control group,and the difference was statistically significant(P<0.05),indicating that Shuxin Taijiquan can effectively relieve the anxiety of patients with unstable angina.It is also superior to conventional treatment.5.Depression self-rating scale:The results of the study showed that after treatment,there was no significant difference in the SDS standard score of the control group(P>0.05)and a significant difference in the SAS standard score of the treatment group(P<0.05)when compared before and after the group,and there was a significant improvement in the SAS standard score of the patients in the treatment group,indicating that Shuxin Taijiquan can effectively relieve the depressive state of patients with unstable angina.6.Echocardiography:The results of the study showed that after treatment,LVEF was 59.40±3.15%and LVED was 48.30±6.1 1 mm in the control group and LVEF was 60.86 ±3.64%and LVED was 48.82 ± 4.69 mm in the treatment group.Compared with the pretreatment period.LVEF and LVED improved in both groups,with statistical differences(P<0.05);compared between the groups,there was no significant difference in LVEF between the two groups(P>0.05).It indicates that after 4 weeks of treatment,Shu Xin Taijiquan can improve patients’ cardiac function to a certain extent,but the advantage is not outstanding compared with the control group.7.Safety:No patients in both groups showed no significant arrhythmias and other adverse events during the treatment period,and no significant abnormalities were seen in patients’ vital signs and laboratory tests during the treatment period,which proved that Shu Xin Taijiquan has a certain degree of safety.Conclusion:Shu Xin Tai Chi can improve the TCM syndrome of patients with unstable angina pectoris of coronary heart disease,improve exercise tolerance,increase the distance of 6MWT,effectively improve the quality of life of patients with unstable angina pectoris,and has certain advantages in improving the frequency of angina attacks,and can relieve anxiety and depression.It has a dual heart treatment effect and good safety. |
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