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目的探讨穴位按摩结合肢体功能锻炼对冠心病患者踝臂指数(ankle brachial index,ABI)和脉搏波传导速度(pulse wave velocity,PWV)的影响。方法将180例冠心病患者按Grace评分分为低危组(58例)、中危组(68例)和高危组(54例)3组。每组内再运用随机数字表法分为实验组与对照组,低危组分别为29例,中危组分别为34例,高危组分别为27例。对照组接受常规治疗护理及肢体功能锻炼训练,实验组在对照组基础给予穴位按摩。在干预前、干预7 d、干预30 d及干预90 d测量各组患者ABI与PWV的数值。结果方差分析结果表明:两组在干预前、干预7 d、干预30 d及干预90 d时ABI、PWV在低危、中危、高危组中,处理与时间交互效应比较,均P>0.05,说明时间和处理无交互作用,即时间因素(1 d、7 d、30 d、90 d)不随分组(实验组和对照组)的不同而不同;在低危组中,时间主效应比较,均P>0.05,差异无统计学意义;在中危、高危组中时间主效应比较,均P<0.05,差异具有统计学意义,说明不同时间点(1 d、7 d、30 d、90 d)两组主效应是有区别的;在低危组中处理主效应比较,均P>0.05,差异无统计学意义;在中危组、高危组中主效应比较,均P<0.05,差异具有统计学意义,进一步两两比较表明,实验组中危组、高危组患者在干预7 d、干预30 d时ABI较对照组高,而PWV较对照组低,组间比较,差异具有统计学意义(均P<0.01),但在干预前及干预90 d时两组患者PWV、ABI比较,差异无统计学意义(均P>0.05)。结论穴位按摩结合肢体功能锻炼能有效改善冠心病患者外周动脉的血运情况,提升ABI、降低PWV。
Objective To investigate the effects of acupoint massage and limb functional exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease. Methods 180 patients with coronary heart disease were divided into low risk group (58 cases), middle risk group (68 cases) and high risk group (54 cases) according to Grace score. Each group was divided into experimental group and control group by using random number table. There were 29 cases in low risk group, 34 cases in middle risk group and 27 cases in high risk group. The control group received routine treatment and physical training, and the experimental group received acupressure massage on the basis of the control group. Before intervention, 7 d intervention, 30 d intervention and 90 d intervention were used to measure the ABI and PWV in each group. Results The ANOVA results showed that the ABI and PWV in both groups before intervention, intervention 7 days, intervention 30 days and intervention 90 days were lower than those of middle-risk and high-risk groups (P <0.05) Indicating that there is no interaction between time and treatment, that is, the time factor (1 d, 7 d, 30 d, 90 d) does not vary with the group (experimental group and control group); in the low-risk group, (All P> 0.05). There was no significant difference between the two groups (P> 0.05), and the difference was statistically significant at different time points (1 d, 7 d, 30 d, 90 d There was a difference between the two groups in the main effects; in the low-risk group, the main effects of treatment were compared, P> 0.05, the difference was not statistically significant; in the medium-risk group, high-risk group, the main effects were compared, P <0.05, Statistical significance, further comparison showed that the experimental group of intermediate risk group, high-risk group of intervention at 7 d, intervention 30 d ABI higher than the control group, and PWV lower than the control group, the difference between the groups was statistically significant (P <0.01). However, there was no significant difference in PWV and ABI between the two groups before and 90 days after intervention (all P> 0.05). Conclusion Acupoint massage combined with limb functional exercise can effectively improve the blood supply of peripheral arteries in patients with coronary heart disease, improve ABI and lower PWV.