太极拳对高血压前期患者血压变异性的影响

【作者】 杨燕；

【导师】 常佩芬；

【作者基本信息】 北京中医药大学 ， 中西医结合临床（专业学位）， 2020， 硕士

【摘要】 研究目的:本研究以太极拳和有氧运动为主要治疗措施,经过对照干预前后患者家庭血压监测(HBPM)获取血压和血压变异性的变化,评估太极拳干预高血压前期的疗效是否优于有氧运动,针对高血压前期患者切实可行的运动处方进行探索。研究方法:本研究中共纳入50例高血压前期人群作为研究目标,随机分为太极拳组25例和有氧运动组25例。两组除运动方式不同外,均予以相同的饮食及体重控制、禁烟限酒、心理疏导方面干预,太极拳组在此干预基础上联合太极拳运动作为干预方法,有氧运动组则在此基础上联合有氧运动。干预期共3月,患者在入组后每月最后一周开始进行家庭自测血压并收集数据,要求连续3天、每天早晨(6:00-10:00)和晚上(18:00-22:00)餐前1小时、连续2次测量并记录,将血压变异性界定为家庭血压监测的每个月血压平均值的标准差。剖析两种运动方式对高血压前期人群的血压及血压变异性产生的影响。研究结果:1.基本资料:经过3月的干预,太极拳组脱落2例,最终太极拳组和有氧运动组纳入病例分别为23例和25例,脱落率4%,两组患者的性别、年龄的对比均无统计学意义(P>0.05),具备可比性。2.二十四小时动态血压:治疗前太极拳组和有氧运动组两组的动态血压参数及小时间血压变异性均无统计学意义(P>0.05),具备可比性。3.家庭自测血压:干预前太极拳组和有氧运动组的家庭自测血压监测(HBPM)比较差异无统计学意义(P>0.05),具有可比性。干预3月后,两组血压数据较干预前进行比较差异均有统计学意义(P<0.05);太极拳组的收缩压、舒张压均明显低于有氧运动组(P<0.05),两组降压幅度比较也存在显著差异(P<0.05)。4.血压变异性:干预前太极拳组和有氧运动组的HBPM血压变异性比较差异无统计学意义(P>0.05),具有可比性。治疗3月后,太极拳组的全天DBPV、清晨SBPV、清晨DBPV、夜间SBPV均显著低于干预前(P<0.05);其余BPV参数与干预前相比均无统计学意义(P>0.05);有氧运动组的血压变异性参数与干预前相比均无统计学意义(P>0.05)。太极拳组的全天DBPV、早晨SBPV、早晨DBPV、晚上SBPV均明显低于有氧运动组(P<0.05)。结论:1.干预3月后,太极拳、有氧运动均能明显使得高血压前期患者的血压参数下降;太极拳降压效果优于有氧运动。2.太极拳可一定程度改善高血压前期患者的血压变异性。更多还原

【Abstract】 Objective:this study used tai chi and aerobic exercise as the main treatment measures,through comparison before and after the intervention patients home blood pressure monitoring(HBPM)to obtain the change of blood pressure and blood pressure variability and evaluate the efficacy of tai chi chuan intervention prehypertension is better than aerobic exercise,in patients with prehypertension practical exploration on the exercise prescription.Methods:A total of 50 patients with pre-hypertension were reflected in the present study as the research objective,and were randomly divided into the Tai Chi group(25 cases)and the aerobic exercise group(25 cases).In addition to different exercise modes,the two groups received the same diet and weight control,smoking and alcohol restriction,and psychological counseling interventions.The tai ji quan group combined tai ji quan on the basis of the intervention method,and the aerobic exercise group combined aerobic exercise on the basis of the intervention method.Intervention period,a total of 3 months,patients in the group after the last week of every month to start home blood pressure self-test and collect data,ask for three consecutive days,(6-10:00)every morning and night(18:00 to 22:00)1 hour before meal,2 consecutive,measure and record,gives a definition of blood pressure variability of home blood pressure monitoring every month average blood pressure(a total of six reading)standard deviation.To analyze the influence of two kinds of exercise on blood pressure and blood pressure variability in prehypertension.Research results:1.Basic data:after 3 months of intervention,2 patients in the tai ji quan group fell off,and finally 23 patients in the tai ji quan group and 25 patients in the aerobic exercise group were included,with a fall of the rate of 4%.The comparison of gender and age of patients in the two groups was not statistically significant(P>0.05),indicating comparability.2.24-hour ambulate blood pressure:before treatment,there was no significant difference in ambulating blood pressure parameters or small time blood pressure variability between the tai ji quan group and the aerobic exercise group(P>0.05),indicating comparability.3.Blood pressure measurement at home:there was no significant difference in HBPM between the tai ji quan group and the aerobic exercise group before intervention(P>0.05),indicating comparability.After 3 months of intervention,blood pressure data of the two groups were significantly different from that before intervention(P<0.05).Systolic blood pressure and diastolic blood pressure of the Taijiquan group were significantly lower than those of the aerobic exercise group(P<0.05),and there was also a significant difference between the two groups(P<0.05).4.Blood pressure variability:there was no statistically significant difference in blood pressure variability between the tai ji quan group and the.aerobic exercise group before intervention(P>0.05),indicating comparability.After 3 months of treatment,the DBPV of the entire day,the SBPV of the morning,the DBPV of the morning and the SBPV of the night in the Taijiquan group were significantly lower than those before intervention(P<0.05).Other BPV parameters were not statistically significant compared with those before intervention(P>0.05).Blood pressure variability parameters in the aerobic exercise group were not statistically significant compared with those before intervention(P>0.05).The DBPV of the tai ji quan group throughout the day,SBPV of the morning,DBPV of the morning and SBPV of the evening were significantly lower than those of the aerobic exercise group(P<0.05).Conclusion:1.After 3 months of intervention,tai ji quan and aerobic exercise can significantly reduce blood pressure parameters of patients with pre-hypertension;the antihypertensive effect of tai ji quan is better than that of aerobic exercise.2.Tai ji quan can improve blood pressure variability of pre-hypertension patients to a certain extent.更多还原