To Investigate The Effect Of Baduanjin Exercise Therapy On Cardiac Rehabilitation Of Patients With Acute Myocardial Infarction After PCI

Objective:To investigate the effect of Baduanjin(BDJ)exercise therapy on cardiac rehabilitation of patients with acute myocardial infarction(AMI)after Percutaneous Transluminal Coronary Intervention(PCI).Methods:This study was a prospective randomized controlled trial.Sixty patients who met the inclusion criteria after AMI underwent PCI were randomly divided into experimental group and control group by random number table,with 30 patients in each group.With the control group patients specification of coronary heart disease secondary prevention drug therapy and regular teaching,the basis of the patients in the control group up BDJ exercise therapy,BDJ movement version will be subject to state general administration of sports promotion version,experimental group patients after discharged practice BDJ,exercise 5 days a week,ex 2 times a day,in the morning and evening,each time practice BDJ in 1 time,about 15 min on average every time,total daily practice length about 30 min.The treatment course was 2 months,and the follow-up time node was the induction period,4 weeks of treatment and 8 weeks of treatment.Cardiac structure and function indexes,such as LVEF,LVED,NT-pro BNP,were observed before and after exercise.LDL-C,TC and other biochemical indicators;Cardiopulmonary function indexes,such as walking distance,METS value,and Borg grading in the 6-minute walking test before and after exercise;SDNN,RMSSD and other heart rate variability indicators;The improvement of quality of life indicators such as Seattle angina questionaire(SAQ),Chinese medicine symptom integral scale and SF-36 the improvement of the quality of life scale(SF-36)and psychological state indicators such as Hamilton Anxiety and Depression Scale(HAMA、HAMD).Results:(1)In terms of cardiac structure and function:NT-pro BNP and LVEF in both experimental group and control group were improved compared with those before treatment,while LVED in experimental group was improved compared with that before treatment,while LVED in control group was slightly increased.The difference of LVED before and after treatment was 4.37±4.77 mm in experimental group and 1.93±3.46 mm in control group,respectively.The difference of LVEF before and after treatment in experimental group and control group was11.60±6.30% and 4.53±5.63%,respectively,with statistical significance(P< 0.05).There was no significant difference in the improvement of NT-pro BNP between the treatment group and the control group(P > 0.05).(2)Cardiopulmonary function and motor ability: the METS value of the6-minute walking test in experimental group and control group was improved compared with before treatment,the 6-minute walking distance in experimental group was improved compared with before treatment,but the 6-minute walking distance in control group was slightly decreased compared with before treatment.The difference of METS in experimental group and control group before and after treatment was 0.71±0.23 and 0.03±0.39,respectively.The difference of 6-minute walking distance between experimental group and control group was 108.17±35.49 m and-4.73±59.57 m,respectively,with statistical significance(P < 0.05).(3)Heart rate variability: the heart rate variability(SDNN,RMSSD)of the experimental group and the control group were improved compared with before treatment.The difference of SDNN between experimental group and control group was 29.55±13.57 and 14.18±5.86,respectively.The difference of RMSSD between the experimental group and the control group before and after treatment was 5.98±2.12 and 1.93±0.98,respectively,with statistical significance(P < 0.05).(4)In terms of blood lipid metabolism:the levels of blood lipid(TC,LDL-C)in both experimental group and control group were improved compared with those before treatment.The difference of TC in experimental group and control group before and after treatment was 1.08±1.04mmol/L and 0.59±1.00mmol/L respectively.The difference in LDL-C between experimental group and control group before and after treatment was 1.05±1.16mmol/L and 0.57±0.88mmol/L,respectively,without statistical significance(P > 0.05).(5)Patients quality of life aspects: experimental group and control group patients’ limited physical activity level,the stable of angina,attack of angina,extent of disease cognitive aspects in the SAQ was improved,in the aspects of the limited physical activity level,the stable of angina,attack of angina,the treatment group patients improve more obvious;The total scores of TCM symptoms,chest tightness,chest pain,shortness of breath,dry mouth and bitter mouth,urination and tongue coating in the experimental group and the control group were improved compared with those before treatment,and the improvement was more obvious in the experimental group.Physiological function,physical pain,energy,social function,emotional function and mental health scores in the test group and the control group were all improved compared with those before treatment,and the improvement was more obvious in the test group.The differences were statistically significant(P < 0.05).(6)Mental state: The scores of HAMA and HAMD in experimental group and control group were improved compared with those before treatment.The difference of HAMA between experimental group and control group was11.80±3.82 and 9.53±5.62,respectively.The difference of HAMD between experimental group and control group was 9.73±2.99 and 6.23±2.84 before and after treatment,respectively,with statistical significance(P < 0.05).(7)No patients complained of obvious discomfort during the process of this study and the process of return to the hospital for follow-up review.The electrocardiogram,blood analysis,liver and kidney function,electrolyte level,stool and urine routine of the experimental group and the control group showed no exacerbation or recurrence.Conclusion:Adding BDJ exercise therapy in treatment plan of patients who are diagnosed with AMI after PCI,based on the secondary prevention of coronary heart disease with conventional patients teaching,can further improve patients’ cardiac structure and function,improve cardiopulmonary function and exercise capacity,heart rate variability index,further reduce the index of blood lipid metabolism,and improve the patients quality of life,at the same time improve patients psychological status.And it has high security.