Yeh Gloria Y, Wayne Peter M, Phillips Russell S
Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, and Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass., USA.
Med Sport Sci. 2008;52:195-208. doi: 10.1159/000134300.
To review the physiological and psychosocial effects of a 12-week T'ai Chi program (TC) in patients with heart failure (HF) as previously reported in a clinical trial.
We randomized 30 patients with chronic HF (left ventricular ejection fraction < or =40%) to receive TC plus usual care (n = 15), or usual care alone (wait-list control, n = 15). Outcome measures included quality of life, exercise capacity, B-type natriuretic peptide, catecholamine levels, heart rate variability, and sleep stability.
The mean age (+/-SD) of patients was 64 +/- 13 years, mean baseline ejection fraction (+/-SD) was 23 +/- 7%, and median New York Heart Association Class was 2 (range 1-4). At 12 weeks, patients who participated in TC showed improved quality of life (mean change -17 +/- 11 vs. 8 +/- 15, Minnesota Living with HF Questionnaire, p = 0.001), increased exercise capacity (mean change 85 +/- 46 vs. -51 +/-58 m, 6-min walk, p = 0.001), and decreased B-type natriuretic peptide (mean change -48 +/- 104 vs. 90 +/- 333 pg/ml, p = 0.03) compared to the control group. Those who participated in TC also showed improvement in sleep stability (increase in high-frequency coupling +0.05 +/- 0.10 vs. -0.06 +/- 0.09 proportion of estimated total sleep time, p = 0.04; reduction in low-frequency coupling -0.09 +/- 0.09 vs. +0.13 +/- 0.13 proportion of estimated total sleep time, p < 0.01), compared to the control group.
TC may enhance quality of life, exercise capacity, and sleep stability in patients with chronic HF.
回顾一项太极拳项目（TC）对心力衰竭（HF）患者的生理和心理社会影响，该研究结果已在之前的一项临床试验中报道。
我们将30例慢性HF患者（左心室射血分数≤40%）随机分为两组，一组接受TC加常规护理（n = 15），另一组仅接受常规护理（等待名单对照组，n = 15）。结局指标包括生活质量、运动能力、B型利钠肽、儿茶酚胺水平、心率变异性和睡眠稳定性。
患者的平均年龄（±标准差）为64±13岁，平均基线射血分数（±标准差）为23±7%，纽约心脏协会心功能分级中位数为2级（范围1 - 4级）。在12周时，与对照组相比，参与TC的患者生活质量得到改善（明尼苏达心力衰竭生活问卷平均变化-17±11 vs. 8±15，p = 0.001），运动能力增强（6分钟步行平均变化85±46 vs. -51±58米，p = 0.001），B型利钠肽降低（平均变化-48±104 vs. 90±333 pg/ml，p = 0.03）。与对照组相比，参与TC的患者睡眠稳定性也有所改善（估计总睡眠时间中高频耦合增加+0.05±0.10 vs. -0.06±0.09，p = 0.04；低频耦合减少-0.09±0.09 vs. +0.13±0.13，p < 0.01）。
TC可能提高慢性HF患者的生活质量、运动能力和睡眠稳定性。
