“24式简化太极拳”对维持性血液透析患者多维度健康结局的影响

Effects of “24-Style Simplified Tai Chi” on Multidimensional Health Outcomes in Patients Undergoing Maintenance Hemodialysis

摘要: 目的：探讨“24式简化太极拳”干预对维持性血液透析(Maintenance Hemodialysis, MHD)患者多维度健康结局的影响，为临床康复管理提供科学依据。方法：采用前瞻性、单中心，利用随机数字表法，将2024年1月至2025年6月在南充市中心医院血液透析中心接受治疗的60例MHD患者按1:1比例随机分为试验组(n = 30)和对照组(n = 30)。两组患者在维持原有透析与治疗方案基础上，对照组接受常规护理；试验组在常规护理基础上进行为期18个月的“24式简化太极拳”训练干预。干预前后分别评估生存质量(简明健康调查问卷，SF-36)、心理状态(焦虑自评量表，SAS；抑郁自评量表，SDS)、睡眠质量(匹兹堡睡眠质量指数，PSQI)、疲劳程度(Piper疲劳量表，PFS)、衰弱程度(FRAIL量表)、平衡能力(Berg平衡量表)、四肢肌肉量(骨骼肌质量指数，ASMI)、心肺功能、炎症指标(C-反应蛋白，CRP)以及肺部感染发生率、心血管事件、住院率、跌倒事件等临床终点。结果：干预18个月后，试验组在生存质量、心理状态、睡眠质量、体力功能、心肺耐力、CRP水平等方面均较对照组显著改善(P < 0.05)。在临床终点方面，试验组的心血管事件发生率与住院率亦显著低于对照组(P < 0.05)，而肺部感染与跌倒事件未见统计学差异。结论：规律练习“24式简化太极拳”可有效改善MHD患者的微炎症状态、心肺功能、身体疲劳、心理健康与生活质量，并可能降低心血管并发症与住院风险，为MHD患者提供了一种安全、可行且具有多重益处的非药物康复干预策略。

Abstract: Objective: To investigate the effects of “24-form simplified Tai Chi” intervention on multidimensional health outcomes in patients undergoing Maintenance Hemodialysis (MHD), providing a scientific basis for clinical rehabilitation management. Methods: A prospective, single-center study was conducted. Using a random number table, 60 MHD patients treated at the Hemodialysis Center of Nanchong Central Hospital between January 2024 and June 2025 were randomly assigned in a 1:1 ratio to an intervention group (n = 30) or a control group (n = 30). While maintaining their original dialysis and treatment regimens, the control group received routine care. The intervention group received routine care plus an 18-month “24-form simplified Tai Chi” training intervention. Assessments pre- and post-intervention included quality of life (Short Form-36 Health Survey, SF-36), psychological status (Self-Rating Anxiety Scale, SAS; Self-Rating Depression Scale, SDS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), fatigue level (Piper Fatigue Scale, PFS), frailty status (FRAIL Scale), balance ability (Berg Balance Scale), limb muscle mass (Appendicular Skeletal Muscle Mass Index, ASMI), cardiopulmonary function, inflammatory markers (C-reactive protein, CRP), as well as clinical endpoints including incidence of pulmonary infection, cardiovascular events, hospitalization rate, and fall events. Results: After 18 months of intervention, the intervention group showed significant improvements compared to the control group in quality of life, psychological status, sleep quality, physical function, cardiopulmonary endurance, and CRP levels (P < 0.05). Regarding clinical endpoints, the incidence of cardiovascular events and hospitalization rate were also significantly lower in the intervention group than in the control group (P < 0.05), while no statistically significant differences were observed in pulmonary infections and fall events. Conclusion: Regular practice of “24-form simplified Tai Chi” can effectively improve the micro-inflammatory state, cardiopulmonary function, physical fatigue, psychological health, and quality of life in MHD patients, and may reduce the risk of cardiovascular complications and hospitalization. It provides a safe, feasible, and multi-beneficial non-pharmacological rehabilitation intervention strategy for MHD patients.