Impact of individualized exercise based on cardiopulmonary monitoring combined with acupuncture at Jiaji points on oxidative stress-related indicators in patients after PCI

Shao Minglu; Ren Min; Zhuang Yan; Qu Yu; Jiang Linling; Ma Guanghui; Gan Mengjie; Meng Xianzhong

doi:10.11986/j.issn.1673-873X.2024.07.14

Abstract：Objective To investigate the impact of individualized exercise based on cardiopulmonary exercise testing combined with acupuncture at Jiaji points on the cardiopulmonary function and oxidative stress-related indicators in patients after per-cutaneous coronary intervention(PCI)for coronary heart disease,to provide a reference for clinical decision-making.Meth-ods A total of 120 patients who underwent PCI and visited the Department of Rehabilitation Medicine and the outpatient service of Department of Cardiology at Pudong New Area People's Hospital from January 2021 to December 2023 were se-lected as the study participants and randomly assigned to four groups:acupuncture group,rehabilitation group,combined group,and control group,with 30 cases in each group.All groups underwent cardiopulmonary exercise testing before and after treatment.The control group received standardized drug treatment.The other three groups received treatment based on the control group,with the acupuncture group receiving acupuncture at Jiaji points,the rehabilitation group receiving in-dividualized exercise treatment based on cardiopulmonary exercise testing,and the combined group receiving both acupunc-ture at Jiaji points and individualized exercise treatment,with an observation period of 8 weeks for all groups.The primary outcome measure was the peak oxygen uptake(VO2/kg)after treatment,and the peak metabolic equivalent(MET)value,oxygen pulse(VO2/HR),and the slope of the carbon dioxide ventilatory equivalent(VE/VCO2)were compared among the groups before and after treatment.The levels of plasma superoxide dismutase(SOD),malondialdehyde(MDA),heme oxygen-ase-1(HO-1),and glutathione peroxidase 4(GPX4)were measured and compared before and after treatment.Results A total of 107 patients completed the observation,and the baseline data of all groups were comparable(P＞0.05).Within-group comparisons showed that the peak MET and VO2/HR increased significantly,and the VE/VCO2 slope decreased significantly in the acupuncture group after treatment(P＜0.05).The peak VO2/kg,MET,and VO2/HR increased significantly,and the VE/VCO2 slope de-creased significantly in the rehabilitation group and the combined group after treatment(P＜0.05).Between-group comparisons showed that the peak VO2/kg and the average VE/VCO2 slope were significantly better in the combined group than in the other three groups after treatment(P＜0.05).No statistically significant differences were observed in the above indicators between the acupuncture group and the rehabilitation group after treatment(P＞0.05).Within-group comparisons showed that the levels of SOD,HO-1,and GPX4 increased significantly,and the level of MDA decreased significantly in the acu-puncture group,rehabilitation group,and the combined group after treatment(P＜0.05).Between-group comparisons showed that the improvement in the above indicators was significantly better in the combined group than in the other three groups after treatment(P＜0.05).Conclusion Individualized exercise prescription based on cardiopulmonary exercise tes-ting combined with acupuncture at Jiaji points demonstrates favorable effects on the cardiopulmonary function of patients af-ter PCI for coronary heart disease,which is better than acupuncture or rehabilitation treatment alone.The combined treat-ment can increase the levels of plasma SOD,HO-1,and GPX4,and decrease the level of MDA,indicating that the com-bined treatment can effectively resist oxidative stress and play a role in cardiac protection,justifying promotion in clinical practice.