目的探讨太极拳运动对血液透析患者焦虑、抑郁状态和睡眠质量的影响。方法采用非随机、同期对照研究的方法，按照纳排标准入选后，根据患者意愿将愿意参加太极拳运动的40 例患者作为干预组，同时在所有符合入组条件的患者中选取年龄、体质量指数相匹配的40 例患者作为对照组。两组患者均予常规血液透析治疗及护理，干预组在此基础上接受由研究者提供的规律太极拳运动；对照组日常活动照常，但不采取任何运动干预。6 个月后对两组患者的焦虑、抑郁状态和睡眠质量进行评价。结果共有71 例患者完成研究，退出9 例(干预组6 例，对照组3 例)。6 个月后，干预组的焦虑和抑郁得分均低于对照组(焦虑自评量表得分：46.36±8.21 比50.49±9.88，t =-3.848，P=0.001；抑郁自评量表得分：41.39±9.04 比51.39±10.25，t =-4.862，P =0.001)，匹兹堡睡眠质量指数总分(7.15±4.27比9.29±4.02, t=-2.194，P=0.032)及睡眠持续性(0.91±0.83 比1.39±1.08，t =-2.110，P =0.038)、睡眠效率(0.71±0.94 比1.53±1.16，t=-3.281，P=0.002)两个因子得分均低于对照组。结论太极拳运动能改善血液透析患者的焦虑、抑郁状态，并能提高睡眠质量，可以作为血液透析患者选择的一种运动方式，值得临床推广。
Objective To investigate the effect of Tai Chi exercise on the improvement of anxiety, depression and sleep quality in hemodialysis patients. Methods This was a non- randomized and concurrent control trial. A total of 40 patients willing to take part in this study were enrolled as the intervention group. At the same time, 40 patients with age and body mass index matched to those in intervention group were selected as the control group. Patients in the two groups received regular hemodialysis and nursing. Tai Chi training provided by the researchers was conducted in the intervention group, but not in the control group. The anxiety
and depression scores and sleep quality were measured after 6 months. Results Seventy-one patients (in intervention group 6 cases dropped out; in control group 3 cases dropped out) completed this study. After 6 months, the intervention group had lower scores of self- rating anxiety scale (SAS) (46.36±8.21 vs. 50.49± 9.88, t=3.848, P=0.001), self-rating depression scale (SDS) (41.39±9.04 vs. 51.39±10.25, t=4.862, P=0.001), Pittsburgh sleep quality index (7.15±4.27 vs. 9.29±4.02, t=2.194, P=0.032), sleep continuity (0.91±0.83 vs. 1.39±1.08, t=2.110, P=0.038), and sleep efficiency (0.71±0.94 vs. 1.53±1.16, t=3.281, P=0.002), as compared with those in the control group. Conclusion Tai Chi exercise can improve the state of anxiety and depression and sleep quality in hemodialysis patients. This exercise mode can be used in hemodialysis patients and can be carried out widely.
