Abstract: Background　Obesity-related hypertension（ORH），as a long-term persistent chronic disease，is growing in prevalence in China. Exercise is an important means of prevention and treatment for ORH，but due to the limitations of space，distance and cost in exercise rehabilitation，exercise completion and compliance are mostly difficult to ensure，and the health benefits of exercise are greatly reduced. Therefore，it is important to explore appropriate exercise prescription and management models. Objective　To evaluate the clinical efficacy and safety of five-body balance exercise based on the "hospital-gym-community" model for patients with ORH. Methods　This was a prospective randomised controlled study. 84 ORH patients recruited at Guang'anmen Hospital of the China Academy of Traditional Chinese Medicine from June 2022 to December 2023 were selected and randomly divided into the experimental group（n=42） and the control group（n=42） by using the SPSS 26.0 online random number generator. Subjects in both groups received the same lifestyle intervention. The control group was provided with moderate-intensity aerobic exercise，and the experimental group was provided with the five-body balance exercise training based on the "hospital-gym-community" rehabilitation model for a period of 6 months. Systolic blood pressure（SBP），diastolic blood pressure（DBP），mean arterial pressure（MAP），waist circumference（WC），body weight（BW），body mass index （BMI），hip circumference（HC），waist-to-hip ratio（WHR），waist-to-height ratio（WHtR），fasting blood glucose （GLU），total cholesterol（TC），low-density lipoprotein cholesterol（LDL-C），very low-density lipoprotein cholesterol （VLDL-C），triglycerides（TG），serum ceramides（Cer），Self-rating Anxiety Scale（SAS），Self-rating Depression Scale（SDS），Short-form Health Survey-36（SF-36），and Pittsburgh Sleep Quality Index（PSQI） were observed before and after the intervention in the two groups of subjects. The major adverse cardiovascular events（MACE） and exercise injuries that occurred during the intervention were also recorded. Results　Eventually 37 subjects in the experimental group and 36 subjects in the control group completed the trial. After 6 months of rehabilitation，SBP，DBP，MAP，WC，BW，BMI，HC，WHR，WHtR，LDL-C，Cer，SAS，SDS，and PSQI in the experimental group were lower than those in the control group（P<0.05），SF-36 was higher than those in the control group（P<0.05），and there was no statistically significant difference between GLU，TC，VLDL-C，TG in the experimental group and the control group（P>0.05）. SBP，DBP，MAP，WC，BW，BMI，HC，WHR，WHtR，GLU，LDL-C，VLDL-C，TG，Cer，SAS，SDS，and PSQI were lower than before the intervention in the experimental group（P<0.05），SF-36 was higher compared to the pre-intervention in the experimental group（P<0.05），and the difference in TC before and after the intervention was not statistically significant（P>0.05）. There were no MACE or exercise injuries in both groups. Conclusion　The five-body balance exercise based on the "hospital-gym-community" rehabilitation model can promote the blood pressure and morphological indexes of patients with ORH，improve the quality of life，and its efficacy is better than the conventional aerobic exercise，with good safety. It also reduces serum ceramide levels，reflecting to some extent the potentially beneficial effects of the exercise programme in reducing cardiovascular risk.

Key words: Obesity-related hypertension, Five-body balance exercise, Traditional Chinese medicine exercise, Rehabilitation mode, Efficacy research

摘要： 背景　肥胖相关性高血压（ORH）作为一种长期持续的慢性病，在我国的发病率日益增长。运动是ORH 重要的防治手段，但由于运动康复中场地、距离和费用的限制，运动的完成度和依从性多难以保证，运动所带来的健康效益被大幅降低。因此，探索合适的运动处方和管理模式至关重要。目的　评估基于“医院 - 体育馆 - 社区”模式的五体平衡操运动对 ORH 患者的临床有效性和安全性。方法　本研究为前瞻性随机对照研究。选取 2022 年 6月—2023 年 12 月在中国中医科学院广安门医院招募的 ORH 患者 84 例为研究对象，利用 SPSS 26.0 在线随机数生成器随机分为试验组（n=42）和对照组（n=42）。两组受试者均接受相同的生活方式干预，对照组配合中等强度的有氧运动，试验组配合基于“医院 - 体育馆 - 社区”康复模式的五体平衡操训练，干预周期为 6 个月。观察两组受试者干预前后的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、腰围（WC）、体质量（BW）、体质指数（BMI）、臀围（HC）、腰臀比（WHR）、腰高比（WHtR）、空腹血糖（GLU）、血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL-C）、三酰甘油（TG）、血清神经酰胺（Cer）以及焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活质量量表（SF-36）和匹兹堡睡眠质量量表（PSQI）得分，并记录干预过程出现的主要心血管不良事件（MACE）和运动损伤情况。结果　最终，试验组 37 例、对照组 36 例受试者完成了试验。6 个月康复锻炼后，试验组 SBP、DBP、MAP、WC、BW、BMI、HC、WHR、WHtR、LDL-C、Cer 及 SAS、SDS、PSQI 得分低于对照组（P <0.05），SF-36 得分高于对照组（P <0.05）；GLU、TC、VLDL-C、TG 与对照组比较，差异无统计学意义（P>0.05）。试验组的干预后 SBP、DBP、MAP、WC、BW、BMI、HC、WHR、WHtR、GLU、LDL-C、VLDL-C、TG、Cer 及 SAS、SDS、PSQI 得分低于干预前（P <0.05），SF-36 得分高于干预前（P <0.05）；TC 与干预前比较，差异无统计学意义（P>0.05）。两组均未出现 MACE 和运动损伤。结论　基于“医院 - 体育馆 - 社区”康复模式的五体平衡操运动能较好地改善 ORH 患者的血压和形态学指标，提高患者的生活质量，疗效优于常规有氧运动，安全性较好，同时还可以降低血清 Cer 水平，一定程度上反映了该运动方案在降低心血管风险中的潜在有益效应。

关键词: 肥胖相关性高血压, 五体平衡操, 中医传统运动, 康复模式, 疗效研究