中医体质对血瘀质慢性心力衰竭患者的生命质量影响
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摘要
目的:观察中医体质干预对慢性心力衰竭患者生命质量的影响,为体质干预调理慢性心力衰竭提供依据。方法:选取2017年1月至2018年12月于北京中医医院顺义医院治未病科和心血管科就诊的体质辨识属于血瘀质的慢性心力衰竭患者86例作为研究对象,随机分为观察组和对照组,对照组使用西药(ARB、ACEI、β受体阻滞剂、醛固酮受体拮抗剂、利尿剂)治疗;观察组在对照组的基础上,采用调理体质的方法进行干预。6个月后,分别观察并比较2组心力衰竭患者心功能、pro-BNP、6 min步行距离(6 MWT)、明尼苏达心力衰竭生命质量量表(MLHFQ)评分的变化。结果:1) 2组患者治疗后,观察组的总有效率93%,对照组的总有效率74%,2组的总有效率比较,具有统计学意义,P <0. 05。2) 2组患者治疗前后Pro-BNP比较,数据有统计学意义(P <0. 05)。治疗后2组患者的Pro-BNP比较也有统计学意义(P <0. 05)。3) 2组患者治疗前后6 MWT比较均有统计学意义(P <0. 05)。治疗后2组患者6步行试验比较,步数也具有统计学意义(P <0. 05)。4)治疗前后2组心力衰竭患者的MLHFQ评分,经计算,均有显著性的统计学意义。治疗后2组患者比较,亦均有统计学意义(P <0. 05)。结论:通过体质干预结合西药常规治疗慢性心力衰竭,能够改善患者心功能、提高运动耐量,改善患者的生命质量,在慢病管理中可以推广。
Objective: To observe the influenceeffects of TCM constitutional intervention on the quality of life of patients with chronic heart failure,and to provide evidence for physical intervention to regulate chronic heart failure. Methods: From January 2017 to December 1818,at Department of Preventive Treatment and Cardiovascular Department of Beijing Hospital of Traditional Chinese Medicine Shunyi Hospitalthe Shunyi Hospital of Beijing Chinese Medicine Hospital,the physical and mental health examinations were performed. 86 patients with chronic heart failure who belonged to blood stasis were divided into the treatment group and the control group,. and t The control group. was given Western medicine( ARB,ACEI,β-blockers,aldosterone receptor antagonists,diuretics) was used for treatment; the treatment group was treated with conditioning method based on the control group. Six months later,changes in cardiac function,pro-BNP,6-minute walking distance( 6 MWT),and Minnesota Heart Failure Quality of Life Scale( MLHFQ) scores were observed and compared between the two groups. Results: 1) AAfter treatment,the total effective rate of the treatment group was 93%,and the total effective rate of the control group was 74%. The total effective rate of the two groups was statistically significant( P < 0. 05). 2) There were significant differences in the data between Pro-BNP before and after treatment( P < 0. 05). There was also a statistically significant difference in Pro-BNP between the two groups after treatment( P < 0. 05). 3)There were significant differences in 6 MWT between the two groups before and after treatment( P < 0. 05). After the treatment,the number of steps was also statistically different( P < 0. 05). 4) The MLHFQ scores of the two groups of heart failure patients before and after treatment were statistically significant. There were also statistical differences between the two groups after treatment( P <0. 05). Conclusion: The combination of physical intervention and western medicine in the treatment of chronic heart failure can improve the heart function,improve exercise tolerance and improve the quality of life of patients. It can be promoted in chronic disease management.
Objective: To observe the influenceeffects of TCM constitutional intervention on the quality of life of patients with chronic heart failure,and to provide evidence for physical intervention to regulate chronic heart failure. Methods: From January 2017 to December 1818,at Department of Preventive Treatment and Cardiovascular Department of Beijing Hospital of Traditional Chinese Medicine Shunyi Hospitalthe Shunyi Hospital of Beijing Chinese Medicine Hospital,the physical and mental health examinations were performed. 86 patients with chronic heart failure who belonged to blood stasis were divided into the treatment group and the control group,. and t The control group. was given Western medicine( ARB,ACEI,β-blockers,aldosterone receptor antagonists,diuretics) was used for treatment; the treatment group was treated with conditioning method based on the control group. Six months later,changes in cardiac function,pro-BNP,6-minute walking distance( 6 MWT),and Minnesota Heart Failure Quality of Life Scale( MLHFQ) scores were observed and compared between the two groups. Results: 1) AAfter treatment,the total effective rate of the treatment group was 93%,and the total effective rate of the control group was 74%. The total effective rate of the two groups was statistically significant( P < 0. 05). 2) There were significant differences in the data between Pro-BNP before and after treatment( P < 0. 05). There was also a statistically significant difference in Pro-BNP between the two groups after treatment( P < 0. 05). 3)There were significant differences in 6 MWT between the two groups before and after treatment( P < 0. 05). After the treatment,the number of steps was also statistically different( P < 0. 05). 4) The MLHFQ scores of the two groups of heart failure patients before and after treatment were statistically significant. There were also statistical differences between the two groups after treatment( P <0. 05). Conclusion: The combination of physical intervention and western medicine in the treatment of chronic heart failure can improve the heart function,improve exercise tolerance and improve the quality of life of patients. It can be promoted in chronic disease management.
引文
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[9]李凡,陶娟,涂亚庭.刺山柑乳膏治疗银屑病的临床观察[J].中国医药,2013,8(10):1453-1454.
[10]卜晓佳. 6分钟步行试验在慢性心力衰竭患者中的应用进展[J].中国心血管杂志,2014,19(2):158-160.
[11]Keteyian SJ,Pina IL,Hibner BS,et al. Clinical role of exercise training in the management of patients with chronic heart failure[J]. Journal of cardiopulmonary rehabilitation and prevention,2010,30:67-76.
[12]O Connor CM,Whellan D J,Lee KL,et al. Efficacy and safety of exercise training in patients with chronic heart failure. HF-ACTION randomized controlled trial[J]. JAMA,2009,301:1439-1450.
[13]吕均,樊慧,岳良明,等.有氧运动对不同体质老年高血压伴心衰患者的影响J].中国中医药现代远程教育,2014,12(6):91-92.
[14]Smith S J,Benjamin E J,Bonow R O,et al. AHA/ACCF secondary prevention and risk reduction:therapy for patients with coronary and other atherosclerotic vascular disease:2011 update[J]. Circulation,2011,124:2458.
[15]陈燕,梁涛.心力衰竭患者运动康复的研究进展[J].中华护理杂志,2013,48(7):666-668.
[2]中国心血管病报告编写组.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521.
[3]张健,张宇辉.多中心、前瞻性中国心力衰竭注册登记研究———病因、临床特点和资料情况初步分析[J].中国循环杂志,2015,30(5):413.
[4]张子彬,Tsung 0. Cheng[美],张玉传.充血性心力衰竭学[M].北京:科学技术文献出版社,2000:3-24,551-570.
[5]顾东风,黄广勇,何江,等.中国心力衰竭流行病学调查及其患病率[J].中华心血管病杂志,2003,31(1):3-6.
[6]童建军,柏建中. 307例慢性心力衰竭病因分析[J].承德医学院学报,2010,27(4):383-384.
[7]魏玲,苏瑶,付莉,等.老年慢性心力衰竭的多病因性及心衰类型分析[J].西南国防医药,2010,20(3):259-261.
[8]王琦.中医体质学[M].北京:人民卫生出版社,2009,1:2.
[9]李凡,陶娟,涂亚庭.刺山柑乳膏治疗银屑病的临床观察[J].中国医药,2013,8(10):1453-1454.
[10]卜晓佳. 6分钟步行试验在慢性心力衰竭患者中的应用进展[J].中国心血管杂志,2014,19(2):158-160.
[11]Keteyian SJ,Pina IL,Hibner BS,et al. Clinical role of exercise training in the management of patients with chronic heart failure[J]. Journal of cardiopulmonary rehabilitation and prevention,2010,30:67-76.
[12]O Connor CM,Whellan D J,Lee KL,et al. Efficacy and safety of exercise training in patients with chronic heart failure. HF-ACTION randomized controlled trial[J]. JAMA,2009,301:1439-1450.
[13]吕均,樊慧,岳良明,等.有氧运动对不同体质老年高血压伴心衰患者的影响J].中国中医药现代远程教育,2014,12(6):91-92.
[14]Smith S J,Benjamin E J,Bonow R O,et al. AHA/ACCF secondary prevention and risk reduction:therapy for patients with coronary and other atherosclerotic vascular disease:2011 update[J]. Circulation,2011,124:2458.
[15]陈燕,梁涛.心力衰竭患者运动康复的研究进展[J].中华护理杂志,2013,48(7):666-668.