中西医结合在慢性心衰康复治疗中的应用

Application of the integrative medicine in the rehabilitation treatment of chronic heart failure

目的:探究采用中西医结合的方法对慢性心力衰竭康复治疗的临床效果。方法:选取2011年12月～2013年1月我院慢性充血性心力衰竭病人78例,随机分为治疗组和对照组。对照组39例,给予西医利尿、强心、运动康复和减轻心脏负荷等常规训练。治疗组39例,在采用西医治疗的基础上依据中医辨证疗法选用炙甘草汤加味对患者进行治疗。4周为1个疗程,总计3个疗程。结果:将两组治疗结果进行对比,治疗组的显效率和总有效率分别为38%和87%均优于对照组的显效率和总有效率的27%和76%,具有显著差异性,有统计学意义(P<0.05)。对两组左心室射血分数、6min步行试验以及治疗后基础心率均有明显改善,相比于治疗前,差异有明显性或非常明显性意义(P<0.05,P<0.01);将治疗后两组6min步行试验结果进行比较,表明治疗组优于对照组,具有明显性差异(P<0.05)。治疗过程结束后治疗组以及对照组的Boston心力衰竭诊断标准积分都得到了显著的改善。相比于治疗前,具有明显性差异(P<0.05)。结论:运用中西医结合疗法针对慢性心衰康复治疗的过程中,可采用西药和心衰恢复运动训练联合中药炙甘草汤加味进行治疗,可以有效的提高临床治疗效果,缩短心衰病人的体能恢复时间,从根本上改善病人的生存质量。

Objective： To investigate the clinical effect of the integrative medicine on the rehabilitation treatment of chronic heart failure. Methods： To select 78 cases with chronic congestive heart failure from December 2011 to January 2013 in our hospital were randomly divided into treated group and control group. A control group of 39 cases, treated with modem medicine diuretic, strong heart, exercise rehabilitation and reduce the load on the heart and other conventional training. The treated groups of 39 cases were treated with TCM therapy selection of Zhigancao decoction based on the modem medicine treatment. 4 weeks for 1 courses of treatment, a total of 3 courses. Results： Comparing the results of two groups, the treated group markedly effective rate and total efficiency rate were 38% and 87% were better than the control group, 27% and 76%, there was a statistically significant （P〈0.05）. On two groups of left ventricular ejection fraction, 6 minutes walking test and the basis of heart rate after treatment were obviously improved, compared with before treatment, there were significant or very significant difference （P〈0.05, P〈0.01）; the two groups after the treatment, 6 minutes walking compared the test results, the treated group was better than the control group, with significant difference （P〈0.05）. Group and Boston heart failure diagnosis standard group integral process after the end of treatment was markedly improved. Comparing with first treatment, there was a statistically significant （P〈0.05）. Conclusion： The integrative medicine and heart failure recovery training combined with Zhigancao decoction can effectively improve the clinical treatment effect on treating chronic heart failure, shorten the recovery time of the patients with heart failure, improve the survival quality of patients radically.