中医药参与冠心病支架术后心脏康复48例临床观察

Effect of traditional Chinese medicine on cardiac rehabilitation:an observation of 48 heart stent cases

目的探讨中医药参与心脏康复的效果。方法 96例心脏支架术后的患者随机分成综合康复组和对照组(各48例),对照组采用常规心脏康复(按照出院医嘱口服药物,健康宣教,开出运动处方)。综合康复组在常规心脏康复的基础上,应用中医体质辨识软件进行体质辨识,分为气虚血瘀型、阳虚型、痰湿型三型,给予中药汤剂口服、穴位针刺、穴位艾灸、刮痧治疗。观察8周后两组心电图、心脏超声和六分钟步行试验结果和SF-36量表各项评分情况。结果两组患者心电图(心率、心律、ST-T)、心脏超声结果(左室舒张末径、左室射血分数、E/A值)与治疗前比较无明显差异。两组六分钟步行试验治疗后均较治疗前有明显提高,但两组比较差异无统计学意义(P>0.05)。综合康复组SF-36量表各项评分与治疗前比较,除生理机能、情感职能[有所提高,但差异无统计学意义(P>0.05)]两项之外,均有明显改善(P<0.05),与对照组比较,差异有统计学意义(P<0.05)。对照组患者SF-36量表各项评分与治疗前比较也有提高,但是差异无统计学意义(P>0.05)。结论中医药参与的综合心脏康复提高了康复治疗效果,体现了对患者全面的服务和关爱,是从单纯生物医学模式向心理、生物、社会模式转变的探索。

Abstract：Objective To investigate the effect of traditional Chinese medicine on cardiac rehabilitation. Methods Ninety-six heart stent eases were randomly divided into comprehensive rehabilitation group and the control group ,48 cases for each group. The control group adopted routine cardiac rehabilitation （in accordance with the prescribed oral medication, the hospital health education, prescribing exercise）. Comprehensive rehabilitation group adopted conventional cardiac rehabilitation, in addition, based on application of constitution identification software for identification of constitution, patients divided into Qi deficiency type, yang deficiency type, phlegm dampness type, were given oral decoction of Chinese herbal medicine, acupuncture, moxibustion, and scraping therapy. Results After 8 weeks, ECG and uhrasonographic results were not significantly different from those before treatment. Six-minute walking experiment results greatly improved compared with those before treatment, yet with no significant difference between the two groups （ P 〉 0.05 ）. Except for physiological function and emotional function, SF-36 scale scores were greatly improved with significant difference between the two group（ P 〉 0.05 ）. SF-36 scale scores in the control group also increased compared with that before treatment ,but tbe difference was not statistically significant （P 〉 0.05 ）. Conclusions Comprehensive cardiac rehabilitation with traditional Chiese medicine improves the rehabilitation effect of patients ,which is to explore the transition from simple biomedical model to biological, psychological, social patterns.