中医药治疗联合中医护理在经皮冠状动脉介入术后再狭窄患者的应用分析

Application analysis of TCM treatment combined with TCM nursing in patients with restenosis after percutaneous coronary intervention

目的:分析探讨中医药治疗联合中医护理在经皮冠状动脉介入(PCI)术后再狭窄(ISR)患者的应用价值。方法:选取2014年9月-2017年3月我院收治的108例PIC术后ISR患者,采用随机数字表法分为观察组和对照组,每组54人。两组患者均给予中西医联合治疗(阿托伐他汀钙片10mg,1次/d;氯吡格雷片150mg,2次/d;阿司匹林肠溶片100 mg,1次/d;中药采用养心汤,基础组方白芍、黄芪、麦冬、红参、川芎、枳壳、五味子、当归、生地黄、牛膝、苍术、半夏、木香、甘草)。在此基础上,对照组采用心内科常规护理,观察组采用常规护理+中医护理。最后,于治疗前后参考《中药新药临床研究指导原则》评判患者临床疗效标准,自我护理能力测定表评判患者自我护理能力,并加以分析比较。结果:观察组患者的临床疗效为79.63%(43/54),高于对照组的临床疗效62.96%(34/54),差异有统计学意义(P<0.05)。另外干预后,两组患者的自我护理能力均明显改善,观察组患者的健康知识水平、自我概念、自我责任感、自我管理能力、总分等均高于对照组,差异有统计学意义(P<0.05)。结论:中医药治疗联合中医护理通过抑制PCI术后ISR患者的炎症反应,改善其ISR症状,并提高患者的自我护理能力。

Objective： To explore the application value of TCM treatment combined with TCM nursing in patients with restenosis after percutaneous coronary intervention. Methods： 108 patients with restenosis after percutaneous coronary intervention treated in our hospital from September 2014 to March 2017 were selected and randomly divided into the observation group and the control group, with 54 cases in each group. Both groups received integrated TCM and western medicine treatment（Atorvastatin, 10 mg, once every day; Clopidogrel tablets 150 mg, twice every day; Aspirin Enteric-coated tablets 100 mg, once every day; TCM Yangxin decoction（ 养心汤）： Radix Paeoniae Alba, Radix Astragali, radix ginseng, Rhizoma Chuanxiong（ 川芎）, Fructus aurantii, angelica, rehmannia, Schisandra chinensis, Rhizoma Atractylodis, radix, pinellia, licorice, Radix Aucklandiae）. On the basis of integrated treatment, the control group received routine nursing while the observation group received routine nursing combined with TCM nursing. Before and after treatment, Guiding principles of clinical research on new drugs of traditional Chinese medicine was referred to as criteria for evaluating the clinical efficacy of patients and self-care ability measurement table was used to judge the patient’s self nursing ability, analysis and comparison of two groups were made. Results： The total effective rate of the observation group was 79.63%（43/54）, which was significantly higher than that of the control group, 62.96%（34/54）, the difference was of statistical significance（P〈0.05）. In addition, the self-care ability of two groups was significantly improved after intervention. The health knowledge level, self-concept, self responsibility, self-management ability and total score of the observation group were all higher than those of the control group, the difference was of statistical significance（P〈0.05）. Conclusion： TCM treatment combined with TCM nursing could relieve the ISR symptoms and improve the patient’s self nursing ability by inhibiting the inflammatory reaction of ISR patients after PCI operation.