基于“三辨三期三调”探讨针药联合对慢性心力衰竭患者运动耐力影响的真实世界研究

A Real-World Study on the Effect of Combined Acupuncture and Traditional Chinese Medicine on Exercise Tolerance in Patients with Chronic Heart Failure Based on"Three Identifications,Three Phases and Three Adjustments"

目的基于“三辨三期三调”探讨真实世界中针药联合对慢性心力衰竭患者运动耐力的影响。方法基于大型医院信息系统(hospital information system,HIS)集成数据库,提取2017年1月-2022年8月云南中医药大学第一附属医院/云南省中医医院所有出院诊断为慢性心力衰竭患者病例,共纳入1080例。将应用“三辨三期三调”针药联合疗法529例设为观察组,未应用“三辨三期三调”针药联合疗法551例设为对照组。通过χ2检验、倾向评分匹配法分析两组患者运动耐力疗效。结果倾向评分法处理前后均显示观察组总有效率明显优于对照组(P<0.001)。结论基于“三辨三期三调”针药联合治疗能够明显改善慢性心力衰竭患者的运动耐力。

Objective To explore the impact of acupuncture and medicine combination on exercise endurance in patients with chronic heart failure in the real world based on the"three identifications,three phases,and three adjustments".Methods Based on the integrated database of large hospital information system(HIS),1080 patients with chronic heart failure diagnosed as discharged,were selected.from the First Affiliated Hospital of Yunnan University of Chinese Medicine,Yunnan Provincial Hospital of Traditional Chinese Medicine from January 2017 to August 2022.529 cases of using the combination therapy of"three identifications,three phases,and three adjustments"acupuncture and medicine were set as the observation group,while 551 cases of not using the combination therapy of"three identifications,three phases,and three adjustments"acupuncture and medicine were set as the control group.Adoptχ2 Test and propensity score matching were used to analyze the effect of exercise endurance of patients in the two groups.Results The propensity score method showed that the total effective rate of the observation group was significantly better than that of the control group before and after treatment(P<0.001).Conclusion The combination therapy of acupuncture and medicine based on the principle of"three identifications,three phases,and three adjustments"can significantly improve the exercise endurance of patients with chronic heart failure.