分级诊疗制度下全科—专科中西医结合管理模式对气阴两虚型房颤患者干预效果研究

Inter vention of Integrated Traditional Chinese and Western Medicine in Community Based on Hierarchical Diagnosis and Treatment Situation Fibrillation Patients with Qi and Yin Deficiency Syndrome Effect of Research

目的:观察分级诊疗制度下全科—专科中西医结合管理模式对气阴两虚型房颤患者的干预效果,以进一步提升社区医疗服务能力。方法:选取2020年1月—2021年12月上海市浦东新区上钢社区卫生服务中心收治的气阴两虚型房颤患者100例,将其随机分为观察组(n=50)和对照组(n=50)。观察组采用“全科—专科”管理中西医结合管理模式,对照组采用家庭医生常规管理模式。干预时间为180天,比较两组患者的干预效果。结果:干预后,观察组患者认知评价得分增加(16.22±0.78)分、遵医行为评价得分增加(5.76±1.35)分、CSMS量表得分增加(26.22±0.78)分、SF-36量表得分增加(262.22±15.84)分,对照组各项得分分别增加(7.38±0.22)分、(1.61±0.51)分、(7.38±0.22)分和(145.25±13.31)分,两组比较差异均有统计学意义(t值分别为42.246、11.014、65.246和20.915,P值均<0.05)。观察组患者中医症状评分和心率疗效评估总有效率分别为90%和96%,均高于对照组(74%和84%),差异均有统计学意义(χ^(2)值分别为4.522和4.000,P值均<0.05)。结论:分级诊疗制度下“全科—专科”中西医结合管理模式对气阴两虚型房颤患者的管理效果优于家庭医生常规管理模式,凸显了中医适宜技术在社区慢性病管理中的作用,提升了社区医疗服务能力。

OBJECTIVE To observe the pairs of different management modes under the situation of hierarchical diagnosis and treatment Fibrillation Patients with Qi and Yin Deficiency Syndrome Evaluation of intervention effect.METHODS A total of 100 patients with atrial fibrillation admitted to Shanghai from January 2020 to December 2021 were randomly divided into observation group(n=50)and control group(n=50).The observation group adopted the“general practice-specialty”management mode of integrated Chinese-westem medicine.The control group used the family doctor routine management model.The intervention period lasted for 180 days.To compare the intervention effect in the two patient groups.RESULTS After the intervention,In the observation group,cognitive evaluation score(16.22±0.78),compliance behavior score(5.76±1.35),CSMS score(26.22±0.78),SF-36 score(262.22±15.84).The scores of the control group increased(7.38±0.22),(1.61±0.51),(7.38±0.22),(145.25±13.31),respectively(X^(2)=42.246,11.014,65.246,20.915,respectively,P<0.05).In the observation group,the total response rate of TCM symptom score and heart rate efficacy assessment was 90%and 96%,respectively,which were higher than that of the control group(74%and 84%),and the differences were statistically significant(X^(2)=4.522,4.000,respectively,P<0.05).CONCLUSION Under the hierarchical diagnosis and treatment system,the“general practice--specialty”integrated traditional Chinese and W estern medicine management mode has a better management effect of patients with Qi and Yin than the conventional management mode of family doctors,highlighting the role of appropriate Chinese medic ine technology in community chronic disease management,and improving the ability of community medical service.