基于中医养生理论的辨体施护在改善COPD患者临床症状和肺功能中的应用价值

Application value of constitutional differentiation nursing based on traditional Chinese medicine regime theory in improving the clinical symptoms and lung function in patients with chronic obstructive pulmonary disease

目的 探究基于中医养生理论的辨体施护在改善慢性阻塞性肺疾病(COPD)患者临床症状和肺功能中的应用价值。方法 选取2022年6月至2023年5月收治的120例COPD患者,按照随机数表法分为常规组和辨体施护组,每组60例。常规组实施常规护理方法,辨体施护组在常规组基础上采用基于中医养生理论的辨体施护措施,比较2组患者干预前后中医症状评分、COPD测试评分(CAT)、病情变化(急性发作次数、再住院次数、总住院耗时)、肺功能[1 s用力呼气容积(FEV1)、肺总量(TCL)、FEV1/FVC]、生活质量(QOL)及护理满意度。结果 干预前,2组组间及组内不同体质分型患者中医症状评分比较差异无统计学意义(P>0.05),干预后,2组中医症状评分、CAT评分均下降(P<0.05),且干预后辨体施护组低于常规组(P<0.05),而组内干预后不同体质分型患者中医症状评分比较差异无统计学意义(P>0.05);辨体施护组急性发作次数、住院次数和总住院耗时均少于常规组(P<0.05);干预后,2组FEV1、TLC和FEV1/FVC均升高,且干预后辨体施护组高于常规组(P<0.05);干预后,2组COPD-QOL各维度及总分均升高,且干预后辨体施护组生理、心理、环境评分及总分均高于常规组(P<0.05);辨体施护组满意度为93.33%,高于常规组的80.00%(P<0.05)。结论 中医养生理论的辨体施护可改善COPD患者临床症状和肺功能,控制疾病复发,提高远期疗效和护理满意度。

Objective To explore the application value of constitutional differentiation nursing based on traditional Chinese medicine(TCM)regime theory on improving the clinical symptoms and lung function in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 120 COPD patients were selected and randomly divided into the control group and constitutional differentiation nursing group by the random number table method,with 60 cases in each group.Patients in the control group were given routine nursing method,while those in the constitutional differentiation nursing group were given constitutional differentiation nursing based on TCM regime theory plus routine nursing.The TCM symptoms scores,COPD Assessment Test(CAT)score,disease condition changes(the number of acute attacks,the number of re-hospitalizations,total hospital stay),pulmonary function(forced expiratory volume in one second[FEV1],total capacity of lung[TCL],FEV1/forced vital capacity[FEV1/FVC]),quality of life(QOL)and nursing satisfaction were compared before and after intervention.Results Before intervention,there were no significant differences in TCM symptoms scores between the two groups and among patients with different constitution types within the groups(P>0.05).After intervention,the TCM symptoms scores and CAT score significantly decreased in both groups(P<0.05),and they were significantly lower in constitutional differentiation nursing group than the control group(P<0.05),However,there were no significant differences in TCM symptoms scores among patients with different constitution types within the groups after intervention(P>0.05).The number of acute attacks,the number of re-hospitalizations and total hospital stay were significantly less or shorter in constitutional differentiation nursing group than those of control group(P<0.05).After intervention,the FEV1,TLC and FEV1/FVC were significantly elevated in both groups,which were significantly higher in the constitutional differentiation nursing group than the control group(P<0.05).The scores of dimensions and total score of QOL in the two groups were significantly enhanced after intervention,and the scores of physiology,psychology and environment and total score in constitutional differentiation nursing group after intervention were significantly higher compared with those of control group(P<0.05).The satisfaction in constitutional differentiation nursing group was significantly higher than that of control group(P<0.05).Conclusion Constitutional differentiation nursing based on TCM regime theory can improve the clinical symptoms and pulmonary function in COPD patients,control the disease recurrence,and enhance the long-term efficacy and nursing satisfaction.