中西医结合对慢性心力衰竭康复治疗的作用

Rehabilitation therapeutic effects of integrated TCM and WM in patients with chronic cardiac failure

关键词:  心衰康复  中西医结合  炙甘草汤

Key words:  rehabilitation of congestive heart failure  integrated TCM with WM  Zhigancao decoction

摘要:

[目的]观察中西医结合对慢性充血性心力衰竭(CHF)康复治疗的作用。[方法]将90例CHF患者随机分为两组。对照组45例,予西医强心、利尿、减轻心脏负荷及运动康复训练。治疗组45例,在对照组治疗基础上根据中医辨证予以炙甘草汤加味治疗。均以1个月为1个疗程,共治疗3个疗程。[结果]总有效率、显效率治疗组分别为86.67%,37.78%,对照组分别为75.56%,26.67%,两组比较,治疗组优于对照组,差异均有显著性意义(P<0.05)。两组治疗后基础心率、6 min步行试验及左心室射血分数均有显著改善,与治疗前比较,差异有显著性或非常显著性意义(P<0.05,P<0.01);其中治疗后两组6 min步行试验比较,治疗组优于对照组,差异有显著性意义(P<0.05)。治疗后两组中医证候及Boston心力衰竭诊断标准积分均有明显改善,与治疗前比较,差异均有显著性意义(P<0.05)。[结论]在慢性心衰康复治疗中采用中西医结合疗法,应用中药炙甘草汤加味联合西药及心衰康复运动训练,能提高临床疗效,促进心衰患者的体能恢复,改善患者生存质量。

Abstract:

[Objective] To observe the rehabilitation management effect of traditional Chinese medicine(TCM) combined with Western medicine(WM) in patients with chronic cardiac failures.[Methods] Ninety patients with chronic cardiac failure were randomly divided into two groups.The 45 patients of control group were treated with drugs of strengthen heart,diuretic and reducing heart’s load.At the same time they did a rehabilitation exercises.The 45 patients of treatment group were treated with Western medicine drugs,rehabilitation exercises and Zhigancao decoction according to the diagnostic and therapeutic principle of TCM.A course of treatment was 1 month,The two groups were all treated for three courses.[Results] The total effective rate was 86.67% and 75.56%(P<0.05),obvious effective rate was 37.78% and 26.67%(P<0.05) in control group and treatment group respectively.The patients in both groups were significantly improved in basal heart rate,6 min walking test and left ventricular ejection fraction after treatment.Compared with the result before treatment the statistical difference was significant or very significant(P<0.05,P<0.01).The patients in treatment group was significantly improved in 6min walking test,having statistical significance when compared with control group.(P<0.05).The patients in both groups were significantly improved in TCM syndrome and Boston cardiac failure diagnostic criteria scores after treatment.Compared with pre-treatment statistical significance was obvious(P<0.05).[Conclusion] The therapeutic effect of the integrated TCM with WM in treating chronic cardiac failure is significant.Zhigancao decoction combined with Western medicine and rehabilitation exercise can improve the clinical curative effect,promote the recovery of physical ability,improve the life quality in patients with of chronic cardiac failure.