标题：基于“整体观”的中医慢病管理模式对慢性心力衰竭患者疗效、心功能和生活质量的影响

      作者：徐卓婧，李娟，张芬红    西安市第五医院(陕西省中西医结合医院)心血管内科，陕西 西安 710082

      卷次： 2024年35卷1期

      【摘要】 目的 探讨基于“整体观”的中医慢病管理模式对慢性心力衰竭(CHF)患者的疗效、心功能和生活质量的影响。方法 选取2020年1月至2023年4月西安市第五医院心血管内科收治的99例CHF患者为研究对象，依据随机数表法分为对照组49例和中医组50例，对照组患者采取常规慢病管理，中医组患者在常规慢病管理基础上，基于“整体观”给予患者中医慢病管理模式干预，干预时间 3个月，比较两组患者的临床疗效，以及干预前后的中医症候总积分、氨基末端脑肽钠前体(NT-proBNP)水平、6 min步行试验距离(6MWD)、每搏输出量(SV)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)和明尼苏达生活质量(MLHFQ)评分。结果 中医组患者的治疗总有效率为 96.00%，明显高于对照组的 83.67%，差异有统计学意义(P<0.05)；干预前，两组患者的中医症候总积分、SV、LVESD、LVEDD、LVEF、NT-proBNP水平、6MWD、MLHFQ评分比较差异均无统计学意义(P>0.05)；干预后，两组患者的中医症候总积分、心脏功能指标、NT-proBNP水平、6MWD、MLHFQ评分均明显改善，且干预后，中医组患者的中医症候总积分、SV、LVESD、LVEDD、LVEF、NT-proBNP水平、6MWD、MLHFQ评分等指标改善明显优于对照组，差异均有统计学意义(P<0.05)。结论 CHF采取基于“整体观”的中医慢病管理模式治疗可提升患者临床疗效与生活质量，改善患者心脏功能。
      【关键词】 慢性心力衰竭；中医慢病管理模式；整体观；疗效；心脏功能；生活质量
      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2024）01—0043—05

Influence of TCM chronic disease management mode based on "holistic view" on the efficacy, cardiac function,and quality of life of patients with chronic heart failure.
XU Zhuo-jing, LI Juan, ZHANG Fen-hong. Department ofCardiovascular Medicine, Xi'an Fifth Hospital (Shaanxi Integrated Traditional Chinese and Western Medicine Hospital),Xi'an 710082, Shaanxi, CHINA
【Abstract】 Objective To observe the influence of TCM chronic disease management mode based on "holisticview" on the efficacy, cardiac function, and quality of life of patients with chronic heart failure. Methods Ninety-ninepatients with chronic heart failure admitted to Department of Cardiovascular Medicine, Xi'an Fifth Hospital from Janu-ary 2020 to April 2023 were selected and divided into a control group (49 cases) and a traditional Chinese medicinegroup (TCM group, 50 cases) according to random number table method. Patients in the control group received con-ventional chronic disease management, and patients in the traditional Chinese medicine group received TCM chronicdisease management mode based on "holistic view" plus conventional chronic disease management, for 3 months. Theclinical efficacy of the two groups of patients was compared, as well as the total score of TCM symptoms, the level ofamino-terminal brain natriuretic peptide precursor (NT-proBNP), 6 min walking test distance (6MWD), stroke volume(SV), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricu-lar ejection fraction (LVEF), Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after treat-ment. Results The total effective rate of TCM group was 96.00%, which was significantly higher than 83.67% of con-trol group (P<0.05). Before treatment, there were no significant differences in total TCM syndrome score, SV, LVESD,LVEDD, LVEF, NT-proBNP level, 6MWD, and MLHFQ scores between the two groups (P>0.05). After treatment, thetotal score of TCM symptoms, cardiac function index, NT-proBNP level, 6MWD, and MLHFQ scores of patients in bothgroups were significantly improved; after treatment, the improvement of TCM syndrome total score, SV, LVESD,LVEDD, LVEF, NT-proBNP level, 6MWD, MLHFQ score in TCM group was significantly better than that in controlgroup; the differences were statistically significant (P<0.05). Conclusion TCM chronic disease management modebased on "holistic view" in the treatment of chronic heart failure can improve the clinical efficacy and quality of life ofpatients, and improve the heart function of patients.
      【Key words】 Chronic heart failure; TCM chronic disease management mode; Holistic view; Curative effect; Car-diac function; Quality of life