社区中医健康管理对慢性阻塞性肺疾病稳定期患者的影响

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目的:观察社区中医健康管理对慢阻肺稳定期患者的影响。方法:选取2017?年6?月至2018?年6?月于北京市西城区展览路社区卫生服务中心就诊的慢阻肺稳定期患者79?例作为研究对象,采用简单随机化分组分为中医管理组39?例,年龄(70.77±5.91)岁,病程为(7.97±3.12)年,其中男性26?例;对照组40?例,年龄(70.60±5.93)岁,病程为(7.70±3.01)年,其中男性25?例。两组均给予西医常规治疗,中医管理组在西医常规治疗的基础上进行1?年的中医健康管理,包括建立慢阻肺患者中医健康管理电子档案,指导患者进行呼吸吐纳、八段锦、穴位按摩、穴位贴敷、依据中医体质辨识的饮食指导。对患者进行连续的管理、随访,记录管理前及管理后慢阻肺患者的中医证候疗效、慢阻肺患者自我评估测试(CAT)问卷评分、急性加重次数,肺功能。结果:中医管理组临床控制6?例,显效8?例,有效19?例,总有效率为84.61%;对照组临床控制2?例,显效3?例,有效25?例,总有效率为75.00%,中医管理组中医证候总有效率优于对照组。中医管理组CAT评分为(7.46±3.28)分,急性加重次数为(4.21±2.61)次,第1?秒用力呼气容积(FEVn 1)为(1.99±0.79)L,用力肺活量(FVC)为(2.63±0.92)L;对照组CAT评分为(10.38±4.68)分,急性加重次数为(6.03±3.00)次,FEVn 1为(1.66±0.65)L,FVC为(2.41±0.81)L。中医管理组CAT评分降低、1?年内急性加重次数减少,FEVn 1增高,与对照组比较差异有统计学意义。n 结论:社区中医健康管理能改善慢阻肺稳定期患者的症状,减少急性加重次数,改善肺功能。“,”Objective:To observe the effects of community traditional Chinese medicine (TCM) health management of patients with chronic obstructive pulmonary disease (COPD).Methods:From June 2017 to June 2018, 79 patients were selected as study subjects. These patients were randomly divided into two groups. The TCM management group had 39 patients (of which 26 were male), with an average age of (70.77±5.91) years and the course of disease of (7.97±3.12) years. The control group had 40 patients (of which 25 were males), with an average age of (70.60±5.93) years and the course of disease of (7.70±3.01) years. Both groups were given conventional western medicine treatment. The TCM management group was administered TCM health management for 1 year on the basis of the conventional western medicine treatment. This management included establishing electronic archives for COPD patients, Hu Xi Tu-Na, Baduanjin, acupoint massage, acupoint plaster, and dietary guidance according to the TCM physique identification. Management and follow-up of patients was continuous. The TCM syndrome score, CAT score, number of acute exacerbations, and lung function of COPD patients were recorded before and after 1 year of treatment.Results:In the TCM management group, there were 6 cases of clinical control, with 8 and 19 cases displaying obvious and effective effects, respectively. The total effective rate was 84.61%. In the control group, there were 2 cases of clinical control, with 3 cases and 25 cases displaying obvious and effective effects, respectively. The total effective rate was 75.00%. The curative effect of the TCM syndrome in the TCM management group was better than that in the control group. In the TCM management group,the CAT score was (7.46±3.28) points and the number of acute exacerbations was (4.21±2.61) times, the forced expiratory volume (FEVn 1) in the first second was (1.99±0.79) L, and the forced vital capacity (FVC) was (2.63±0.92) L. In the control group, the CAT score was (10.38±4.68), the number of acute exacerbations was (6.03±3.00), FEVn 1 was (1.66±0.65) L, and FVC was (2.41±0.81) L. The CAT score and the number of acute exacerbations in the TCM management group decreased, while the number of FEVn 1 increased, which was statistically significant compared to the control group.n Conclusion:Community TCM health management can improve the symptoms of COPD patients at a stable stage, reduce the number of acute exacerbations, and improve lung function.
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