中医辨证施护及中药穴位贴敷对改善慢性心力衰竭患者生活质量的影响

目的评价中医辨证施护及中药穴位贴敷对慢性心力衰竭（CHF）患者生活质量的影响。方法采用随机数字表法，将湖南省中医药研究所附属医院心内科确诊为CHF的76名患者分为治疗组39例和对照组37例，两组均给予CHF常规护理，治疗组加用中医辨证施护、中药穴位贴敷等综合护理措施。两组以1个月为1个疗程，分别评价治疗前后疗效及患者的明尼苏达心力衰竭生活质量调查表（LiHFe）评分、检测患者的6min步行试验距离和左室射血分数（LVEF）。结果两组患者。O功能分级比较，治疗组总有效率为92．3％，对照组总有效率为75．7％，两组比较差异有统计学意义（u=2．12，P〈0．05）；治疗后，治疗组与对照组相比较，LiHFe评分分别为（30．25±2．15）分比（36．12±3．27）分，差异有统计学意义（t=9．29；P〈0．01）；6min步行距离为分别为（302．27±21．39）m比（256．35±26．28）m，差异有统计学意义（t=7．71；P〈0．01）；LVEF分别为（61．26±8．13）％比（55．32±7．66）％，差异有统计学意义（t=3．27；P〈0．01）。结论通过运用中医辨证施护和中药穴位贴敷对CHF患者进行护理干预，可以明显提高CHF患者的疗效，显著改善其生活质量。

Effect of TCM dialectical nursing and acupoint application on the life quality of patients with chronic heart failure

Objective To assess the effect of TCM dialectical nursing and acupoint application on the life quality of patients with chronic cardiac failure （CHF）. Methods Seventy-six patients with CHF were randomly divided into treatment group （ n = 39） and control group （ n = 37 ）. The treatment group patients received nursing intervention combined dialectical nursing with acupoint application of Chinese herb, all patients in control group received routine care. The course of treatment of both groups was one month. Therapy efficacy, score of Minnesota Heart Failure Quality of Life Questionnaire （LiHFe） , the distance in six-minute walk, left ventricular ejection fraction（LVEF） before and after treatment were observed. Results Total effective rate of the treatment group and control group was 92.3% and 75.7%, respectively,and the difference was statistically significant（ u =2. 12 ,P 〈 0. 05 ）. There was statistically difference between the treatment group and the control group after treatment in the quality of life[ （ 30.25 ± 2. 15 ） vs （ 36. 12 ± 3.27 ） ], the distance in six-minute walk [ （ 302.27 ± 21.39） m vs （ 256.35 ± 26.28 ） m ], left ventricular ejection fraction [ （ 61.26 ± 8.13 ） % vs （55.32 ± 7.66 ） % ], （ t = 9.29,7.71,3.27, respectively; P 〈 0.01 ）. Conclusions Nursing intervention combined dialectical nursing with acupoint application of TCM can significantly enhance the curative effect and improve quality of life of CHF patients.