中西医结合治疗方案对慢性心力衰竭患者预后及生活质量影响的研究

目的观察中西医结合治疗方案对慢性心力衰竭的疗效及其生活质量的影响。方法采用随机双盲安慰剂对照试验设计方法 ,选择150例慢性心力衰竭患者(剔除2例、脱落3例)分为试验组71例和对照组73例,分别采用中西医结合疗法和西药加中药安慰剂疗法治疗,并使用明尼苏达生活质量问卷(Minnesota Living with Heart Failure Questionnaire,mlHFQ),评价患者的生活质量水平,使用心衰评分表评价患者的心衰改善水平。结果两组在治疗8周、12周心衰评分比较差异均无统计学意义(P﹥0.05);与对照组比较,试验组患者治疗24周后心衰程度明显改善(P﹤0.05);两组4周mlHFQ评分比较差异均无统计学意义(P﹥0.05),治疗8周～24周后,试验组mlHFQ评分较对照组低,差异有统计学意义(P﹤0.01)。可以看出中医综合治疗方案有改善慢性心力衰竭患者生活质量的趋势,并且随着随访日期的延长,差异越显著。结论中西医结合治疗方案可降低慢性心力衰竭再次住院率,有改善患者24周生活质量的趋势。

Study of influence of comprehensive protocol of integrated chinese and western medicine on quality of life of the patients with chronic heart failure

OBJECTIVE To observe the influence of comprehensive protocol of integrated Chinese and Western medicine on the efficacy and quality of life of the patients with chronic heart failure.METHODS Randomized double-blind placebo-controlled trial design method was adopted.150 patients with chronic heart failure were randomly divided into(2 excluding cases,3 loss cases)test group(71 patients)and control group(73 patients).Combined therapy of Chinese and Western medicine and Western medicine with Chinese medicine placebo were adopted for both groups,respectively.Qualities of life of the patients were evaluated by Minnesota Living with Heart Failure Questionnaire(mlHFQ),and the improvement level of heart failure was evaluated by heart failure score.RESULTS There was no significant difference in the heart failure score between the two groups at week 8 and week 12(P﹥0.05).Compared with control group,the heart failure was significantly improved for the patients in the test group after 24 weeks of treatment(P﹤0.05).At week 4,there was no significant difference in the mlHFQ score between the two groups(P﹥0.05).After week 8 to week 24,mlHFQ score in the test group was lower than the control group.There was significant difference in mlHFQ score(P﹤0.01).It could be seen that comprehensive protocol of integrated Chinese and Western medicine had a trend of improving the quality of life of the patients with chronic heart failure.And with the extension of follow-up,the difference was more significant.CONCLUSION Comprehensive protocol of integrated Chinese and Western medicine can reduce the readmission rate of the patients with chronic heart failure,which has a trend of improving the quality of life within 24 weeks.