陈艳俏　张成英　陈少军

[摘要] 目的 观察中西医结合心脏康复治疗慢性心力衰竭患者的临床效果。 方法 选择2015年1月～2016年1月在北京市怀柔区中医医院住院的慢性心力衰竭患者100例，按随机数字表法将其分为治疗组和对照组，每组各50例。对照组给予常规西医治疗，治疗组在此基础上联合给予中西医结合心脏康复治疗。治疗前、治疗后6个月对两组患者纽约心脏病协会（NYHA）心功能分級、6 min步行试验（6MWT）及中医症状疗效进行评价。 结果 治疗组心功能疗效总有效率（84.0%）、中医症状疗效总有效率（90.0%）均高于对照组（70.0%、80.0%），差异均有统计学意义（均P < 0.05）。治疗后，两组6MWT均较治疗前明显增加，且治疗组增加更为显著，差异有统计学意义（P < 0.05）。 结论 中西医结合心脏康复能显著改善慢性心力衰竭患者的心功能、运动耐量及中医症状。

[关键词] 中西医结合心脏康复；慢性心力衰竭；临床效果

[中图分类号] R541.61 [文献标识码] A [文章编号] 1673-7210（2017）09（c）-0157-04

[Abstract] Objective To observe the clinical efficacy of cardiac rehabilitation of integrated Chinese and western medicine in the treatment of patients with chronic heart failure. Methods One hundred patients with chronic heart failure hospitalized in Traditional Chinese Medicine Hospital of Beijing Huairou from January 2015 to January 2016 were selected and divided into treatment group and control group by random number table， with 50 cases in each group. The control group was treated by conventional western medicine therapy， on basis of which， the treatment group was added with cardiac rehabilitation of integrated Chinese and western medicine. Before treatment and after treatment for 6 months， the cardiac function classification of New York Heart Association （NYHA）， 6-min walking test （6MWT） and the efficacy of traditional Chinese medicine （TCM） symptoms between two groups were compared. Results The total effective rate of cardiac function （84.0%）， TCM symptoms （90.0%） in the treatment group were all higher than those of control group （70.0%， 80.0%）， with statistically significant differences （all P < 0.05）. After treatment， 6MWT in both groups were all increased more than those before treatment， and the improvement in the treatment group was more remarkable， with statistically significant difference （P < 0.05）. Conclusion Cardiac rehabilitation of integrated Chinese and western medicine can significantly improve the cardiac function， exercise tolerance and TCM symptoms of patients with chronic heart failure.

[Key words] Cardiac rehabilitation of integrated Chinese and western medicine； Chronic heart failure； Clinical efficacy

慢性心力衰竭是指由各种疾病引起心肌收缩功能减弱，使心脏的血液输出量减少，不足以满足机体需要，由此产生一系列症状和体征的临床综合征，是多种心脏疾病的终末阶段。慢性心力衰竭一旦发生，病情进行性加重，需反复住院治疗，给个人生活、家庭经济带来沉重的负担，同时增加了社会医疗卫生支出，心力衰竭已成为我国心血管病领域重要的公共卫生问题。

近年来，心脏康复已经成为心血管疾病综合治疗体系中重要的组成部分，即在规范的药物治疗基础上，通过多种干预措施，包括运动训练、饮食指导、心理调节、定期监测各项指标和接受健康教育等，改善患者生活质量，回归正常社会，降低心血管病患者的再住院率和病死率。……