张娇娇 黄德才 王朝辉

【摘要】 目的：觀察温针灸配合中医导引术用于慢性冠心病患者的康复效果。方法：采用便利抽样法选取本院2019年4月-2020年3月就诊的慢性冠心病患者164例，按照随机数字表法分为观察组和对照组，各82例。两组均进行常规治疗，在此基础上，对照组采用中医导引术，观察组采用温针灸配合中医导引术。比较两组患者治疗前后的6分钟步行试验距离（6MWT）、Brog呼吸困难评分、中医症状评分、血液流变学指标变化和治疗后的临床效果。结果：观察组治疗后的6MWT显著高于同期对照组及本组治疗前（P<0.05）;观察组治疗后的Brog呼吸困难评分显著低于同期对照组及本组治疗前（P<0.05）。两组治疗后中医症候总积分均显著低于治疗前，且观察组低于对照组（P<0.05）;观察组治疗效果优于对照组（P<0.05）。观察组治疗后的全血高切黏度、全血低切黏度、血细胞比容及纤维蛋白原均显著低于本组治疗前及同期对照组（P<0.05）。结论：温针灸配合中医导引术用于慢性冠心病患者，能够有效延长6MWT，改善临床症状和血液流变学指标，提高临床疗效。

【关键词】 温针灸 中医导引术 慢性冠心病

[Abstract] Objective： To observe the rehabilitation effect of warming acupuncture combined with traditional Chinese medicine guidance in patients with chronic coronary heart disease. Method： A total of 164 patients with chronic coronary heart disease （CHD） from April 2019 to March 2020 were selected by convenient sampling， according to the random number table method， the patients were divided into observation group and control group， each with 82 cases. Both groups received routine treatment， on this basis， the control group adopted TCM guidance， while the observation group adopted warm acupuncture combined with TCM guidance. The 6-minute walking distance （6MWT）， Brog dyspnea score， TCM symptom score， hemorheology index change before and after treatment and clinical effect after treatment were compared between the two groups. Result： The 6MWT of the observation group after treatment was significantly higher than those of the control group during the same period and before treatment （P<0.05）. The Brog dyspnea score of the observation group after treatment was significantly lower than those of the control group and before treatment （P<0.05）. After treatment， the total score of TCM syndromes in both groups were significantly lower than those before treatment， and the observation group was lower than that of the control group （P<0.05）. Treatment effect of the observation group was better than that of the control group （P<0.05）. The high-cut viscosity of whole blood， low-cut viscosity of whole blood， Hct and fibrinogen in the observation group were significantly lower than those in the control group and before treatment （P<0.05）. Conclusion： Warm acupuncture combined with traditional Chinese medicine guidance for patients with chronic coronary heart disease can effectively prolong 6MWT， improve clinical symptoms and hemorheology indicators， and improve clinical efficacy.

[Key words] Warm acupuncture Chinese medicine guidance Chronic coronary heart diseaseFirst-authors address： Jiamusi Traditional Chinese Medicine Hospital， Jiamusi 154000， China

冠心病是冠状动脉功能性改变或器质性病变所引发的冠状动脉血流及心肌需求间失衡而造成的心肌损害，依据疾病发病特点可分为急性暂时性及慢性两种情况[1]，慢性冠心病属于冠心病的稳定期。一项关于2型糖尿病患者稳定期冠心病的临床指南指出：生活方式改变、运动干预等对降低冠心病全因死亡率具有改善价值[2]。寇兰俊等[3]在总结冠心病的生理、病理特点基础上，构建了符合慢性冠心病的中医导引术，中医导引术对引导生活方式改善具有指导意义，符合慢性冠心病的康复需求。《冠心病稳定型心绞痛中医诊疗指南》中指出：在传统功法基础上配合艾灸贴敷能够改善社会功能，提高患者生活质量[4]。温针灸属于中医传统疗法，能够温通经脉、行气活血，已经被证实具有改善冠心病患者血液流变学指标的功效[5]。……