郑丹　　张艳　　周欣雯　　刘笑静　　雷聪云

[摘要] 目的 探討慢性阻塞性肺疾病（COPD）合并肺心病患者在慢性病管理中采取中医药干预模式的应用价值。 方法 选取2017年2月至2019年2月我院收治且进行跟访的88例COPD合并肺心病患者，对所有患者采取中医药综合干预，干预（6.00±0.10）个月，评价患者干预前后健康知识评分、生活质量评分、负面情绪以及依从性。结果 干预后患者健康知识水平为（80.26±3.85）分，明显高于干预前的（64.83±5.92）分，差异有统计学意义（P<0.05）。干预后患者症状评分、活动评分、影响评分明显低于干预前，差异有统计学意义（P<0.05）。干预后患者汉密尔顿抑郁量表（HAMD）评分、汉密尔顿焦虑量表（HAMA）评分明显低于干预前，差异有统计学意义（P<0.05）;干预后患者依从性为89.77%，明显高于干预前的54.54%，差异有统计学意义（P<0.05）。 结论 COPD合并肺心病患者在慢性病管理中采取中医药干预模式，对促进患者健康知识、负面情绪调整、生活质量以及科学用药等改善均有重要意义，值得推广与应用。

[关键词] 中医药干预模式;COPD;肺心病;慢性病管理;应用价值

[中图分类号] R563.8          [文献标识码] B          [文章编号] 1673-9701（2021）09-0110-04

Investigation on the application of traditional Chinese medicine intervention mode in obstructive sleep breathing management

ZHENG Dan   ZHANG Yan   ZHOU Xinwen   LIU Xiaojing   LEI Congyun

Department of Respiratory Medicine，Lishui Hospital of Traditional Chinese Medicine in Zhejiang Province，Lishui 323000，China

[Abstract] Objective To summarize the application value of traditional Chinese medicine （TCM） intervention mode in chronic disease management of patients with chronic obstructive pulmonary disease（COPD） combined with pulmonary cardiac disease. Methods A total of 88 patients with COPD combined with pulmonary cardiac disease admitted to our hospital from February 2017 to February 2019 were selected as the research objects. All patients were given comprehensive TCM intervention for（6.00±0.10） months. The health knowledge level， quality of life score， negative emotional psychology and compliance of patients before and after the intervention were evaluated. Results After intervention， patients′ health knowledge level was（80.26±3.85）points，which was higher than that of （64.83±5.92）points before intervention， and the difference was statistically significant（P<0.05）. After intervention，the scores of Hamilton depression scale （HAMD）and Hamilton anxiety scale（HAMA） were lower than those before intervention， with statistically significant differences（P<0.05）. After intervention， patients′ symptom score， activity score and influence score were lower than those before intervention， and the differences were statistically significant（P<0.05）. The compliance was 89.77% after intervention， which was higher than that of 54.54% before intervention， and the difference was statistically significant（P<0.05）. Conclusion In the management of chronic diseases in patients with COPD combined with pulmonary cardiac disease，TCM intervention mode is of great significance to promote patients′ health knowledge，negative emotion adjustment，quality of life and scientific medication， which is worthy of promotion and application.

[Key words] Chinese medicine intervention mode; COPD; Pulmonary cardiac disease; Chronic disease management; Application value

慢性阻塞性肺疾病（Chronic obstructive pulmoriary disease，COPD）属于呼吸系统常见病之一，其致残率、致死率较高。结合现代研究分析，COPD与肺心病之间存在密切关系[1]。COPD是一种常见的、可预防的肺部疾病，其特征是由于吸烟和（或）其他有害的吸入性接触而导致的进行性、不可逆的气流限制，常伴有全身症状。到目前为止，还未见有效的基于肺活量测定COPD的全国流行率数据。在大多数关键性研究中，尽管COPD有其局限性，但基于问卷调查的有效数据认为是评估COPD患病率的合理依据。COPD在全球造成了巨大的发病率和死亡率负担，其在直接和间接成本方面造成了巨大的经济负担。COPD患者如果不能有效维持病情稳定，将逐渐发展为肺心病，出现COPD合并肺心病。同单一COPD相比，COPD合并肺心病对应的治疗难度增加，影响患者的生活质量、生存时间[2]。

COPD的治疗目标是预防或减缓进展，提高患者的生活质量。COPD患者除了身体受损外，还承受着与其疾病及其症状相关的精神负担，如焦虑和抑郁。……