| Objective: This subject uses the simplified three stage heart failure exercise rehabilitation program and the constitution of TCM intervention of cardiac rehabilitation on patients with chronic heart failure of qi deficiency, observes rehabilitation therapy and the constitution of TCM intervention in improving the symptoms of patients with chronic heart failure,heart function and improves the quality of life and other aspects of the role,and explores new ideas of combined treatment of traditional Chinese medicine and Western medicine of chronic heart failure cardiac rehabilitation. Methods: According to the inclusion criteria 92 cases of qi deficiency of chronic heart failure patients were divided into the conventional western medicine treatment group, the exercise rehabilitation treatment group, the constitution of traditional Chinese medicine intervention group. The conventional western medicine treatment group received conventional western medicine treatment, the exercise rehabilitation treatment group based on the conventional western medicine treatment with the exercise rehabilitation therapy, the constitution of traditional Chinese medicine intervention group based on the treatment of the exercise rehabilitation treatment group with the constitution of traditional Chinese medicine intervention treatment, observes three groups before and after treatment in patients with heart failure and including left ventricular end diastolic diameter (LVEDd), left ventricular ejectionfraction (EF), each stroke volume(SV), cardiac output(CO), cardiac index(CI), B-type natriuretic peptide precursor (pro-BNP), heart rate(HR), systolic blood pressure(SBP), myocardial oxygen consumption(RPP), 6 minutes walking distance (6MWD), TCM syndrome score, Minnesota quality of life score for heart failure (MLHFQ) and other aspects changes, and the indexes of the three groups after treatment were compared. Result: 1. Three groups of patients before and after treatment and compared to pro-BNP and cardiac ultrasound index: the constitution of TCM intervention group before and after treatment cardiac ultrasound index SV,CO,CI for comparison, there are differences (P<0.05),in which EF has a significant difference (P<0.01); comparison of the exercise rehabilitation treatment group before and after treatment in cardiac ultrasound index of EF,SV, there are differences (P<0.05); and the conventional western medicine treatment group before and after treatment, only CI has difference (P<0.05); pro-BNP there is a significant difference between the three groups of patients before and after treatment (P<0.01). Comparison of cardiac ultrasound index and pro-BNP between the three groups after treatment, compare the constitution of TCM intervention group and the conventional western medicine treatment group, EF, CO has a difference (P<0.05). 2. Three groups of patients with HR, SBP, RPP, 6MWD before and after treatment comparison: three groups of patients before and after HR, SBP, RPP treatment were compared with the difference (P<0.05), the comparison of 6MWD before and after treatment with significant difference (P<0.01). After treatment between the three groups of HR, SBP, RPP were no obvious differences (P>0.05), but the 6MWD constitution of TCM intervention group compared with the conventional western medicine treatment group, the exercise rehabilitation treatment group and the conventional western medicine treatment group were compared with the difference (P<0.05). Compared with the constitution of TCM intervention group and the exercise rehabilitation treatment group with difference (P<0.05). 3. Comparison of three groups of patients before and after treatment of symptomintegral: three kinds of treatment methods can improve heart failure patients with heart palpitations, shortness of breath, fatigue, surface limb edema, dry mouth, asthma, phlegm, oliguresis, abdominal distension, among them, fatigue, edema of the face and limbs, asthma, oliguresis, abdominal distension significantly compared with before and after treatment the difference (P<0.01), and heart palpitations, shortness of breath, dry mouth, expectoration before and after treatment comparison difference (P<0.05). Among them, the constitution of TCM intervention group, sweating, cough, aversion to cold compared before and after treatment with significant difference (P<0.01),the exercise rehabilitation treatment group cough, restlessness compared before and after treatment have significant differences (P<0.05). Between the three groups after treatment, only the constitution of TCM intervention group compared with the conventional western medicine treatment group, spontaneous perspiration and asthma have difference (P<0.05). 4. Comparison of three groups of patients with TCM symptoms: compared with the conventional western medicine treatment group, the constitution of TCM intervention group and the exercise rehabilitation treatment group can improve aversion to cold symptoms, compared with the conventional western medicine treatment group and the exercise rehabilitation treatment group, the difference (P<0.05); compared with the constitution of TCM intervention group and the conventional western medicine treatment group, there is a significant difference(P<0.01); comparison of the exercise rehabilitation treatment group and the constitution of TCM intervention was not significant (P>0.05).To improve the constitution of TCM intervention group cold chills limbs symptoms is superior to the exercise rehabilitation treatment group; compared with the conventional western medicine treatment group, the exercise rehabilitation treatment group can significantly improve the symptoms of irritable, there was a significant difference (P<0.01). The conventional western medicine treatment group and the constitution of TCM intervention group uneasy fidgety symptoms improved significantly, no significant difference (P>0.05). 5. Three groups of patients before and after treatment of MLHFQ, emotional status and other physical conditions, statistically, there were significant differences(P<0.01).Comparison of physical conditions, emotional status and other conditions between the three groups after treatment, compared the constitution of TCM intervention group and the conventional western medicine treatment group, compared with the exercise rehabilitation treatment group and the conventional western medicine treatment, a significant difference (P<0.05). Compared with the constitution of TCM intervention group and the exercise rehabilitation treatment group, the difference had no significant difference (P>0.05). Conclusion: 1. The constitution of TCM intervention group, the exercise rehabilitation treatment group, the conventional western medicine treatment group can significantly reduce the level of pro-BNP before treatment, the exercise rehabilitation treatment group can improve EF, SV before treatment; the constitution of TCM intervention group can improve EF, SV, CO, CI before treatment which is improved by EF the situation is more obvious. Comparison between the three groups after treatment, better than the conventional western medicine treatment group, the constitution of TCM intervention group, EF CO, suggested that the constitution of TCM intervention group to improve the heart function than the conventional western medicine treatment group is more effective. 2. The constitution of TCM intervention group, the exercise rehabilitation treatment group, the conventional western medicine treatment group can improve patients before treatment with HR, SBP, RPP, 6MWD, and 6MWD was improved significantly. Comparison between the three groups after treatment, the 6MWD exercise rehabilitation treatment group is better than the conventional western medicine treatment group, the constitution of TCM intervention group is better than the exercise rehabilitation treatment group and the conventional western medicine treatment group. 3. The constitution of TCM intervention group, the exercise rehabilitation treatment group, the conventional western medicine treatment group can improve the patients with heart failure and heart palpitations, shortness of breath, fatigue, surface limbedema, dry mouth, asthma, phlegm, oliguresis, abdominal distension, the constitution of TCM intervention group on cough, sweating, aversion to cold symptom scores obviously, the symptom integral exercise rehabilitation treatment can improve cough, restlessness; the symptom scores between the three groups after treatment, the constitution of TCM intervention group to improve sweating and asthma than the conventional western medicine treatment group. 4. The constitution of TCM intervention group, the exercise rehabilitation treatment group and the conventional western medicine treatment group can be improved in patients with heart failure of heart palpitations, shortness of breath, fatigue, limb edema, dry mouth, asthma, cough up phlegm, oliguresis, abdominal distension, symptom scores, constitution of TCM intervention group of spontaneous perspiration, cough, cold chills limbs symptoms improved more obviously and the rehabilitation exercise treatment group can improve cough, dysphoric symptom score; among the three groups after treatment symptom score compared constitution of TCM intervention group improve spontaneous perspiration and asthma is better than that of the conventional western medicine treatment group. 5. The constitution of TCM intervention group, the exercise rehabilitation treatment group, the conventional western medicine treatment group can improve the physical condition before treatment, and other emotional status score. But the comparison between the three groups after treatment, the constitution of TCM intervention group, the exercise rehabilitation treatment group is better than the conventional western medicine treatment group. 6. In general, on the basis of the conventional western medicine treatment, the constitution of TCM intervention combined with the exercise rehabilitation treatment in improving heart function and clinical symptoms, improve the quality of life and exercise tolerance than the exercise rehabilitation treatment and the conventional western medicine treatment has certain advantages, it is worthy of clinical application. |
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