作者：梁雪妃，张晓璇，陈名桂，孔丽丽，邱寅龙

单位：

广州中医药大学第二附属医院重症医学科

Units：

Department of Critical Care Medicine, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine;

关键词：

心肌梗死; 经皮冠状动脉介入治疗; 多维度随访; 八段锦序贯疗法; 治疗依从性; 生活质量;

Keywords：

Myocardial infarction;Percutaneous coronary intervention;Multi-dimensional follow-up;Baduanjin sequential therapy;Treatment adherence and compliance;Quality of life;

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.297

Funds：

广东省科学技术厅-广东省中医药科学院联合科研项目（2014A020221092）； 广东省中医药局中医药科研项目（20212072）;广东省中医院中医药科学技术研究专项课题资助（YN2016 HL03）；

摘要：

目的 探讨多维度随访对急性心肌梗死（AMI）患者PCI后八段锦序贯疗法依从性及生活质量的影响。方法 选择2016年7月至2017年8月在广州中医药大学第二附属医院重症医学科住院的48例行PCI的AMI患者为研究对象，采用随机数字表法将其分为对照组和试验组，各24例。对照组采用常规治疗方法，包括健康宣教、饮食控制、遵医嘱服药，康复运动方案选择八段锦序贯疗法，出院后采用常规随访方案；试验组采用常规治疗方法，康复运动方案选择八段锦序贯疗法，出院后采用多维度随访方案。随访6个月观察两组患者遵医嘱服药、定期抽血复查、八段锦锻炼、控制饮食的依从性，干预前及随访6个月采用健康调查简表（SF-36）和冠心病中西医结合生存质量量表评价两组患者生活质量，同时记录随访期间患者心绞痛、气促发生率。结果 48例患者随访过程中共脱落5例，其中试验组1例、对照组4例。两组患者遵医嘱服药率、定期抽血复查率、控制饮食率比较，差异无统计学意义（P>0.05）；试验组患者八段锦锻炼率高于对照组（P<0.05）。随访6个月，试验组SF-36的生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康维度评分及冠心病中西医结合生存质量量表的中西医症状、生理、心理、社会维度评分高于对照组（P<0.05）。两组患者心绞痛、气促发生率比较，差异无统计学意义（P>0.05）。结论多维度随访能提高AMI患者PCI后八段锦序贯疗法的依从性及生活质量，值得推广。

Abstract：

Objective To investigate the effects of multi-dimensional follow-up on compliance of Baduanjin sequential therapy and quality of life of patients with acute myocardial infarction（AMI） after PCI. Methods A total of 48 patients with AMI who underwent PCI in the Department of Critical Care Medicine of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July 2016 to August 2017 were selected as the study subjects. They were divided into control group and experimental group by random number table method, 24 cases in each group. The control group adopted conventional treatment methods, including health education, diet control and taking medication by the doctor’s advice, Baduanjin sequential therapy of rehabilitation exercise program was selected, and the routine follow-up plan was adopted after discharge. The experimental group was treated with conventional treatment methods, and Baduanjin sequential therapy of rehabilitation exercise program was selected, multi-dimensional follow-up was adopted after discharge. The follow up was adopted for 6 months to observe the compliance of taking medication by the doctor’s advice, regular blood re-examination, Baduanjin exercise, and diet control of the two groups of patients. The quality of life of patients in the two groups was evaluated by the MOS Item Short from Health Survey（SF-36） and Quality of Life Scale of Integration of TCM and Western Medicine for Coronary Heart Disease before intervention and at 6 months of follow-up. At the same time, the incidence rate of angina pectoris and dyspnea during the followup was recorded. Results A total of 5 patients fell off during the follow-up of 48 patients, including 1 case in the experimental group and 4 cases in the control group. There was no significant difference in the rate of taking medication by the doctor’s advice, regular blood re-examination, and diet control between the two groups（P > 0.05）; the rate of Baduanjin exercise in the experimental group was higher than that in the control group（P < 0.05）. At 6 months of follow-up, the scores of physiological functioning, rde-physical, bodily pain, general health, vitality, social functioning, rde-emotional, mental health dimension of SF-36 and the scores of symptoms of traditional Chinese and western medicine, physiological, mental and social dimension of Quality of Life Scale of Integration of TCM and Western Medicine for Coronary Heart Disease in the experimental group were higher than those in the control group（P < 0.05）. There was no significant difference in the incidence rate of angina pectoris and dyspnea between the two groups（P > 0.05）. Conclusion Multi-dimensional follow-up can improve the compliance of Baduanjin sequential therapy and quality of life of AMI patients PCI, which is worth promoting.

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