Effects Of Integrated Traditional Chinese And Western Medicine Cardiac Rehabilitation 8E Control Pathway On Exercise Tolerance In Patients With Chronic Heart Failure

ObjectiveBy observing the changes of exercise tolerance related indicators in patients with chronic heart failure after the implementation of cardiac rehabilitation 8E management and control pathway of traditional Chinese and western medicine,to explore the clinical value of cardiac rehabilitation 8E management and control pathway for chronic heart failure,as to provide the basis for the improvement of exercise tolerance by cardiac rehabilitation of integrated traditional Chinese and western medicine and promote the popularization of the concept of cardiac rehabilitation..MethodsA total of 60 patients with chronic heart failure admitted to the Department of Cardiology of our hospital from November 2018 to November 2019 were selected as the study subjects and randomly divided into the test group（8E management and control pathway group）and the control group（conventional treatment group）,with 30 cases in each group.There was no significant difference in the general clinical data such as gender,age,weight,course of disease,cardiac functional classification before treatment and basic diseases between the two groups（P>0.05）.The control group was given conventional anti-heart failure treatment.The experimental group implemented cardiac rehabilitation 8E to control the clinical pathway.The course of treatment was 4weeks.Cardiopulmonary exercise parameters[Peak VO₂,VO₂@AT,Peak Mets,Mets@AT,and VE/VCO₂@Slope],TCM score evaluation,cardiac function classification,NT-pro BNP level,quality of life score,and mental status score（GAD-7,PHQ-9）were recorded before and after treatment in both groups.At the end of the trial,the data of the two groups were compared and analyzed and statistically processed.Results1.Comparison of cardiopulmonary exercise test indexes:Using the examination method of cardiopulmonary exercise testing（CPET）,the therapeutic effect of the control group was evaluated by observing and analyzing the changes of the main indexes of CPET before and after treatment.There were significant differences in Peak VO₂,VO₂@AT,Peak Mets,Mets@AT and VE/VCO₂@Slope between the two groups before and after treatment（P<0.05 or P<0.01）.There was no statistical difference in Peak VO₂,VO₂@AT,Peak Mets,Mets@AT and VE/VCO₂@Slope before treatment between the two groups（P>0.05）.After treatment,the improvement of Peak VO₂,VO₂@AT,Peak Mets and Mets@AT in the test group was significantly better than that in the control group（P<0.05 or P<0.01）,while there was no significant difference in VE/VCO₂@Slope after treatment（P>0.05）.2.NT-pro BNP:There was significant difference between the two groups before and after treatment（P<0.01）;there was no significant difference between the two groups before and after treatment（P>0.05）.3.TCM score evaluation:There were significant differences between the two groups before and after treatment（P<0.01）;comparison:there was no significant difference between the two groups before treatment;there were significant differences between the two groups after treatment（P<0.01）.4.Evaluation of the curative effect of heart failure:The total effective rate of the control group was 65.5%,and the effective rate of the test group was 93.1%.The test group was superior to the control group（P<0.01）.5.Minnesota Living with Heart Failure Scale:There was significant difference between the two groups before and after treatment（P<0.01）;comparison:there was no significant difference between the two groups before treatment（P>0.05）;there was significant difference between the two groups after treatment（P<0.01）.6.Mental status scores（GAD-7 score,PHQ-9 score）:There was no significant difference in GAD-7 and PHQ-9 scores before treatment between the two groups（P>0.05）;there was no significant difference in GAD-7 score and PHQ-9 score before and after treatment in the control group（P>0.05）;there were significant differences in GAD-7 score and PHQ-9 score before and after treatment in the test group（P<0.01）,and there were significant differences in GAD-7 score and PHQ-9 score after treatment between the two groups（P<0.01）.Conclusion1.The implementation of Chinese and Western medicine cardiac rehabilitation8E management and control clinical pathway can significantly improve cardiopulmonary exercise test indicators（Peak VO₂,VO₂@AT,Peak Mets,Mets@AT）,improve cardiopulmonary function,and improve exercise tolerance in patients with chronic heart failure.2.The implementation of Chinese and Western medicine cardiac rehabilitation8E management and control pathway can improve TCM symptoms,quality of life score,PHQ-9 score,GAD-7 score,and improve the quality of life of patients with heart failure.3.The implementation of 8E management and control pathway of cardiac rehabilitation of traditional Chinese and western medicine has certain clinical application value for chronic heart failure.