A Study On Effectiveness Of "Winter Disease Cured In Summer" Using TCM For COPD Prevention And Treatment At Community Level

Objective:At city community level,taking chronic obstructive pulmonary disease(COPD)patients of stable phase as study objects,to analyze the clinical effects of the service,which treated COPD by adopting the method of "winter disease cured in summer"(WDCS)in traditional Chinese medicine(TCM), explore the appropriate technical governance program of synthesis preventing and treating COPD in TCM at community level so as to further meet the community COPD patients' demand of healthcare service,alleviate the symptoms,reduce the attacking of COPD,and provide reference for the controlling of chronic diseases in community,and finally promote the development of community health service.Method:Using available information and prospective intervention method,the sample cases were divided into experimental group and control group,with 160 cases in each group,which was treated with WDCS and traditional treatment respectively.Lung function of some patients from control group was tested.The times of their annual acute onset and clinical symptoms,treatment costs, compliance,the rate of satisfaction as well as the quality of life were investigated in order to understand the effectiveness and feasibility of treatment for community prevention and treatment of COPD by WDCS in TCM.Results:The potential incidence rate of COPD is relatively high in Zhabei District Shanghai and its prevalence rate may be somewhat higher than Shanghai's at large.The incidence of its COPD is closely related with the chronic bronchitis or the bronchial tube asthma,well-connected to upper respiratory tract infection,fume,exposure to occupational dust or chemical substances,smoking (the longer the smoking history is,the larger the quantity is,the closer the quit date is,the more vulnerable the smoker is to COPD)and education level(the lower,the more vulnerable),as well,it has also certain relations with family history,allergic history and nutrition condition,etc..COPD patients at community level had a low cognitive degree but a variety of demand towards service of TCM. After intervention,the clinical symptoms and acute attack times of cases were improved significantly in experimental group,P＜0.05,which had little significantly difference before and after intervention in control group,P＞0.05. There was significant difference on the curative effect of treatment between experimental group and control group,P＜0.05;the total curative effect of treatment group was superior to control group.Both the average total expense and medical expenditure for preventive treatment had statistical significance between the two groups,P＜0.05.Moreover,on average,each expense for most of service item in experimental group was lower than those in control group.Combination of Community Health Service Network Information System with community management of COPD offered convenience for the personalized COPD prevention and treatment.Conclusion:The overall dialectical thinking mode whose content is to rely on IT means,refer to different disease situation,disease nature and body situation, adopt TCM's combinative methods of treatment based on syndrome together with oral administration and vitro therapy in order to cure COPD patients in summer, the characteristics of intervention which are multi-channel and multi-link,as well as the advantages of personalized treatment are fully in accordance with the treatment principle of COPD.Compared with traditional therapy,its appropriate health care technology which could provide simple,convenient,low-cost, efficacious and effective means for community prevention,rehabilitation and treatment of COPD,is characterized with good efficacy and low cost.Meanwhile, the service menu scheme,with which COPD was treated in local communities by adopting the method of WDCS in TCM,is proved feasible on trial,theoretic and realistic conditions,it could reduce the expenses of health resources,after all,it is a good method to control and prevent COPD,which is suitable for community prevention and treatment of COPD in Shanghai and worthy of being disseminated. Its dissemination will bring about favorable scio-economic benefit.