The Foundation Of A System To Management Of Chronic Heart Failure With Western Medicine And TCM

ObjectiveThis study aimed to investigate and analyze key problems of the new Disease Management Programs of Chronic Heart Failure determined by Heart Center in Guangdong Provincial TCM Hospital, using Deuel the Philippine (Delphi) approach, and to evaluate, optimize the Disease Management Programs. Finally, that will be help to formulate a profession approved Disease Management Programs for chronic heart failure by best combing Chinese and Western medicine, and enable the Disease Management Programs to be good for Chronic diseases.MedthodsThis research was based on previous studies (including reviewing existing ways of treating chronic heart failure, categorizing relevant literature of ancient TCM, and organizing relevant literature of modern TCM and so on). Predicting team has formed and questionnaire has been designed in accordance with the newly determined clinical pathway to treat chronic heart failure. Deuel the Philippine (Delphi) approach was used in the questionnaire to get answers from professionals of cardiovascular internal medicine from hospitals of TCM or Western medicine in Guangzhou city. The questionnaire, covering management programs of diagnoses, medicine treatments management and non-medicine treatments management (TCM special care management and telephone intervention and evaluation), then form Disease Management Programs of CHF, asked the experts evaluate the managing means according to the actual situation of present chronic heart failure treatment. After each round of questionnaire collection, the prediction team would carry out statistical analysis, opinions categorization, modification of previous questionnaire, and formation of new questionnaire for experts of next round. In the statistical analysis aspect, it was done by Epidata2.la and spss13.0procedure in computer. This team has done descriptive analysis to expert’s positive feedbacks and the basic situation. Frequency description has been applied analyze each element of the questionnaire.ResultThere were two rounds of questionnaire collection altogether:in the first round, the questionnaire return ratio was100%, and experts’positive feedback was100%. In the first round,25experts, are cardiologist of integration of Chinese and Western heart internal medicine, were from several big hospital inGuangzhou city.96%of the25experts were professors, who were engaged in this specialty for10years or more, which indicates that they were good representatives and authority in this field. In the second round, the questionnaire return-ratio was100%, the experts’positive feedback was100%. All the20experts were professors who have been the cardiologist of integration of Chinese and Western heart internal medicine for10years or more, which indicates that they were good representatives and authority in this field.In the first round85%of the experts believed that controlling medical expense through the management programs was reasonable;95%experts thought it was reasonable to use management programs to advanced the medical quality.95%experts approved that, in the clinics of management programs, practicing western medicine management, should diagnose and treat by referring to the2007"China Chronic Heart failure Diagnosis and Treatment Guide". Over70%experts choice As for TCM approach,80%experts chose the management programs integration of Chinese and Western.95%of the experts believe that management follow-up program may include:diet, exercise, follow-up education, TCM special nursing treatment.95%of experts believe that dietary management program in the management program in the ideal recipe for a good rich protein low-fat diet. For patients with heart failure cardiac function recovery, should intake foods rich in potassium, magnesium and high-fiber, the regulation of great help to patients with heart failure progressionIn the second round,73.3%of experts agreed that24weeks was the exact period of time for management program, The frequency of follow-up of patients with heart failure center decay is set to2weeks.at least80%of experts agree each specific dialectical、 sub-main symptoms、sub-disease, tongue and pulse of Heart failure as well as governing law. According to the patients with heart failure during the management period standardized auxiliary examination results prompts:more than85%experts believe that included in the first week of management program, should be the patients’ blood, emergency biochemistry, coagulation, BNP and cardiac enzymes, troponin, blood gas analysis, biochemistry, electrocardiogram, chest radiograph, the UCG. more than80%of experts believe that at the end of management, patients check BNP, echocardiography, biochemistry, chest radiography, ECG, UCG.ConclusionThis is a study on the evaluation and optimization of management program for chronic heart failure by using Deuel the Philippine (Delphi) approach. It helps to make the management program better and more reasonable. Based on the opinions offered by the experts, we initially formulate the profession standard for management program of chronic heart failure by integrating Chinese and Western medicine. Simultaneously, it has proved that Deuel the Philippine (Delphi) approach is scientific and practical, which involves experts wisdom, knowledge and experiences, and is a scientific methodology to assure TCM research to be objective, practice, traditional and applicable.