The Clinical Application Of Chinese And Western Medicine Combined With Chronic Disease Management In Dilated Cardiomyopathy

Objective: In this issue.We used the research method of retrospective analysis.The clinic data of 25 cases of DCM patient in the our hospital and the others who separately saw the doctor in regular within 6 months were analyzed.Included the Awareness of disease、 Medical scheme、Medication compliance、dosage、Treatment effect、Emergency department caused by cardiovascular events and time in hospital、the costs of treating.We observed the different effects of DCM patient in Self-management ability、quality of life、self-efficacy 、between the plan of treatment in other hospitals and Integrated Chinese and Western Medicine Management of Chronic Diseases in our hospital.We Preliminary discussed on the application effect of DCM integrated Chinese and Western medicine chronic disease management mode in clinical.Methods: We conducted a survey in 72 DCM patients who came to our hospital from January 2018 to October 2018.We investigated the Diagnosis and treatment from patients who see the doctor before six months and Choose the 25 patients who have had complete date and treatment of a reasonable rule more than 6 months.We analyzed the difference from Awareness of disease、Medical scheme、Medication compliance、dosage、Treatment effect、Emergency department caused by cardiovascular events and time in hospital、the costs of treating of patients treated in our hospital and outer court respectively within 6 months.We chose the 25 patients treated by Integrated Chinese and Western Medicine Management of Chronic Diseases before and after.We made the contrast of these patients in Self-management ability,quality of life,Self-efficacy assessment.Results:(1)According to the medical record retrospective analysis.We know 25 patients treated in other hospitals within six months.There are 92% received conventional western medicine treatment.8% were treated with integrated Chinese and Western medicine、16% understand the doctor’s sreatment plan、and 8% got the doctor’s contact information.Medical staff do not provide life guidance and make regular return visits to the patients nor have heart rate monitoring.So patients and their families have a significantly lower awareness of the disease.But under the mode of Integrated traditional Chinese and western medicine chronic disease management in our hospital.Doctors spread the knowledge of patients and their families 、have regularly return visits to conduct life and medication guidance、monitored the blood press and the heart rate.Patients can also contact the doctor at any time to learn about treatment plans and medication consultation.(2)According to the medical record retrospective analysis.We found the patients treated in other hospitals within six months had low rate of compliance with ACEI or ARB(32.0%).β-blockers have a low maximum tolerated dose.9 of them(36%)did not add to the treatment.But under the mode of Integrated traditional Chinese and western medicine chronic disease management.We strengthened patient’s self-management.The compliance rate of 25 patients took ACEI or ARB drugs was 100% and the amount of β-blockers was significantly increased compared with before.Medication compliance was also significantly improved.(3)Under the mode of Integrated traditional Chinese and western medicine chronic disease management.The patient’s LVEDD value was significantly reduced and the LVEF value was significantly increased.(4)Under the mode of Integrated traditional Chinese and western medicine chronic disease management.The number of emergency and rehospitalizations of patients was significantly reduced.But the cost of treatment had increased than before.(5)25 patients Under the mode of Integrated traditional Chinese and western medicine chronic disease management.Their Self-management ability was different from before treatment(P<0.05).Self-efficacy was better than before treatment(P<0.05).Physiological function in quality of life、Physical Role(RP)、Bodily Pain(BP)、General Health(GH)、vitality(VT)、social function(SF)、Role Emotional(RE)、mental health(MH)There were significant differences compared with those before treatment(P<0.05)Conclusion:(1)Under the mode of Integrated traditional Chinese and western medicine chronic disease management,by improving the patient’s drug compliance and Selfmanagement ability.It can allow the dose of ACEI or ARB and β-blockers to reach the target dose or increase the maximum dose that can be tolerated and Improve treatment、Improve patient’s LVEDD value,EF value by patient self-test blood pressure、heart rate and clinical symptoms、constantly adjust the dosage of Chinese and western medicine.(2)We also found that take management plan for patients make positive contribution to living quality 、 Faith in healing and Reduce the number of emergency and readmissions due to cardiovascular events.But routine drug costs will increase because the patient takes Chinese and western medi cine at the same time.Through the discussion in combination of traditional Chinese and western medicine chronic disease management treatment of dilated cardiomyopathy.