Abstract:

Objective　To evaluate the impact of modified Kaitianmen therapy combined with five-tone therapy on the postoperative recovery and sleep quality in patients undergoing interventional treatment for coronary heart disease (CHD). Methods　This prospective study included 120 patients with CHD who underwent interventional treatment at Xi'an People's Hospital and Xi'an Hospital of Traditional Chinese Medicine from February to October 2023. The patients were divided into a control group and an observation group by the random number table method, with 60 patients in each group. In the control group, there were 37 males and 23 females, aged (53.11±4.98) years, and the cardiac function grade was as follows: 5 cases of grade I, 12 cases of grade II, 25 cases of grade III, and 18 cases of grade IV. In the observation group, there were 41 males and 19 females, aged (50.51±5.14) years, and the cardiac function grade was as follows: 6 cases of grade I, 14 cases of grade II, 27 cases of grade III, and 13 cases of grade IV. The control group received modified Kaitianmen therapy, and the observation group received both modified Kaitianmen and five-tone therapy for a week. The rehabilitation outcomes, traditional Chinese medicine (TCM) syndrome score, psychological state [using the Symptom Checklist-90 (SCL-90)], and sleep quality [using the Pittsburgh Sleep Quality Index (PSQI)] were compared between the two groups before and one week after intervention. Independent sample t test and χ² test were used. Results　After intervention, the 6-min walking distance of the observation group was (413.14±36.67) m, which was longer than that of the control group [(364.68±30.70) m], and the left ventricular ejection fraction (LVEF) was (59.96±6.14)%, which was higher than that of the control group [(52.79±4.57)%], with statistically significant differences (both P<0.05). After intervention, the TCM scores of fatigue, chest tightness, shortness of breath, and chest pain in the observation group were (1.96±0.63) points, (2.76±0.43) points, (1.91±0.56) points, and (1.93±0.49) points, which were lower than those in the control group [(3.52±0.79) points, (3.88±0.50) points, (2.95±0.79) points, and (3.65±0.76) points]; the scores of anxiety, depression, interpersonal sensitivity, hostility, compulsion, paranoia, phobia, somatization, and mental illness of the SCL-90 were (1.96±0.20) points, (1.87±0.16) points, (1.72±0.17) points, (1.74±0.18) points, (1.84±0.18) points, (1.98±0.24) points, (2.38±0.32) points, (1.09±0.12) points, and (0.93±0.09) points, which were lower than those in the control group [(2.67±0.33) points, (2.36±0.33) points, (2.27±0.23) points, (2.19±0.20) points, (2.33±0.30) points, (2.72±0.39) points, (3.42±0.34) points, (1.57±0.16) points, and (1.43±0.17) points]; the scores of sleep duration, latency, sleep quality, daytime dysfunction, sleep disorders, hypnotic drugs, and sleep efficiency of the PSQI were (0.76±0.08) points, (0.91±0.06) points, (0.73±0.09) points, (0.97±0.10) points, (0.60±0.07) points, (0.86±0.07) points, and (0.78±0.09) points, which were lower than those in the control group [(1.78±0.51) points, (1.95±0.61) points, (1.65±0.29) points, (2.04±0.22) points, (1.28±0.13) points, (1.84±0.39) points, and (1.82±0.26) points], with statistically significant differences (all P<0.05). Conclusion　The combination of modified Kaitianmen therapy and five-tone therapy can effectively improve the 6-min walking distance and LVEF, reduce the TCM syndrome score and negative emotions, and enhance the sleep quality in patients undergoing interventional treatment for CHD, thus promoting the postoperative recovery.

Key words:

Coronary heart disease, Interventional treatment, Modified Kaitianmen, Five-tone therapy, Recovery effect, Sleep quality

摘要：

目的　评估改良开天门疗法联合五音疗法对冠心病介入治疗患者术后康复效果和睡眠质量的影响。方法　选取在2023年2月至10月期间西安市人民医院及西安市中医医院收治的120例冠心病介入治疗患者作为研究对象，通过随机数字表法将患者分为对照组和观察组各60例。其中对照组男性37例，女性23例，年龄（53.11±4.98）岁，心功能分级：5例Ⅰ级、12例Ⅱ级、25例Ⅲ级、18例Ⅳ级；观察组男性41例，女性19例，年龄（50.51±5.14）岁，心功能分级：6例Ⅰ级、14例Ⅱ级、27例Ⅲ级、13例Ⅳ级。对照组患者接受改良开天门疗法，观察组患者接受改良开天门疗法联合五音疗法，干预周期为一周。比较两组患者干预前及干预一周后康复效果、中医症候评分、心理状态［症状自评量表（SCL-90）］、睡眠质量［匹兹堡睡眠质量指数（PSQI）］。采用独立样本t检验、χ²检验。结果　干预后，观察组患者6 min步行距离为（413.14±36.67）m，长于对照组（364.68±30.70）m，左心室射血分数（LVEF）指标为（59.96±6.14）%，高于对照组（52.79±4.57）%，差异均有统计学意义（均P<0.05）。干预后，观察组患者的中医症候中乏力、胸闷、气短和胸痛评分分别为（1.96±0.63）分、（2.76±0.43）分、（1.91±0.56）分、（1.93±0.49）分，低于对照组的（3.52±0.79）分、（3.88±0.50）分、（2.95±0.79）分、（3.65±0.76）分，SCL-90评分中焦虑、抑郁、人际关系敏感、敌对、强迫、偏执、恐怖、躯体化、精神疾病维度评分分别为（1.96±0.20）分、（1.87±0.16）分、（1.72±0.17）分、（1.74±0.18）分、（1.84±0.18）分、（1.98±0.24）分、（2.38±0.32）分、（1.09±0.12）分、（0.93±0.09）分，低于对照组的（2.67±0.33）分、（2.36±0.33）分、（2.27±0.23）分、（2.19±0.20）分、（2.33±0.30）分、（2.72±0.39）分、（3.42±0.34）分、（1.57±0.16）分、（1.43±0.17）分，PSQI评分中睡眠时间、入睡时间、睡眠质量、日间功能障碍、睡眠障碍、催眠药物、睡眠效率维度评分分别为（0.76±0.08）分、（0.91±0.06）分、（0.73±0.09）分、（0.97±0.10）分、（0.60±0.07）分、（0.86±0.07）分、（0.78±0.09）分，低于对照组的（1.78±0.51）分、（1.95±0.61）分、（1.65±0.29）分、（2.04±0.22）分、（1.28±0.13）分、（1.84±0.39）分、（1.82±0.26）分，差异均有统计学意义（均P<0.05）。结论　改良开天门联合五音疗法能够有效改善冠心病患者介入术后6 min步行距离及LVEF指标，降低患者中医症候评分及负性情绪评分，提升患者的睡眠质量，促进术后康复。

关键词:

冠心病, 介入治疗, 改良开天门, 五音疗法, 康复效果, 睡眠质量