艾灸联合心脏康复指导改善心力衰竭患者心功能及有氧运动能力的临床随机对照研究

Clinical Randomized Controlled Study of Moxibustion Combined with Cardiac Rehabilitation for Improving Cardiac Function and Aerobic Exercise Capacity in Patients with Heart Failure

摘要: 目的：探索艾灸联合心脏康复指导改善心力衰竭的有效性和安全性。方法：选择2024年1月~2025年12月我院收治的慢性心力衰竭患者共100例，随机分为对照组与试验组各50例。对照组采用慢性心力衰竭的常规西药治疗，试验组在对照组的基础上予以艾灸和个体化的心脏康复指导，从低强度开始，循序渐进。分别于治疗前后观察以下指标：临床治疗总有效率、中医症侯积分、BNP浓度水平、左室射血分数、6分钟步行距离、NYHA心功能分级和不良反应发生情况。结果：试验组总有效率92.00%，对照组总有效率82.00% (P < 0.05)。试验组中医证候评分为4.57 ± 0.84分，显著低于对照组6.33 ± 0.97分(P < 0.05)。此外，两组心衰指标均有所改善，其中，试验组BNP浓度为437.52 ± 59.81 pg/mL，显著低于对照组653.86 ± 73.15 (P < 0.05)；试验组左室射血分数为42.66% ± 4.95%，对照组为37.82% ± 6.24%，试验组显著优于对照组(P < 0.05)；试验组6分钟步行距离提升至549.37 ± 49.12米，对照组为415.33 ± 41.82米，试验组显著高于对照组(P < 0.05)。实验组NYHA心功能分级改善人数49人，对照组为46人(P < 0.05)。治疗期间，两组患者实验室检查指标均未出现异常，且无患者反馈身体不适而中途暂停治疗。结论：艾灸联合心脏康复指导改善慢性心衰患者比单纯应用西药有更好的疗效。

Abstract: Objective: To explore the efficacy and safety of moxibustion combined with individualized cardiac rehabilitation guidance in the treatment of chronic heart failure. Methods: A total of 100 patients with chronic heart failure admitted to our hospital from January 2024 to December 2025 were randomly divided into a control group and an experimental group, with 50 cases in each group. The control group was treated with conventional western medicine for chronic heart failure, while the experimental group was treated with moxibustion and individualized cardiac rehabilitation guidance on the basis of the control group, starting from low intensity and gradually increasing. The following indicators were observed before and after treatment: total clinical effective rate, TCM syndrome score, BNP concentration level, left ventricular ejection fraction, 6-minute walking distance, NYHA heart function classification, and adverse reactions. Results: The total effective rate of the experimental group was 92.00%, and that of the control group was 82.00% (P < 0.05). The TCM syndrome score of the experimental group was 4.57 ± 0.84 points, significantly lower than that of the control group (6.33 ± 0.97 points, P < 0.05). In addition, the heart failure indicators of both groups improved. Specifically, the BNP concentration of the experimental group was 437.52 ± 59.81 pg/mL, significantly lower than that of the control group (653.86 ± 73.15, P < 0.05); the left ventricular ejection fraction of the experimental group was 42.66% ± 4.95%, and that of the control group was 37.82% ± 6.24%, with the experimental group being significantly better than the control group (P < 0.05); the 6-minute walking distance of the experimental group increased to 549.37 ± 49.12 meters, while that of the control group was 415.33 ± 41.82 meters, with the experimental group being significantly higher than the control group (P < 0.05). The number of patients with improved NYHA heart function classification in the experimental group was 49, and that in the control group was 46 (P < 0.05). During the treatment period, no abnormal laboratory test indicators were found in either group, and no patient reported discomfort and discontinued treatment. Conclusion: Moxibustion combined with individualized cardiac rehabilitation guidance has better efficacy in treating chronic heart failure than conventional Western medicine alone.