基于微信平台的延伸护理对冠心病伴焦虑状态患者的影响

The Effect of WeChat-Based Extended Nursing on Patients with Coronary Heart Disease Complicated with Anxiety State

摘要: 目的：探讨基于微信平台的延伸护理对冠心病稳定型心绞痛伴焦虑状态患者的中医证候、心绞痛症状、心电图疗效、西雅图心绞痛量表、GAD-7广泛性焦虑量表评分的应用效果，为此类患者出院后延续性护理方案的制定提供临床参考依据。方法：将冠心病稳定型心绞痛(气滞血瘀证)伴有焦虑症的100例患者，随机分为50例对照组和50例观察组。对照组给予冠心病西药规范治疗 + 血府逐瘀汤，观察组在对照组的基础上加用微信平台的延伸护理，疗程8周，观察两组患者的中医证候积分，心绞痛症状积分，心电图疗效，西雅图心绞痛量表，治疗前后GAD-7评分。结果：两组病人的治疗前基线数据没有统计学差异，具有可比性(P > 0.05)；治疗后观察组中医证候疗效总有效率为91.49%，显著优于观察组77.55%，差异具有统计学意义(P < 0.05)，治疗后两组患者中医证候积分和心绞痛症状积分较治疗前明显降低，差异具有统计学意义(P < 0.01)，观察组较对照组低，差异具有统计学意义(P < 0.05, P < 0.01)；治疗后两组病人西雅图量表积分显著增加，观察组西雅图量表积分显著高于治疗后对照组，差异有统计学意义(P < 0.05, P < 0.01)；两组患者在治疗后的GAD-7评分较治疗前显著降低，观察组在治疗后的焦虑量表评分较对照组显著降低，差异具有统计学意义(P < 0.01)。结论：基于微信平台的延伸护理，能明显改善心绞痛(气滞血瘀证)伴有焦虑病人的临床症状，提高病人的生活质量，同时对病人的焦虑状态有明显的改善，疗效确切，延续护理模式在中西医联合线上疗效确切，适用于临床推广。

Abstract: Objective: To observe the clinical efficacy of WeChat-based extended nursing in patients with stable angina pectoris of coronary heart disease (Qi stagnation and blood stasis syndrome) accompanied by anxiety. Methods: A total of 100 patients with stable angina pectoris of coronary heart disease (Qi stagnation and blood stasis syndrome) complicated with anxiety were randomly divided into control group (50 cases) and observation group (50 cases). The control group received standardized western medicine treatment for coronary heart disease combined with Xuefu Zhuyu Decoction. On the basis of the control group, the observation group was given WeChat-based extended nursing, with an intervention course of 8 weeks. The TCM syndrome scores, angina symptom scores, electrocardiogram efficacy, Seattle Angina Questionnaire (SAQ), and Generalized Anxiety Disorder-7 (GAD-7) scores before and after treatment were observed in the two groups. Results: There was no statistically significant difference in baseline data between the two groups before treatment (P > 0.05), indicating comparability. After treatment, the total effective rate of TCM syndromes in the observation group was 91.49%, which was significantly higher than 77.55% in the control group (P < 0.05). The TCM syndrome scores and angina symptom scores of both groups decreased significantly after treatment (P < 0.01), and the scores in the observation group were lower than those in the control group, with statistically significant differences (P < 0.05, P < 0.01). The scores of the Seattle Angina Questionnaire in both groups increased markedly after treatment, and the scores in the observation group were obviously higher than those in the control group (P < 0.05, P < 0.01). The GAD-7 anxiety scores of the two groups were remarkably decreased after treatment, and the anxiety score of the observation group was significantly lower than that of the control group (P < 0.01). Conclusion: WeChat-based extended nursing can effectively relieve clinical symptoms of angina pectoris (Qi stagnation and blood stasis syndrome) in patients complicated with anxiety, improve patients’ quality of life, and alleviate anxiety symptoms with reliable efficacy. The online continuous nursing mode combined with traditional Chinese and western medicine has definite curative effect and is worthy of clinical promotion.