Health Sichuan ｜ Focusing on the management of chronic diseases at the grassroots level, authoritative experts come!

"Preventing chronic diseases, focusing on the grassroots." In recent years, under the overall national layout, chronic disease management has gradually changed from hospital center to grass -roots medical units. The State Health and Health Commission also issued relevant plans to clearly request the construction of a slow disease management center on the county hospital to carry out chronic disease prevention, treatment and rehabilitation work to improve the continuity of medical services.

Recently, the "Healthy China, Empowerment County" (Sichuan Station) -Capitation of the Grassroots Health Persons' business quality hosted by the China Rural Health Association and hosted by the Sichuan Provincial Hospital Association Rural Health Branch was launched online. The project will rely on national brand projects to increase training in grassroots personnel, improve the professional and technical ability, responsibility, and mission of chronic disease prevention and control staff, further do a good job of service guarantee, and actively provide high -quality services for patients with chronic diseases.

The meeting specially invited Zhang Chaoyang, president of the China Rural Health Association, the vice president of the China Rural Health Association, Yang Maokang, Secretary -General of the Sichuan Provincial Hospital Association, and Xiong Wei, President of the Rural Health Branch of the Sichuan Provincial Hospital Association, attended and delivered a speech online. Sun Xuechun, Sichuan Provincial People's Hospital Professor, Professor Wang Wenyan of the Sichuan Provincial People's Hospital, and Professor Ran Xingwu, Huaxing Hospital of Sichuan University as a speaker. 2022) "Update the main points and other content for interpretation and sharing.

Pay attention to the standardized treatment of premature premature fighting, and the safety and efficacy of the choice of drugs

Vibration premature beats are a very common type of arrhythmia in the grassroots clinical. Professor Sun Xuechun of the Sichuan Provincial People's Hospital introduced in the report that in recent years, the concept of treatment of cardiac rhythm has changed. Early treatment simply control the arrhythmia, and found that the patient's mortality rate has not been effectively improved. After years of clinical practice, the medical community has realized that the progress of basic diseases must be controlled, and at the same time, treatment should be more important to reduce mortality and improve and improve the quality of survival in patients.

At this stage, the principle of clinical treatment of arrhythmia in the clinic contains the following four aspects: first is the treatment of basic diseases, then the correction of the induced factors, followed by the treatment of arrhythmia, and finally the improvement of long -term prognosis.

The premature premature beats should also follow the above treatment principles. The treatment measures mainly include the treatment of the cause, the cause of the cause, the treatment of anti -arrhythmia, the treatment of upstream drugs, and the radio frequency ablation.

In recent years, non -drug treatment methods have developed rapidly, but it has limitations. Regardless of economics, therapeutic effects, and the allocation of medical resources (especially for grassroots), the drug treatment status of ventricular arrhythmia is still not shaken.

Professor Sun pointed out that when the grassroots intervene in premature beats, there are several common problems in the following major categories:

① Improper health education leads to patients' medical anxiety;

② ignore psychological guidance, resulting in poor curative effect;

③ ignore the treatment of basic heart disease, leading to aggravation of the original heart disease;

④ ignore the adjustment of diet, sleep and other causes.

In addition, there is a standardized problem of drug treatment. Such as excessive treatment: use a variety of anti -cardiac drugs directly for patients, and even use amino iodine directly; apply ⅠC drugs to patients with inappropriate treatment of patients with heart failure and ischemic heart disease; When using it, it will also cause the side effects such as slowing heart rate, liver and kidney injury.

Based on the above factors, Professor Sun Xuechun particularly emphasized that clinically needed to improve symptoms, protect heart function, reduce mortality, and use drugs that do not increase side effects. In recent years, innovative drugs have carried out a number of evidence -based medical research, which has brought hope for clinical treatment of arrhythmia.

According to Professor Sun Xuechun, the analysis of the charm confirmed that the conjunction of the conjunction of anti -arrhythmia drugs in the pine pine can effectively reduce the occurrence of ventricular premature beats. The series of studies further show that compared with the United States and Western law and placebo, the reducing room reduction room of the ginseng Yangxinxin capsule has effectively alleviated the symptoms at the same time. For heart failure merging ventricular premature beats, ginseng Yang Xinxin capsules can effectively reduce ventricular premature beats and improve heart function; for early patients with sinus merging room, ginseng Yang Xinxin capsules effectively reduce the risk of sinus gentleness at the same time Essence

Based on sufficient evidence -based medical evidence, Ginatsu Yangxin Capsules won "2020 rooms of heart -sex arrhythmia" class IIA recommendation, A -level evidence, consensus recommendation of ginseng Yangxin for treatment of non -organ quality rooms, early instrumental quality, organic quality Early sex room, early heart failure room, early sinus merging room. Certain guidance for clinical clinical.

Grassroots heart failure prevention and treatment, standardized symptomatic and basic treatment is the key

Chronic heart failure, as a serious manifestation of various cardiac diseases or advanced stages, has a high risk of death. As a type of disease that seriously threatens the health of our country, the prevention and treatment of heart failure at the grassroots level is very important. Professor Wang Wenyan of the Sichuan Provincial People's Hospital emphasized that clinical, the more cardiovascular complications, the greater the possibility of relaxation and heart failure.

In the report, Professor Wang introduced the symptoms and basic treatment of diastolic heart failure. It is generally divided into the following aspects:

1. Use diuretics to correct liquid retention;

2. Use ACEI, ARB, β -blockers, etc. to reverse the hypertrophy of the left chamber;

3. If the patient has hypertension, active control should be controlled, and the hypertension should be controlled below 130/80mmHg;

4. Coronary heart disease blood reconstruction treatment;

5. If the patient has atrial fibrillation, the anticoagulant therapy is performed according to the guide to control the heart rate and rhythm.

Regarding the intervention of heart failure, Professor Wang pointed out that complete blood reconstruction benefits the relaxation heart failure with coronary heart disease. In terms of drug treatment, studies have shown that the main RASS inhibitors such as Candan, Elyshardan, Phelini, and scroke are negative on the pre -prognosis of diastolic heart failure; SGLT2 inhibitors are proven to reduce heart failure Patient's cardiovascular death and re -hospitalization rate. Professor Wang Wenyan emphasized that in recent years, evidence -based studies have confirmed that the representative Tongluo drug Qiqiang Qiangxin capsule has a good effect on chronic heart failure and has become a conventional drug for the current treatment of heart failure. A META analysis shows that Qiqiang Qiangxin can reduce the level of BNP and reduce the percentage (E/E ') ratio (E/E') of the early valve diastolic blood flow to the two -pointed valve ring. It confirms the good effect of Qiqiang Qiangxin capsule on diastolic heart failure.

Comprehensive prevention and control, the main point of interpretation

At the meeting, Professor Ran Xingwu of West China Hospital of Sichuan University introduced the "Guidelines for the Prevention and Treatment of Diabetes (2022)" (hereinafter referred to as "New Edition" Guide ") the revision background, basis and main content. Professor Ran pointed out that my country's diabetes has the characteristics of large number of patients, serious complications, and poor prevention and control. The awareness rate, treatment rate and control rate of diabetes are less than 40%.

In terms of diabetes, Professor Ran Xingwu introduced the following aspects of update.

According to Professor Ran Xingwu, a study led by Academician Kobayashi of the Chinese Academy of Traditional Chinese Medicine's College of Traditional Chinese Medicine showed that type 2 diabetes patients with poor blood glucose control for 3 months of stable dosage treatment for the stabilization dose of dual -metamical. On the basis of the two -metammer, the use of Jinlida particles can further reduce the 0.92%of glycated hemoglobin (HBA1C), 1.34 mmol/L on an empty stomach, and the blood glucose 3.0mmol/L in two hours after a meal. Sex, reduce the syndrome of traditional Chinese medicine, improve symptoms, reduce waist circumference, and have higher safety.

In recent years, a large number of studies have confirmed that blood sugar fluctuations are closely related to complications of diabetes. Therefore, blood glucose fluctuations are the new target for diabetes. In response to the improvement of blood sugar fluctuations in traditional Chinese medicine, Professor Ran Xingwu introduced a clinical study of the influence of blood sugar fluctuations in patients with type 2 diabetes, which was led by Academician Jia Weiping, the Sixth People's Hospital of Shanghai. Improve patients with glucose metabolism (HBA1C, fasting blood glucose, postprandial blood sugar) and Chinese medicine syndrome scores. Compared with the control group, the blood glucose level standard deviation of the Patients of the Jinlida particles decreased significantly after treatment (-0.39VS. 0.11, P <0.01), and the time (TIR) ​​within the scope of the blood glucose target improved significantly (23.21% after treatment (23.21%) vs. 2.24%, P <0.01). This shows that Jinlida particles can improve the blood glucose control and blood sugar fluctuations of patients with type 2 diabetes.

During the discussion stage of the meeting, Professor Wang Wenyan was presided over. Professor Zhong Wen of Cardiovascular Department of the Medical Central Hospital of Yishi Medical Center, Professor Zhang Yongqiang of Hejiang County People's Hospital, Professor Wang Haibo of the Department of Internal Medicine of Gulin County People's Hospital Professor He Mengchun served as a guest of discussion, and launched a heated discussion and in -depth exchanges on the content of the lectures, audience questions and clinical work.

Secretary -General Yang Maokang of the Sichuan Provincial Hospital Association introduced in a summary speech that the number of participants in this training conference and width, more than 50 branch venues, more than 5,000 online learning; expert lectures are high, depth, conference design and conference design and The content design is reasonable and has been widely praised by grass -roots medical staff.

It is understood that Sichuan planned to carry out eight large -scale tourism training activities in the province this year, and systematically conducts the learning and work of the new guidelines for the new version of Children's Children's Children's Chronic Disease Management in the province, and further improve the skills of the health management of chronic diseases at the grassroots level.

The "Healthy China, Empowerment County" project sponsored by the China Rural Health Association, as a national public welfare project that improves grass -roots health personnel and county and urban community generalists in the industry, is committed to continuously strengthen continuing education for medical professionals to continuously strengthen continuing education , Comprehensively improve the level of grass -roots diagnosis and treatment. Since the project was launched in July 2021, there have been nearly 20,000 academic activities in primary physicians to empower the academic activities. Nearly 5,000 people in the health science of residents and township residents have been carried out. Grassroots doctors and county and township patients were 260,000. Provide more help for grass -roots talents by the training content close to the grassroots. The organizer said that more grass -roots medical personnel are expected to actively participate in, interact online, and group strategies to help and cheer for the development of healthy China.

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